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A surgical robotics system developed by UCLA engineers and physicians has achieved a major breakthrough in ophthalmic surgery. Horizon Surgical Systems, a UCLA spin-off that licensed the technology, successfully completed the world’s first human clinical trial of robotic-assisted cataract surgery.

Cataracts — clouding of the eye’s natural lens that can lead to vision impairment and ultimately blindness if left untreated — affect approximately 94 million people worldwide. The condition remains the leading cause of global blindness, accounting for about 33 percent of all blind people. Cataract surgery is often cited as the most frequently performed surgery in the world, with more than 26 million procedures a year worldwide. Traditional cataract surgery, while common, poses significant challenges for surgeons, requiring visualization of transparent ocular tissues and extreme precision due to the small (few microns) dimensions of the anatomical structures.

Horizon Surgical Systems announced Oct. 8 the results of its first-in-human study in which 10 patients successfully underwent robotic-assisted cataract surgery for the first time in the world with no adverse events. Dr. Uday Devgan, a former professor of ophthalmology, and Dr. David Lozano Giral, an assistant clinical professor of ophthalmology and a director of Ocular Trauma service, at the Jules Stein Eye Institute at UCLA, performed the surgery, marking a historic milestone in ophthalmic surgical robotics.

As part of the study, each patient received a standard cataract operation — removal of the clouded natural lens followed by implantation of an artificial lens — with the Polaris robotic platform. The surgeon sits at a surgical cockpit located in the operating room and controls the instruments inside the eye. The cockpit incorporates a specialized input device that provides real-time augmentation, guidance overlays and tactile paddles while the surgeon views a 3D monitor displaying ocular anatomy captured through multimodal imaging systems. Surgical robotic arms, attached to a cart near the patient’s head, use interchangeable microsurgical tools attached to the robotic system to make small corneal incisions and remove the cataract-affected lens. The surgeon then implants a clear, patient-specific artificial lens to restore 20/20 vision.

The breakthrough represents more than a decade of multidisciplinary collaboration between engineers at the UCLA Samueli School of Engineering and physicians at the UCLA Stein Eye Institute that was funded in part by multiple National Institutes of Health awards. After more than 15 years of incubation, Horizon was co-founded in 2021 by four current and former UCLA faculty members, including Jacob Rosen, a professor of mechanical and aerospace engineering and bioengineering and director of the Bionics Lab, Tsu-Chin Tsao, a distinguished professor of mechanical and aerospace engineering and director of the Mechatronics and Controls Laboratory, Dr. Jean-Pierre Hubschman, a former professor of ophthalmology at UCLA and founder and former director of the Advanced Robotic Eye Surgery Laboratory and Dr. Steven Schwartz, former chief of the Retina Division at the UCLA Stein Eye Institute. Many of Horizon’s employees are former graduate students of the company’s UCLA founders.

In a recent preprint titled “High‑Precision Surgical Robotic System for Intraocular Procedures,” Rosen, Tsao and Hubschman report that laboratory testing demonstrated a tooltip accuracy of 0.053 millimeters, highlighting the technology’s potential to improve safety and consistency in complex eye surgeries, including cataract procedures.

Rosen attributes the breakthrough to two duos: one focused on disciplines and the other on institutions. From a disciplinary perspective, medicine is a problem-rich environment, while engineering is a solution-rich one. Combining them enables development of relevant and innovative technology. From an institutional perspective, academia provides an intellectually rich setting where researchers can refine both their scientific and technological approaches as well as intellectual property. Industry, in contrast, is fast-paced, emphasizing rapid design cycles to drive toward a finished product.

“Horizon is the result of the privilege of operating within both sides of these duos,” Rosen said. “The professional journey of all of Horizon’s founders — from a concept sketched on a napkin to embracing the first patient who underwent the first robotic cataract procedure — was profoundly meaningful and deeply impactful.”

The robotic technology was licensed to Horizon through UCLA’s Technology Development Group, which manages the university’s intellectual property and helps bring innovations from the lab to the marketplace.

“This milestone demonstrates the strength of UCLA’s innovation ecosystem, where cutting-edge engineering, medical expertise and entrepreneurial support come together to improve lives,” said Amir Naiberg, associate vice chancellor and president and CEO of UCLA Technology Development Group. “Horizon’s success underscores the critical role of university technology transfer in advancing both science and patient care.”

The completion of the first clinical study marks a pivotal step in the clinical regulatory process toward broader adoption of robotic-assisted ophthalmic surgery. Horizon is continuing to refine the Polaris system and plans to pursue additional clinical studies and regulatory approval.