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Subspecialties Cataract, Comprehensive, Cornea / Ocular Surface, Diabetes, COVID-19, Glaucoma, Imaging & Diagnostics, Neuro-ophthalmology, Pediatric, Retina, Professional Development, Health Economics and Policy, Education and Training, Other

Taking the Pressure Off

sponsored by Alcon

Originally launched in 2013, Alcon’s CENTURION® Vision System has developed significantly over the years. The launch of ACTIVE SENTRY® in 2019 – engineered for stable phaco performance across a variety of vacuum levels – signalled a major change in ophthalmology, enabling surgeons to perform cataract surgery at a more physiological intraocular pressure (IOP). The advanced technology enabled surgeons to feel confident operating at more physiological IOP, without compromising anterior chamber stability, or surgical efficiency, or ocular safety (1,2,3,4). Although high levels of irrigation pressures were historically necessary because of technological limitations in phaco systems, these high levels may have undesirable clinical ramifications. These included greater postoperative anterior segment inflammation, more corneal edema, and disruption of the anterior vitreous face. It is for all these reasons that Alcon R&D worked to build a solution that could help surgeons perform cataract surgery at a more physiologic IOP.

ACTIVE SENTRY® was designed to reduce post-occlusion surge and maintain anterior chamber stability by adjusting for IOP fluctuations (5,6). Maintaining the same surgical efficiency as compared to higher intraoperative IOP settings, the more physiological IOP reduces stress on the posterior capsule-anterior hyaloid membrane barrier during cataract surgery (7). Similarly, it can support the health of the anterior segment, with studies showing less postoperative corneal swelling (8,9,10,11,12), greater endothelial cell protection (8,9,10), and less anterior segment inflammation (8,9,11,12).

Aside from the more physiological IOP, the system boasts an array of innovative features. When occlusion break occurs, the ACTIVE SENTRY® Handpiece works with QuickValve™ technology to provide real-time surge minimization ensuring consistent volume and IOP maintenance (1,2). The first-of-itskind irrigation pressure sensor, located in the handpiece itself, detects changes in the anterior chamber as they occur, delivering acute responsiveness at every stage of cataract surgery (13,14).

With its innovative features and unwavering commitment to physician and patient well-being, Alcon’s CENTURION® Vision System with ACTIVE SENTRY® stands as a testament to the pursuit of excellence in modern ophthalmology, setting new standards and ensuring a brighter future for cataract surgery.

For important product information on CENTURION® Vision System, please see your local Directions for Use, or visit Refer to operator’s manual for a list of indications, warnings and precautions.

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  1. CENTURION® Vision System User Manual.
  2. Alcon Data on File, 2017.
  3. A Thorne et al., “Phacoemulsifier occlusion break surge volume reduction,” J Cataract Refract Surg., 44, 1491 (2018).
  4. C Aravena et al., “Aqueous volume loss associated with occlusion break surge in phacoemulsifiers from 4 different manufacturers,” J Cataract Refract Surg, 44, 884 (2018).
  5. KM Miller et al., “Experimental study of occlusion break surge volume in 3 different phacoemulsification systems,” J Cataract Refract Surg, 47, 1466 (2021).
  6. V Vasavada et al., “Real-time dynamic changes in intraocular pressure after occlusion break: Comparing 2 phacoemulsification systems,” J Cataract Refract Surg, 47, 1205 (2021).
  7. V Vasavada et al., “Impact of fluidic parameters during phacoemulsification on the anterior vitreous face behavior: Experimental study,” Indian J Ophthalmol., 67, 1634 (2019). doi:10.4103/ijo.IJO_465_19.
  8. T Kokubun et al. in The 126th Annual Meeting of the Japanese Ophthalmological Society (JOS) (Osaka, Japan, 2022).
  9. M Rauen in American Association of Cataract and Refractive Surgery (ASCRS) Annual Meeting (San Diego, US, 2023).
  10. H Suzuki et al., “Effect of bottle height on the corneal endothelium during phacoemulsification,” J Cataract Refract Surg, 35, 2014 (2009). doi:10.1016/j.jcrs.2009.05.057.
  11. A R Vasavada et al., “Impact of high and low aspiration parameters on postoperative outcomes of phacoemulsification: randomized clinical trial,” J Cataract Refract Surg, 36, 588 (2010). doi:10.1016/j. jcrs.2009.11.009.
  12. V Vasavada et al. Real-time dynamic intraocular pressure fluctuations during microcoaxial phacoemulsification using different aspiration flow rates and their impact on early postoperative outcomes: a randomized clinical trial, J Refract Surg 30, 534 (2014). doi:10.3928/1081597X-20140711-06
  13. Alcon Vision LLC. 2019. Alcon launches advancements to the CENTURION® Vision System at American Society for Cataract and Refractive Surgery Meeting. Available at: media-release/alcon-launches-advancements-centurionr-vision-systemamerican- society-cataract-and. Accessed Feb 2022.
  14. D Cyril et al., “Active Sentry versus OZil hand piece: A prospective randomized comparative study,” J Cataract Refract Surg, 48:328 (2021).
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