Global Phacoemulsification Practices And Clinical Determinants Of Day-1 Corneal Clarity: An International Surgeon Survey
Published 2026 - 44th Congress of the ESCRS
Reference: FP25.06 | Type: Free paper | DOI: 10.82333/0tzz-5555
Authors: Dr Adnan Abdul Majeed* 1 , A/Prof. Khalid Iqbal Talpur 1
1Ophthalmology,sindh institute of Ophthalomlogy and visual sciences SIOVS ,hyderabad,Pakistan
Purpose
To evaluate global variations in phacoemulsification practice patterns and identify clinical factors associated with day-1 postoperative corneal clarity. Early corneal clarity is a critical indicator of endothelial preservation, surgical efficiency, and rapid visual recovery. This study aimed to determine modifiable perioperative variables influencing early corneal edema following routine cataract surgery.
Setting
International, cross-sectional, web-based survey of practicing cataract surgeons across tertiary care institutions and private ophthalmic centers worldwide.
Methods
A structured online questionnaire collected data on surgeon demographics, surgical experience, annual volume, preoperative case selection patterns, phaco machine platform, energy modulation mode (continuous, pulse, burst, torsional), effective phaco time (EPT), cumulative dissipated energy (CDE), nucleus disassembly technique, incision location, ophthalmic viscosurgical device (OVD) strategy, and postoperative management.
The primary outcome measure was self-reported day-1 corneal status categorized as:
• Completely clear
• Mild stromal edema
• Significant corneal edema
Associations between clinical variables and postoperative corneal clarity were analyzed using descriptive and comparative statistical methods.
Results
A total of 100 surgeons from multiple geographic regions responded. Considerable variability was observed in energy modulation strategies and endothelial protection techniques.
Lower effective phaco time, reduced cumulative dissipated energy, use of pulse/burst or torsional modes, and routine dispersive or soft-shell OVD techniques were associated with higher proportions of completely clear corneas on postoperative day 1.
Higher energy usage and prolonged emulsification time were associated with increased rates of early corneal edema.
Conclusions
Day-1 corneal clarity following phacoemulsification appears strongly influenced by modifiable perioperative clinical factors, particularly energy utilization and endothelial protection strategies. Optimization of surgical parameters may enhance immediate visual recovery and reduce early corneal edema.
These findings highlight globally variable practices and identify key areas for surgical standardization and training.