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Centurion active fluidics linked to lower intraoperative pain and corneal thickness versus gravity-based fluidics in cataractNewer cataract surgery tech caused less pain and needed less extra numbing medicine

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Key Takeaway
Recognize lower intraoperative pain scores with active fluidics versus gravity-based fluidics in cataract patients.

This prospective cohort study included 130 patients (65 per group) undergoing phacoemulsification for age-related cataract. The intervention utilized the Centurion Vision System with active fluidics targeting an intraocular pressure of 30 mmHg. The comparator group received the Stellaris Elite System with gravity-based fluidics at approximately 62 mmHg. Follow-up duration was 1 month.

Primary outcomes assessed intraoperative discomfort via supplemental anesthesia requirement and patient-reported pain scores on a 0–10 numerical rating scale. Fewer patients in the Active Fluidics Group required supplemental anesthesia, with absolute numbers of 3.1% versus 13.8% (relative risk 0.22; 95% CI 0.05–0.98; p = 0.028). Median pain scores were 1 versus 3 (p < 0.001). Day-1 central corneal thickness increase was smaller with active fluidics, showing a mean difference of −18.4 μm (28.4 vs. 46.8 μm; 95% CI −26.1 to −10.7; p < 0.001).

Endothelial cell density loss and final visual acuity were comparable between groups, though specific numbers were not reported. No intraoperative complications occurred during the procedure. Serious adverse events, discontinuations, and tolerability data were not reported.

The study design is observational, limiting causal inference regarding the fluidic systems. Limitations and practice relevance were not reported in the source material. Clinicians should interpret these findings cautiously within the context of the specific surgical settings and equipment used.

Cataract surgery is a common procedure, but the fluid used to keep the eye open can sometimes cause discomfort. A recent study looked at whether a newer system using active fluidics could make the experience smoother for patients. The team compared this new technology against a standard gravity-based system used in many clinics today. They followed 130 patients who were having their cataracts removed to see how they felt and how their eyes recovered.

The results were clear for those undergoing the surgery. People using the active fluidics system reported lower pain levels, with median scores of just 1 out of 10 compared to 3 for the standard system. Furthermore, far fewer patients in the new group needed extra anesthesia to manage discomfort during the operation. Only 3.1% required additional numbing medicine versus 13.8% in the standard group. The new system also caused less swelling in the cornea immediately after surgery.

While the study found these promising benefits, it involved a specific group of patients and looked at outcomes for only one month. The researchers noted that the new system did not cause more serious safety issues or affect the final vision compared to the standard method. However, because the study size was limited, these findings should be viewed as a strong signal rather than a final rule for all surgeries. The data suggests that technology focusing on fluid control can genuinely improve the patient experience.

What this means for you:
A newer cataract surgery system reduced pain and the need for extra numbing medicine during the procedure.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
BackgroundPhacoemulsification under topical anesthesia requires adequate intraocular pressure (IOP) maintenance, but elevated IOP may contribute to patient discomfort and corneal stress. Active fluidics technology enables surgery at lower target pressures, yet the impact on patient-centered outcomes remains underexplored.MethodsThis prospective cohort study compared the Centurion Vision System with active fluidics (target IOP 30 mmHg) vs. the Stellaris Elite System with gravity-based fluidics (approximately 62 mmHg) in patients undergoing phacoemulsification for age-related cataract. Propensity score matching (1:1) balanced baseline characteristics between groups. The primary outcome was intraoperative discomfort, assessed by supplemental anesthesia requirement and patient-reported pain scores (numerical rating scale, 0–10). Secondary outcomes included central corneal thickness (CCT), endothelial cell density (ECD), and visual acuity over 1 month of follow-up.ResultsAfter matching, 130 patients (65 per group) were analyzed. Fewer patients in the Active Fluidics Group required supplemental anesthesia (3.1% vs. 13.8%; relative risk 0.22; 95% CI 0.05–0.98; p = 0.028). Median pain scores during phacoemulsification were lower in the Active Fluidics Group (1 vs. 3; p < 0.001). Day-1 CCT increase was smaller with active fluidics (28.4 vs. 46.8 μm; mean difference −18.4 μm; 95% CI −26.1 to −10.7; p < 0.001), though this difference resolved by 1 month. ECD loss and final visual acuity were comparable between groups. No intraoperative complications occurred.ConclusionPhacoemulsification using active fluidics at lower target IOP was associated with reduced intraoperative discomfort and attenuated early postoperative corneal edema while maintaining equivalent safety and visual outcomes.
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