EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1545140
SUMMER 2026 | EYEWORLD | 37 C DIGITAL MOMENTUM by Ellen Stodola Editorial Co-Director About the physicians Anshu Arundhati, MD Deputy CEO of Education Singapore National Eye Centre Clinical Director Singapore Eye Bank Singapore David Cherwek, MD Vice President of Clinical Services and Technologies Orbis International H. Burkhard Dick, MD, PhD Ruhr University Bochum Bochum, Germany Joaquín Fernández, MD, PhD Qvision, Department of Ophthalmology VITHAS Almería Hospital Almería, Spain Yu-Hsuan (Alex) Huang, MD, PhD Universal Eye Center Taipei, Taiwan Pavel Stodulka, MD, PhD Gemini Eye Clinic Zlin, Czech Republic Katherine Talcott, MD Associate Professor of Ophthalmology Cole Eye Institute Cleveland Clinic Cleveland, Ohio geometry, and it's a relatively consistent, routine procedure and high volume. All these things give robotics the potential to be a great contrib- utor in this small, delicate space. With the right technology, cataract surgery is a good candidate for robotic surgery, he said. What can be expected from robotic oph- thalmic surgery? Dr. Thompson noted reduced training time, a lower dexterity threshold, en- abling new procedures, improving ergonomics, improving surgical technique, improving refrac- tive outcomes, and eventually the potential to automate a full or partial procedure. David Cherwek, MD, presented "Inten- sive Virtual Reality Cataract Surgery Training: Unlocking the Next Generation of Skilled Phacoemulsification Surgeons in LMICs." When people talk about simulation, they think it's a one and done, however, Dr. Cherwek thinks it's part of a pathway, and you have to have structure around that pathway. A novice is not going to know what they don't know. The biggest mistake is saying simulators will make you surgically competent, Dr. Cher- wek said. They're going to make you surgically ready, so when you walk in the OR, you know the steps of the procedure, the task, and you have some micro-dexterity skill. A problem facing residencies today is faculty fatigue, he added, and this can be reduced by automating it with simulators. Simulation is used by Orbis International to teach manual small incision cataract surgery. Dr. Cherwek thinks simulators should be used more and be part of a pathway. Simulators can help get through the basic science, he said, adding that no one should walk into the OR and not know the basic anatomy. Simulators are the best way to get people ready for the OR, he said, mentioning the Eyesi Surgical (Haag-Streit). Simulation is reaching everywhere, though Dr. Cherwek thinks the U.S. is lagging in the best way to adopt it. Woong-Joo Whang, MD, presented on optimizing effective lens position prediction using deep learning with attention mechanisms. Attention mechanism for IOL power calculations identifies the relationship between input vari- ables. It is dynamically weighing which inputs A symposium hosted by the combined societies of the American Society of Cataract and Refractive Surgery (ASCRS), the European Society of Cataract and Refractive Surgeons (ESCRS), and the Asia-Pacific Association of Cataract and Refractive Surgeons (APACRS) focused on topics in AI, robotics, and surgical simulation, with representatives from all three societies presenting. Kevin M. Miller, MD, Pannet Pangputhipong, MD, and H. Burkhard Dick, MD, moderated the session. Katherine Talcott, MD, shared updates on AI in macular imaging. She said that imaging for retina specialists is critical to everyday care of patients, however, imaging modalities can be time intensive to review. OCTs generate hun- dreds of B-scans, and it can be hard to not miss subtle findings. The burden of retinal disease is only increasing, Dr. Talcott said, and she thinks the field is ready for help from AI to manage retinal disease from an imaging perspective. The biggest integration of AI is in diabetic retinopathy screening, Dr. Talcott said, men- tioning the LumineticsCore (formerly IDx-DR, Digital Diagnostics). This can help address low screening rates in diabetes and lead to more ap- propriate referrals and earlier disease diagnoses. Another example of commercially avail- able AI technology is home OCT, which enables between-visit monitoring for nAMD progression and potentially earlier detection of disease ac- tivity and facilitation of personalized treatment. This could reduce treatment burden for patients and physicians, Dr. Talcott said. She also mentioned the CIRRUS PathFinder (Zeiss), a platform that helps users see if there are abnormal findings on an OCT. This is a refer- ral decision prediction tool based on B-scans of interest, and individual B-scans identified as ab- normal are labeled by the program. The review highlights the location of the abnormal B-scan for the program and recommends an interval for referral to a more specialized provider. Vance Thompson, MD, highlighted the next generation of ophthalmic robotics. What we do has complexities, but there's a low variability in ocular anatomy compared to general surgery, he said. There's also low variability in ocular AI, robotics, and surgical simulation: a 2026 ASCRS Annual Meeting highlight continued on page 38