Your next ophthalmic equipment decision will be shaped by forces that didn’t exist—or barely existed—five years ago. That’s not hyperbole. The convergence of AI-powered diagnostics, tissue-sparing laser technology, ambulatory surgical center expansion, reimbursement restructuring, and accelerating demographic demand is fundamentally changing what equipment a well-run practice needs, how it’s configured, and where it sits.
We’ve been tracking these shifts closely. Here are the five that matter most for your planning horizon.
1. AI Has Moved from Interesting to Essential
A 2025 survey found that 78% of ophthalmologists identified artificial intelligence as the single most transformative trend in their field. The market data backs them up—AI in ophthalmology reached roughly $315 million last year and is projected to grow at 36.8% annually through 2035. Those aren’t speculative numbers. They’re being driven by real clinical adoption.
Four FDA-cleared autonomous diabetic retinopathy screening systems are now available in the US. LumineticsCore (formerly IDx-DR) was the first autonomous AI system approved in any field of medicine, back in 2018. EyeArt has been validated on over 500,000 patients globally and secured Norway’s entire national health system as a client in September 2025. A 2025 meta-analysis in the American Journal of Ophthalmology reported pooled sensitivity of 95% and specificity of 91% for autonomous DR detection.
And yet—and this is the part that should get your attention—fewer than 5% of diabetic patients received ophthalmic imaging for DR screening between 2019 and 2023, according to JAMA Ophthalmology. That gap between what’s available and what’s being used represents an enormous clinical and business opportunity.
Beyond screening, AI is embedding itself in every layer of ophthalmic care. Zeiss CIRRUS PathFinder now interprets OCT reports automatically. At AAO 2025, a machine learning algorithm from UCL and Moorfields significantly outperformed trained human graders at diagnosing glaucoma. Alcon demonstrated AI-assisted cataract surgical planning at ESCRS. The FDA cleared a record 295 AI-enabled medical devices in 2025, with ophthalmology among the leading specialties.
The practical implication for equipment planning: the diagnostic devices you buy in 2026 should have AI integration built in or on the near-term roadmap. Standalone hardware without an intelligence layer is starting to look like a technology dead end.
2. Tissue-Sparing Laser Therapy Is Winning the Clinical Argument
The shift from suprathreshold burns to subthreshold micropulse treatment has moved from academic debate to clinical consensus. The data’s getting hard to argue with.
For glaucoma, a landmark five-year study published in December 2024 showed that micropulse transscleral laser therapy achieved a 32.5% average IOP reduction with low complications and only a 38% retreatment rate over the full study period. A Mayo Clinic trial with the revised P3 delivery device reported surgical success rates of 73–80% at six months. For retinal disease, a 2026 study evaluating panmacular subthreshold micropulse 577nm in central serous chorioretinopathy patients demonstrated sustained improvements at 24-month follow-up.
Meanwhile, the 577nm yellow wavelength continues displacing 532nm green as the preferred retinal treatment wavelength. The clinical rationale is straightforward: better oxyhemoglobin absorption targeting, negligible xanthophyll uptake for safer macular work, improved transmittance through lens opacities, and lower power requirements. Every major manufacturer now offers a 577nm platform.
For your practice, the question isn’t whether to adopt these modalities. It’s whether your current platform supports them—and if it doesn’t, how quickly you need to upgrade.
3. SLT as First-Line Therapy Is No Longer Debatable
The LiGHT trial’s six-year results settled this. Nearly 70% of SLT-treated eyes maintained drop-free IOP control without surgery, and 90% of patients needed only one or two treatments over the entire period. A June 2025 meta-analysis covering 60 studies and 8,934 eyes confirmed comparable IOP reduction to topical medications, with treatment success rates of 98% at one year, 89% at five years, and 72% at ten years. The European Glaucoma Society, AAO, and UK NICE all now recommend SLT as a first-line or adjunctive treatment.
The SLT segment is projected to achieve the highest growth rate among all ophthalmic laser types through 2035—roughly 6.8% CAGR.
But here’s the development that could accelerate everything. Alcon’s Voyager Direct SLT, launched in the US in February 2025, delivers 120 laser pulses in two to three seconds without a gonioscopy lens or manual aiming. Fully automated. The GLAUrious trial found 62% of DSLT patients remained medication-free at 12 months. By eliminating the gonioscopy skill barrier—traditionally the biggest obstacle to broader SLT adoption—Voyager opens the procedure to a much wider pool of providers. Roughly five million Americans with diagnosed glaucoma are potential candidates.
If your practice treats glaucoma and you’re not offering SLT, the clinical and financial case for adding it has never been stronger. And if you’re already doing SLT, watch the DSLT space closely.
4. The ASC Boom Is Rewriting Equipment Requirements
The US ambulatory surgical center market reached roughly $44–47 billion in 2025 and is projected to hit $80.6 billion by 2035. Ophthalmology is one of the top ASC specialties, with nearly 2,000 ASCs running ophthalmology programs in 2026.
The economics remain compelling: 40–60% lower procedure costs versus hospital outpatient departments, operating margins estimated at 30–45% of net revenues, and practice valuations that command one to three times higher EBITDA multiples with ASC ownership. CMS regulatory changes for 2026 expanded ASC-eligible procedures to include MIGS beyond common codes, glaucoma drainage implants, corneal transplants, and laser procedures previously restricted to hospitals.
For equipment manufacturers and the practices they serve, the ASC environment changes the purchasing equation. Compact footprint matters more. Multi-function platforms that replace two or three standalone units are preferred—because square footage in an ASC is expensive, and every piece of equipment needs to justify its floor space. About 30% of new femtosecond laser installations are now occurring in ASC settings, and that share is growing.
Private equity continues accelerating the trend. Webster Equity Partners merged three retina practices into a 12-ASC platform in September 2025. McKesson’s ~$850 million acquisition of 80% of PRISM Vision Holdings brought 91 offices and 7 surgery centers under one roof. These consolidated entities buy equipment differently than independent practices—they negotiate system-wide platform agreements, prioritize standardization across locations, and expect vendor partners who can support multi-site deployments.
5. The Demographic Math Is Unforgiving
This is the trend underneath all the other trends.
AMD affects approximately 200 million people worldwide today and is projected to reach 288 million by 2040. Diabetic retinopathy affected 103 million adults in 2020 and is expected to hit 160 million by 2045—a 55% increase driven by the global diabetes epidemic. Glaucoma is projected to increase from 76 million to nearly 112 million by 2040. In the US specifically, the population aged 65 and older is forecast to grow from 58 million to 82 million by 2050. Since cataracts affect 70% of individuals by age 80, the procedural demand curve is structurally positive for decades.
What that means practically: the practices that invest now in scalable, multi-function equipment platforms—systems that can handle rising retinal laser volume, growing SLT demand, and increasing cataract throughput without proportional increases in capital spending or floor space—will be better positioned than those making piecemeal equipment decisions.
What This Means for Your Next Decision
These five shifts aren’t independent forces. They’re converging. AI is embedding into diagnostic equipment you’re already buying. Tissue-sparing lasers are becoming the clinical standard while SLT demand accelerates. ASCs are compressing equipment footprints while expanding procedure volumes. Reimbursement is shifting toward facility-based, laser-friendly codes. And demographic math guarantees growing demand for at least the next two decades.
The practices that navigate this well won’t be the ones that chase every new technology announcement. They’ll be the ones that think carefully about platform consolidation, clinical versatility, and total cost of ownership—and make equipment decisions that account for where the field is heading, not just where it is today.
That’s a conversation worth having now. Not next year.
Eye Care Technologies provides equipment evaluation, procurement support, and technology planning for ophthalmic practices across the US. We’re here when you’re ready to think through your next move. http://www.eyecaretechnologies.com
