ESCRS - PO319 - Outcomes Of Phacoemulsification Performed By The New Intrepid Hybrid Tip In Comparison To The Balanced Tip Using The Active Sentry Handpieceand Active-Fluidics Centurion System: A Single-Center, Prospective, Randomized Study.

Outcomes Of Phacoemulsification Performed By The New Intrepid Hybrid Tip In Comparison To The Balanced Tip Using The Active Sentry Handpieceand Active-Fluidics Centurion System: A Single-Center, Prospective, Randomized Study.

Published 2025 - 43rd Congress of the ESCRS

Reference: PO319 | Type: Free paper | DOI: 10.82333/m8ew-w978

Authors: Narendrasingh Shivdansingh Verma* 1

1Ophthalmology,Verma Eye Hospital,Surendranagar,India

Purpose

The recently developed INTREPID Hybrid Tip is a polymer-ended tip designed to minimize damage to the capsular bag and other tissues. However, data on basic intraoperative performance metrics using this new tip are still scarce. This study aims to compare the intraoperative phacoemulsification performance metrics between the new Hybrid tip and the Balanced tip, using the Active Sentry handpiece and active-fluidics Centurion system (Centurion® Vision System, Alcon Lab, USA).

Setting

This is a prospective, randomized, non-inferiority study conducted at the Sense Organs Department of Sapienza University of Rome, Italy. The study aims to include a total of 510 eyes of 510 patients. A drop-out of 10% was considered to obtain at least 255 patients per group. We hereby present the results of an interim analysis on 304 eyes, 152 eyes operated with the Hybrid tip and 152 eyes with the Balanced tip, comparable for patients’ age (73.93 ±7.5 vs. 73.09 ±7.7 years, respectively).

Methods

Patients undergoing phacoemulsification, with lens nuclear opacity grade 3, according to the LOCS III grading scale, were randomized between the groups. The primary endpoint was to evaluate the difference between groups in the total ultrasound (US) time (sec). Secondary endpoints were: cumulative dissipated energy (CDE), torsional amplitude, aspiration time (sec), and fluid use (mL). In addition, the postoperative change in the following corneal parameters was assessed: endothelial cell density (ECD), coefficient of variation (CV) of endothelial cell size, percentage of hexagonal endothelial cells (HEXA), and central corneal thickness (CCT).

Results

The total US time was lower in the Hybrid compared to the Balanced group (51.94 ±30.01 vs 63.86 ±33.53, p =0.001, respectively). The CDE (8.96 ±5.20 vs 7.99 ±5.54, p=0.03, respectively) and average torsional amplitude (42.92 ±10.80 vs 29.64 ±8.47, p<0.0001, respectively) were higher in the Hybrid group. The aspiration time (151.66 ±55.02 vs 197.26 ±75.22, p<0.0001, respectively) and fluid use (46.86 ±20.34 vs 57.10 ±21.28, p<0.0001, respectively) were lower in the Hybrid group. The Hybrid group showed lower percentage of ECD loss (-1.05 ±6.67 vs -5.86 ±11.39, p<0.0001, respectively) with aspiration time as the only significant predictor (p=0.04, adj. R2 =0.113). There were posterior capsule ruptures in 2 eyes in the Balanced group, only.

Conclusions

Our interim results suggest that the Hybrid tip, despite higher energy use, seems to reduce endothelial cell loss compared with the Balanced tip. As data collection continues, the final analysis will provide a more comprehensive understanding of these findings.