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Introduction <p>This prospective randomized controlled trial aims to evaluate the effectiveness and safety of a 180° nuclear flip technique in phacoemulsification cataract surgery, comparing it with the traditional endocapsular approach for cataracts of Emery–Little grade&#xa0;III and below.</p> Methods <p>A total of 142 patients were randomly assigned to either the 180° nuclear flip group (<i>n</i> = 71) or the conventional endocapsular phacoemulsification group (<i>n</i> = 71). The primary outcomes measured were total phacoemulsification time (TPT) and effective phacoemulsification time (EPT). Secondary outcomes were the incidence of postoperative corneal endothelial cell loss (ECL) at 7 and 28&#xa0;days, as well as intraoperative complications including posterior capsule rupture (PCR).</p> Results <p>The mean TPT was substantially shorter in the flip group (43.75 ± 17.16&#xa0;s) compared to the conventional group (58.45 ± 22.27&#xa0;s) (<i>P</i> &lt; 0.0001). Similarly, the mean EPT was also significantly reduced in the flip group (11.08 ± 5.25&#xa0;s vs. 14.87 ± 8.54&#xa0;s, <i>P</i> = 0.0046). There were no PCR cases in the flip group, whereas there was one case (1.4%) in the traditional group. At 28&#xa0;days postoperatively, the mean ECL rate of the flip group (3.7%) was lower than that of the conventional group (4.9%), although this difference did not reach statistical significance.</p> Conclusion <p>The 180° nuclear flip technique is a safe, efficient, and effective method for managing cataracts of grade&#xa0;III hardness and below. It may help reduce the risk of complications, improves intraoperative stability by creating a more spacious operating field, and significantly reduces phacoemulsification time.</p> <p>Video available for this article.</p> Trial Registration <p>chictr.org.cn identifier, ChiCTR2500105241.</p>

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180-Degree Nuclear Flip: A Safety and Efficacy Assessment of a Phacoemulsification Technique for Cataract Nuclei of Grade III and Below

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月16日

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  • Ruibo Chen,
  • Tao Xu,
  • Guorong Shi,
  • Chunyan Xi,
  • Mengqing Yin,
  • Kai Hu,
  • Bing Chen

摘要

Introduction

This prospective randomized controlled trial aims to evaluate the effectiveness and safety of a 180° nuclear flip technique in phacoemulsification cataract surgery, comparing it with the traditional endocapsular approach for cataracts of Emery–Little grade III and below.

Methods

A total of 142 patients were randomly assigned to either the 180° nuclear flip group (n = 71) or the conventional endocapsular phacoemulsification group (n = 71). The primary outcomes measured were total phacoemulsification time (TPT) and effective phacoemulsification time (EPT). Secondary outcomes were the incidence of postoperative corneal endothelial cell loss (ECL) at 7 and 28 days, as well as intraoperative complications including posterior capsule rupture (PCR).

Results

The mean TPT was substantially shorter in the flip group (43.75 ± 17.16 s) compared to the conventional group (58.45 ± 22.27 s) (P < 0.0001). Similarly, the mean EPT was also significantly reduced in the flip group (11.08 ± 5.25 s vs. 14.87 ± 8.54 s, P = 0.0046). There were no PCR cases in the flip group, whereas there was one case (1.4%) in the traditional group. At 28 days postoperatively, the mean ECL rate of the flip group (3.7%) was lower than that of the conventional group (4.9%), although this difference did not reach statistical significance.

Conclusion

The 180° nuclear flip technique is a safe, efficient, and effective method for managing cataracts of grade III hardness and below. It may help reduce the risk of complications, improves intraoperative stability by creating a more spacious operating field, and significantly reduces phacoemulsification time.

Video available for this article.

Trial Registration

chictr.org.cn identifier, ChiCTR2500105241.