{
  "abstract": "Introduction The four-dimensional Unity phacoemulsification tip is designed to optimize tip motion and reduce time and energy consumption in cataract surgery. This study highlights a modified flip-and-chop technique with an added multidirectional jerking motion to the phacoemulsification handpiece intraocularly (referred to as the \"five-dimensional flip-and-chop\") and compares the cumulative dissipated energy (CDE) between the four-dimensional Unity system (Alcon Inc., Geneva, Switzerland) and the torsional Centurion system (Alcon Inc., Geneva, Switzerland) under this technique. Methods This is a retrospective, sequential, non-randomized comparison of 40 consecutive cases of Centurion to 40 consecutive cases of Unity performed by a single surgeon at a single ambulatory surgical suite. The initial cataract density between the groups was compared using optical coherence tomography (OCT) image quality (IQ) values from a single Maestro 2 device (Topcon, Tokyo, Japan). Results The two groups had comparable mean ages, sex distributions, and IQs. The mean CDE was significantly lower in the Unity group (5.39; SD=2.8) than in the Centurion group (8.23; SD=5.9), with p=0.0075. Conclusion Utilizing the modified \"five-dimensional flip-and-chop\" technique, the four-dimensional Unity system produced significantly lower CDE than the torsional Centurion system. The addition of this technique to the phacoemulsification handpiece may further improve the efficiency of phacoemulsification.",
  "abstract_shown": true,
  "affiliations": [
    "Ophthalmology, John A. Burns School of Medicine, University of Hawaii, Honolulu, USA.",
    "Ophthalmology, Zhongli University Eye Center, Taoyuan, TWN.",
    "Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ming Chen"
    },
    {
      "affs": [
        1
      ],
      "name": "Hung-Yuan Lin"
    },
    {
      "affs": [
        2
      ],
      "name": "Emily J Kang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4sqeb4g0yr69r.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.118645",
  "fulltext_url": "https://europepmc.org/articles/PMC13712403",
  "id": "4sqeb4g0yr69r",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948744",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Ophthalmology"
    ],
    [
      "openalex",
      "2731|Intraocular Surgery and Lenses"
    ]
  ],
  "openalex": "W7223696559",
  "pdf_url": "https://europepmc.org/articles/PMC13712403?pdf=render",
  "pmcid": "PMC13712403",
  "pmid": "42948744",
  "published": "2026-10-26",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/4sqeb4g0yr69r.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:34Z",
      "native_id": "MED:42948744",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948744"
    },
    {
      "first_seen": "2026-10-31T12:22:59Z",
      "native_id": "PMC13712403",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.118645"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2731|Intraocular Surgery and Lenses",
      "subfield": "general"
    }
  ],
  "title": "Comparison of Cumulative Dissipated Energy Between Two Phacoemulsification Systems Using a Modified Flip-and-Chop Technique With Multidirectional Jerking Movement From a Phacoemulsification Handpiece.",
  "title_text": "Comparison of Cumulative Dissipated Energy Between Two Phacoemulsification Systems Using a Modified Flip-and-Chop Technique With Multidirectional Jerking Movement From a Phacoemulsification Handpiece.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:59Z",
  "url": "https://research.draconitic.com/paper/4sqeb4g0yr69r",
  "venue": "Cureus",
  "versions": []
}