Evaluation Of The Benefit Of Active Sentry Handpiece With Low-Pressure Settings Compared To Conventional Phaco

The aim of this study is to assess the postoperative outcomes of cataract surgery using Centurion Active Sentry technology (Alcon) with low-pressure settings compared to conventional Stellaris Elite (Bausch & Lomb) phacoemulsification. The primary focus is on corneal pachymetry changes, endothelial cell loss, and anterior chamber stability.

This prospective, controlled clinical study was conducted at the Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Germany, involving patients undergoing routine cataract surgery.

Sixty-six eyes of 33 patients were planned to be randomly assigned to undergo phacoemulsification either with the Active Sentry handpiece set to low-pressure mode or with conventional phacoemulsification settings. The primary endpoint was the change in central corneal thickness from preoperative measurements to postoperative day 1. Secondary endpoints included corneal thickness progression at 1 week and 3 months postoperatively, endothelial cell count changes, visual recovery, and intraoperative anterior chamber stability assessed by the frequency of anterior chamber events.

On postoperative day 1, the central corneal thickness in the Active Sentry group was measured at 605.2 µm ± 55.24, reflecting an increase of 56.3 µm ± 42.37 compared to preoperative values. The Stellaris Elite group exhibited a postoperative central corneal thickness of 626.45 µm ± 89.33, with an increase of 79.4 µm ± 75.53 from preoperative measurements. In the Active Sentry group, the endothelial cell count at three months postoperatively was 2255.29 ± 649.23 cells/mm², representing a reduction of 301.86 ± 482.43 cells/mm² from preoperative values. The Stellaris Elite group showed an endothelial cell count of 2358.67 ± 377.86 cells/mm² at three months, corresponding to a decrease of 325.33 ± 315.56 cells/mm² from baseline.

Preliminary results suggest that the Alcon Active Sentry handpiece with low-pressure settings may offer superior postoperative outcomes compared to a conventional phacoemulsification system. The device demonstrated a smaller increase in central corneal thickness and less endothelial cell loss.