AI in Eye Care professional co-editors Rehan Ahmed, MD and Scot Morris, OD, note a breakthrough in surgical ophthalmology with the successful human trials of robotic cataract surgery. The California company, a UCLA spin-off called Horizon Surgical, completed 10 robotic cataract surgeries. Dr. Ahmed calls the trial development “a momentous week for ophthalmology,” explaining that the effort is “a true game-changer.”
During the discussion, Dr. Ahmed explains that the robot completes the cataract surgery entirely on its own, utilizing safety features that include things like optical coherence tomography guidance. He says, “The probe knows exactly how deep it is. You know exactly where you are, how deep to make your groove, when to split the nucleus and how to aspirate it out.”
This technology makes procedures predictable and repeatable, which could address workforce strains, as Dr. Ahmed discusses concerns over the shortage of ophthalmologists. He says, “There are countries where there are literally less than 10 surgical ophthalmologists in the whole country.” Robotic cataract surgery could streamline procedures, like cataract surgeries, and raise baseline safety and access. He adds that robotics may allow experienced surgeons to focus on complex cases, while routine cases become more automated.
Kiosks vs. Telemedicine
Dr. Ahmed examines the growing role of point-of-care testing kiosks and says the technology is present in the market: “It’s not that it’s coming, it’s already here.” The kiosks vary in scope as some perform basic refraction, others add retinal photos, topography or visual field screening.
Dr. Morris calls kiosks a “mixed bag,” as they have both advantages and risks. He supports kiosks that expand access, noting they can draw new patients into care. He approves of kiosks that can “lead [patients] down the path of them going, ‘Hey, something’s not right, we need to go see a doctor.’”
At the same time, he’s concerned patients may conflate limited testing from a kiosk as a full clinical evaluation. “If all you’re doing is a refraction, I think you need to be very clear: this is not an eye exam, this is a refraction,” Dr. Morris says. Patients should be told that kiosk tests differ from clinician-conducted routine eye exams so they understand what care still requires professional attention. He continues, “The problem always with a kiosk has been we have no interaction from doctor to patient. I think a kiosk is a place you go to have a bunch of testing done that’s not interactive.”
Dr. Morris differentiates noninteractive kiosks from telemedicine. Unlike kiosks, telemedicine models allow providers to review data and advise patients remotely. He highlights a patient interaction where they had driven two hours and 15 minutes to him for care and how that is not always feasible. Accessibility can be difficult for rural and time-constrained patients who would benefit from remote access to specialists and diagnostics. “I need to have something out there that these people can telemedicine with me when they’re having issues,” he says.
Dr. Morris and Dr. Ahmed are both aligned on priorities: “we’re both pro-access, pro-technology, pro what’s in the best interest for the patient.” They agree that AI-enabled robotics, multimodal models and kiosk diagnostics will continue playing a role in expanding access while also raising regulatory and clinical questions as the technologies mature.
For more on this conversation, listen to this episode of Real Talk.
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