First published on March 31, 2026:
What sets Custom Surgical apart from traditional medtech competitors is its rigorous platform approach. Instead of simply developing standalone devices, the startup, based at the MTZ (Munich Technology Center), is building an integrated infrastructure of hardware, data management, and AI for ophthalmology.
The company was founded by Federico Acosta. The Colombian native arrived in Munich around eight years ago to study at TU München. That is where he and co-founder Fernando Benito laid the foundation for Custom Surgical. Today, the startup is tackling a structural issue in the global healthcare market: rising demand for ophthalmic diagnostics paired with a shortage of specialists.
Their approach could be shifting diagnostic processes in part from purely physician-driven tasks toward AI-assisted evaluation.
Three Stages: From Hardware to the Cloud and AI Diagnostics
Custom Surgical’s technology is based on a three-stage model:
1. Digitizing existing microscopes
In the first step, the startup addresses the reality in practices and clinics: many ophthalmic devices are analog or offer only limited digital capabilities.
With products like “MicroREC” or “MicroREC 3D,” existing microscopes can be digitized with minimal effort. The solutions are designed as plug-and-play systems and, according to the company, can be installed in under a minute—without any specialized technical knowledge.
One example is an optical system that connects smartphones directly to microscopes, enabling photo and video capture.
2. Cloud-based data platform
A proprietary cloud platform stores and structures the captured data. According to the company, it is GDPR- and HIPAA-compliant and serves as a central repository (a digital storage location that systematically archives research data or software files and makes them accessible) for image and video data.
This offers several advantages for doctors: surgical and diagnostic data are organized automatically, and sharing with colleagues worldwide is significantly simplified. The content can also be used seamlessly for research, teaching, and documentation. At the same time, comprehensive data storage provides additional legal safeguards.
3. AI to support diagnosis
Custom Surgical is currently building its AI platform on this data foundation. The goal is to detect pathologies automatically and support doctors with diagnoses.
Worldwide, the number of patients is growing faster than the number of trained ophthalmologists. AI is intended to help bridge this gap and make diagnostics more efficient.
3D Visualization Transforms Training and Surgical Workflows
With its new “MicroREC 3D” product, the startup is also introducing a 3D component to ophthalmology. Instead of looking through traditional eyepieces, doctors wear 3D glasses to follow procedures digitally.
This delivers several benefits:
- better ergonomics during surgery for the operating surgeon
- real-time transmission for training or remote assistance
- enhanced training through realistic depth perception
Spatial vision is crucial, especially in complex procedures such as retinal or glaucoma surgeries—an area where conventional 2D systems reach their limits.
Focus on Accessible Digitization Rather Than High-End Devices
A key element of the growth strategy is positioning the company as a cost-effective alternative to entirely new digital microscopes. State-of-the-art devices from established manufacturers are often expensive and difficult to integrate. Custom Surgical relies instead on modular upgrades to existing infrastructure.
“Doctors don’t need to buy a completely new system—they can digitize their existing equipment,”
explains Head of Growth Giuliana Menezes in an interview with Munich Startup.
In addition to ophthalmologists, this technology also targets small and medium-sized clinics, veterinarians, and the fields of neurosurgery, ENT, and endodontics.
Competition: Startup Meets Medtech Corporates
Custom Surgical operates in a market dominated by major players such as ZEISS, Leica, and Alcon, some of which are already collaborating with or investing in the startup. At the same time, the company faces stringent regulatory requirements, such as FDA and ISO certifications, lengthy approval processes, and lower brand awareness compared to established providers. Nevertheless, the team sees these very conditions as an opportunity to move faster with more flexible, software-centric solutions and clearly differentiate itself from the competition.
Munich as a Location for Medtech and AI Development
Munich plays a pivotal role for Custom Surgical: founders Federico Acosta and Fernando Benito met at TU München. Today, the company benefits from the local ecosystem through access to research and talent, as well as proximity to established medtech companies. Custom Surgical also enjoys support from networks like Werk1 and the Munich Technology Center.
