ArticleFrontiers in medicine2026
Enhanced efficiency and endothelial protection of the intraocular lens shell technique in phacoemulsification: a retrospective stratified analysis by nuclear hardness.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The intraocular lens (IOL)-shell technique may improve intraoperative stability during phacoemulsification, but whether its benefits vary by nuclear hardness remains uncertain. This study evaluated the safety and efficiency of the IOL-shell technique and explored its effects across nuclear hardness subgroups. Methods: This retrospective study included 200 patients undergoing phacoemulsification: 100 treated with the IOL-shell technique and 100 treated with the conventional technique. Outcomes included operative time, cumulative dissipated energy (CDE), corneal endothelial cell loss, posterior capsule rupture (PCR), corneal edema, and best-corrected visual acuity (BCVA) at 1 month. Subgroup and interaction analyses were performed according to nuclear hardness (≥ Grade IV vs. ≤ Grade III). Results: Baseline characteristics were comparable between groups. Compared with the conventional group, the IOL-shell group had shorter operative time (12.79 ± 2.00 vs. 15.13 ± 2.52 min, Conclusions: The IOL-shell technique improved surgical efficiency, reduced ultrasound energy use, enhanced endothelial protection, decreased corneal edema, and promoted early visual recovery after phacoemulsification. Its efficiency advantage was particularly evident in eyes with nuclear hardness ≥ Grade IV. The apparent reduction in PCR should be interpreted cautiously because of the limited number of events.
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