CataractSAM-2: A Domain-Adapted Model for Anterior Segment Surgery Segmentation and Scalable Ground-Truth Annotation

We present CataractSAM-2, a domain-adapted extension of Meta's Segment Anything Model 2, designed for real-time semantic segmentation of cataract ophthalmic surgery videos with high accuracy. Positioned at the intersection of computer vision and medical robotics, CataractSAM-2 enables precise intraoperative perception crucial for robotic-assisted and computer-guided surgical systems. Furthermore, to alleviate the burden of manual labeling, we introduce an interactive annotation framework that combines sparse prompts with video-based mask propagation. This tool significantly reduces annotation time and facilitates the scalable creation of high-quality ground-truth masks, accelerating dataset development for ocular anterior segment surgeries. We also demonstrate the model's strong zero-shot generalization to glaucoma trabeculectomy procedures, confirming its cross-procedural utility and potential for broader surgical applications. The trained model and annotation toolkit are released as open-source resources, establishing CataractSAM-2 as a foundation for expanding anterior ophthalmic surgical datasets and advancing real-time AI-driven solutions in medical robotics, as well as surgical video understanding.

Mohammad Eslami, Dhanvinkumar Ganeshkumar, Saber Kazeminasab, Michael G. Morley, Michael V. Boland, Michael M. Lin, John B. Miller, David S. Friedman, Nazlee Zebardast, Lucia Sobrin, Tobias Elze · 2026