A New Era in Cataract Surgery

In October 2025, Uday Devgan MD performed the first robotic cataract surgery procedures in humans using the Polaris platform from Horizon Surgical Systems.

“The experience was amazing, and the outcomes were excellent,” Dr Devgan said. “There were no adverse events or complications, and visual acuity outcomes were excellent.”

While the success of those first cases establishing the feasibility of robotic cataract surgery represents a milestone event, it is equally or even more remarkable to consider the improvements made to the system over the ensuing few months, he told EuroTimes.

“This is a field that is changing rapidly,” Dr Devgan said. “Therefore, I am 100% certain that during my career I will be watching an autonomously functioning robot complete an operation better than the top 1% of cataract surgeons.”

Targeting full automation

Of the ten cases performed in October 2025, five were completed with Dr Devgan fully controlling the robot. The other five were performed through a combination of surgeon control and surgeon supervision.

“Operating with only surgeon supervision represents the holy grail for robotic cataract surgery,” Dr Devgan explained. “It is analogous to ‘driving’ a Tesla with autopilot. The car is driving by itself, but a human is there to supervise the drive.”

Progress along the path to full surgeon supervision is occurring quickly, judging from the multiple improvements made to the robotic system between October 2025 and June 2026. The accelerated development trajectory is being powered by the exponential rate at which artificial intelligence (AI) is advancing.

Horizon Surgical’s robotic system uses a 4K 3D camera and real-time optical coherence tomography to image the surgical field. The captured data are continuously analysed by AI to identify intraocular tissues and safely guide the robotic arm movements. Improvement in AI predictive model accuracy is allowing surgery to be performed with higher precision, leading to greater safety and enabling a higher level of automation.

The latest iteration of the system also features physical upgrades from the platform used for the first in-human trial. While the robot Dr Devgan operated with in October had just two arms—one for fixating the eye and the other working inside—the current robot features a second intraocular arm. In addition, the footprint of the robot has been significantly reduced, which will allow it to integrate into more operating rooms, even those with less space, Dr Devgan said.

Professional impact

Dr Devgan reassured his colleagues that the eventual commercial roll-out of autonomously operating cataract surgery robots will not eliminate the need for human cataract surgeons.

“Although the robot may be capable of operating without hands-on surgeon control, surgeons will still have to be involved in each procedure, providing supervision. They might be fulfilling that role at a station just several feet away from the patient or they may be located a few thousand miles away,” he said.

“The promise of the robot is not that it will address workforce shortages by replacing human surgeons. Rather, the benefit of the robot is that it can equalise outcomes by making all surgeons as talented as the best surgeons in our field. I think that is something magical.”

Uday Devgan MD is founder of Devgan Eye Surgery, Los Angeles, California, US, where he specialises in cataract and refractive surgery. He is a former Clinical Professor of Ophthalmology at the UCLA Jules Stein Eye Institute, Los Angeles. devgan@gmail.com