Comparison Of Surgical Efficiency And Corneal Impact Between The Constellation® Vision System And Unity™ Vcs In Paired-Eye Cataract Surgery

Published 2026 - 44th Congress of the ESCRS

Reference: POCAT288 | Type: Free paper | DOI: 10.82333/m0v6-j916

Authors: Dr Yoshihito Sakanishi* ¹ , Dr Tatsuya Fujii ² , Dr Ayumi Ouchi ² , Prof. Dr Nobuyuki Ebihara ²

¹Ophthalmology,Sakanishi Eye Clinic,Ryugasaki,Japan;Ophthalmology,Juntendo University Urayasu Hospital,Urayasu,Japan, ²Ophthalmology,Juntendo University Urayasu Hospital,Urayasu,Japan

Purpose

The CONSTELLATION® Vision System has been widely used as a combined cataract–vitrectomy platform. In 2025, the UNITY™ VCS system was introduced. This study aimed to compare the efficiency and surgical impact of phacoemulsification between these two systems in cataract surgery.

Setting

Sakanishi Eye Clinic, Japan.

Methods

This prospective paired-eye study included patients with bilateral cataracts of similar severity and the same nuclear grade who underwent cataract surgery in both eyes between December 2025 and February 2026. One eye was assigned to the CONSTELLATION® Vision System (CONSTELLATION group) and the other to UNITY™ VCS (UNITY group). All surgeries were performed by a single experienced surgeon. The same Balanced tip was used in both groups. Phaco settings were longitudinal plus Ozil torsional ultrasound for CONSTELLATION and 4D phaco mode for UNITY. Outcomes included anterior chamber phaco tip dwell time, total ultrasound time, cumulative dissipated energy (CDE), and percentage increase in central corneal thickness on postoperative day 1.

Results

Thirty-nine patients (78 eyes) were included (17 men, 22 women; mean age 75.5 ± 8.9 years). In the CONSTELLATION group, anterior chamber phaco tip dwell time was 104.4 ± 28.7 seconds, total ultrasound time was 43.7 ± 12.9 seconds, and CDE was 3.14 ± 1.82. The percentage increase in CCT was 9.2 ± 5.7%. In the UNITY group, anterior chamber phaco tip dwell time was 83.7 ± 24.0 seconds, total ultrasound time was 30.0 ± 11.8 seconds, and CDE was 2.16 ± 1.00. The percentage increase in CCT was 10.5 ± 8.5%. Anterior chamber phaco tip dwell time, total ultrasound time, and CDE were all significantly lower in the UNITY group (p < 0.01 for all comparisons). The percentage increase in CCT did not differ significantly between groups (p = 0.41).

Conclusions

In this paired-eye study, UNITY™ VCS demonstrated significantly shorter phaco tip dwell time, reduced ultrasound time, and lower cumulative dissipated energy compared with the CONSTELLATION® Vision System. These findings suggest improved phacoemulsification efficiency without increased early postoperative corneal impact.