Startup ForSight Wants Its Robots To Operate On Your Eyeballs

Forbes

6 days ago

ForSight Robotics founders (left to right) Daniel Glozman, Joseph Nathan and Moshe Shoham ForSight Robotics
C ataract surgery is one of the world's most common medical procedures, with more than 4 million of them done each year in the United States alone, but there simply aren't enough doctors available to meet the demand for everyone who needs the surgery. Enter robotics. An Israeli startup is betting that robots can ultimately do the procedure better and cheaper than human doctors.
ForSight Robotics on Tuesday said it had raised $125 million led by Eclipse Ventures to expand its robotic platform, called Oryom, which it says is the world's first for cataracts and other eye diseases. The funding represents the second-largest Series B investment in a surgical robotics startup, and brings ForSight's total investment to $195 million. The new money values the company at an estimated $500 million—a substantial increase since it last raised funds in 2022 at a $162 million valuation, according to VC database PitchBook. Additional investors include Fred Moll, the cofounder of Intuitive Surgical and pioneer of robotic surgery, who has joined the company's strategic advisory board.
ForSight has been testing its robot on pig eyes, and plans to complete its first full robotic surgery on a human patient later this year. It's targeting the U.S. market and is in early conversations with the FDA. While ForSight's robots would be the first for cataracts, robotic surgery has become increasingly commonplace since $185 billion (market cap) Intuitive Surgical received FDA approval for its Da Vinci robots 25 years ago.
'At first people were intimidated by robotics' advancement,' Dr. Joseph Nathan, ForSight's cofounder, president and chief medical officer, told Forbes. 'Now they are seeing robotics as the things that will get them the best outcomes.'
Cataract surgery, where a surgeon replaces a clouded optical lens with an artificial one, is a very quick procedure, typically taking less than 15 minutes to perform. It's a painstaking task because of the dexterity required to work in such a tiny space. But the surgery's repetitive nature and the fact that it's bloodless makes it easier for robots to handle. 'What we are trying to solve through robotics is a new level of eye care,' Nathan said. 'The procedure itself is the same steps over and over because of the similar anatomy of the eye regardless of age or race.'
More than 1 billion people globally suffer from some form of preventable vision impairment or avoidable blindness, according to the World Health Organization. Yet a worldwide shortage of eye doctors—with only 32 ophthalmologists and 14 cataract surgeons per million people—means a vast number of them will never get treatment. That gap is only going to get worse, as the number of ophthalmologists is falling, while demand for eye surgeries to avoid blindness is surging, Nathan said.
ForSight's founders first met at the Technion, Israel's institute of technology. Moshe Shoham, a professor emeritus and former head of the Technion's robotics laboratory, had previously cofounded several other robotics companies, including Mazor, which focused on spine surgery and was acquired by Medtronic in 2018 for $1.6 billion. Nathan, a surgeon, had previously led efforts to commercialize healthcare technology coming out of the school.
He approached Shoham after wondering why robots for eye surgery didn't already exist despite similar technology being used in other surgeries for the past few decades. They subsequently teamed up with Daniel Glozman, an early student of Shoham's and former head of R&D at Medtronic Ventor Technologies, to launch the company in 2020. 'Many of the successful medical device companies in Israel have come out of Moshe's lab,' said Eclipse partner Seth Winterroth, who led the investment. 'Fred [Moll] and Moshe [Shoham] are the godfathers of surgical robotics.'
In March 2021, ForSight raised its first $10 million in seed funding led by Eclipse to develop a surgical robotics platform that could do high-precision and cost-effective eye surgery. Winterroth made that investment along with the firm's partner emeritus Pierre Lamond, one of the country's most respected investors in semiconductors and deep tech who is now 94.
'There is only one procedure that is done more than cataract surgery and that is blood drawing,' said Moll. He said that he had looked at ophthalmological robots a number of years ago, but didn't invest in them then because of the emergence of laser-assisted cataract surgeries, which promised to improve the procedure. 'As far as real surgical technique [that could be helped by robotics], cataract surgery is at the top of the list,' he said.
ForSight spent the past four years developing its robotic system that pairs microsurgical robots with computer vision and machine learning algorithms. To test out its bots, ForSight brought in top cataract surgeons to perform the procedure on pig eyes mounted on the topography of a human face. The use of porcine eyes is a common way for surgeons to train as they are, perhaps surprisingly, extremely similar to human eyes. All told, the company (which is now on the third generation of its robot) has done some 300 test procedures on pigs' eyes, Nathan said. By bringing in cataract surgeons, the company is able to incorporate their feedback as it refines the system's technology and design. There is always a doctor in the loop doing the surgery.
Nathan said that the company will begin gathering clinical data later this year with the hopes of receiving regulatory approval in the U.S. and being able to commercialize here in 'the next few years.' Eclipse's Winterroth said that the company has enough funding now to get through the FDA approval process.
Longer term, Nathan sees opportunity both in populous countries like India, where the gap between the number of people who need cataract surgery and the surgeons available is especially large, and for the robot to do other ophthalmologic surgeries, such as retina repairs, treatments for glaucoma and even more rare and complex surgeries that few doctors are capable of performing. 'Robotics will have to take over,' he said. 'There is no human way to close the gap as we see it.'
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