Vendors Report Progress with Cortical Visual Prosthetics

by Jeremy Koff, senior consulting editor

February 2026 issue

The road to developing a viable visual neuroprosthetic system to restore sight has been long and difficult. But several vendors remain in the game and much of the activity involves cortical stimulation approaches.

At last month’s NANS annual meeting, Nader Pouratian, professor and chair, department of neurological surgery at UT Southwestern Medical Center, presented long-term results from the Orion cortical visual prosthesis system, reporting six-year outcomes from the first-in-human feasibility study in profoundly blind patients. The findings demonstrate durable safety and measurable functional benefit—and mark the latest chapter in a decades-long effort to restore vision through neurostimulation.

Six-Patient Study Shows Safety and Functional Gains

The Orion early feasibility study enrolled six subjects between 2018 and 2019, all bilaterally blind with either no light perception or bare light perception. Participants represented a range of etiologies—including glaucoma, optic neuropathy, and trauma—highlighting a key advantage of cortical stimulation: its ability to bypass damaged retinal and optic pathways.

The system uses a glasses-mounted camera connected to a video processor that converts visual input into stimulation patterns delivered wirelessly to a 60-electrode epicortical array implanted over the occipital cortex. The stimulation produces phosphenes—perceived points of light—which patients learn to interpret as environmental cues.

After six years of follow-up, all implanted devices remained functional, with fewer than 4% of electrodes losing functionality. Three subjects had devices safely explanted after three years, and one at study completion. Only one serious adverse event—a seizure early in the study—was reported, and no additional seizures occurred following adjustments to stimulation parameters. Functional testing demonstrated consistent improvements when the system was activated. Subjects showed enhanced performance in detecting and localizing visual targets and identifying motion across the visual field. All participants achieved mild positive or positive scores on observer-rated functional vision assessments.

Although Orion does not restore natural vision, Pouratain emphasized that even limited perception—such as detecting moving people or objects—represents a significant functional gain for individuals who previously had no visual interaction with their environment. It also represents a significant advance over Argus II, which stimulated retinal ganglion cells to transmit signals through the optic nerve to the brain, prompting the field to move “upstream” to cortical stimulation.

Pouratian offered his views on the future of cortical stimulation. “I want to highlight that these are patients who otherwise have absolutely no vision, and this gives them a visual interaction with the world that they might not otherwise have. The solution will be in integrating these visual prostheses with other visual aids that exist that patients are using in order to continue enhancing.”

From Argus to Orion: A Long Development Journey

The Orion program traces its origins to Second Sight Medical Products, founded by neurotechnology pioneer Alfred Mann and Robert Greenberg. The company achieved a historic milestone when in 2013 its Argus II retinal prosthesis became the first FDA-approved artificial vision device, implanted in more than 350 implants worldwide, with retinitis pigmentosa.

Despite its regulatory and reimbursement success, Argus II faced substantial commercialization challenges, ultimately leading to its discontinuation. In 2022, Second Sight, which at the time was publicly traded on the NASDAQ exchange, merged with Nano Precision Medical, founded by Adam Mendelsohn, son of a Second Sight director and early investor in Second Sight, forming Vivani Medical and shifting corporate priorities toward drug-delivery implants. Neurostimulation assets were subsequently transferred into a subsidiary called Cortigent to continue development of Orion and related technologies.

Today, Cortigent is positioned as a developer of precision neurostimulation BCIs aimed at restoring critical body functions, including vision and motor recovery after stroke. Despite the commercial challenges faced by Cortigent and other visual prosthetics, the contributions to the field by Second Sight and others are enormous. Yet, the future remains uncertain.

In 2025, Vivani announced plans to spin off Cortigent as an independent publicly traded company, with the goal of enabling each entity to focus on distinct therapeutic areas. The proposed transaction was intended to position Cortigent among the few public companies dedicated to neuromodulation and BCI technologies. However, the company later withdrew the previously announced record date for the spin-off due to external factors, including government shutdown delays. The evolving timeline reflects broader challenges facing companies in this sector. Visual neuroprosthetics programs require substantial capital investment over long development periods, while the number of potential acquirers or strategic partners remains limited. These realities have historically made commercialization difficult even after achieving regulatory milestones.

At the same time, investors have shown uneven enthusiasm for publicly traded neurostimulation companies, particularly those still in early clinical stages. The combination of high development costs, uncertain reimbursement pathways, and limited exit opportunities has contributed to ongoing financial headwinds across the field.

Clinical Momentum Amid Commercial Uncertainty

Despite these challenges, the Orion results underscore a growing sense of clinical momentum in cortical neurostimulation. Advances in neuroscience, microelectronics, wireless power delivery, and data processing have enabled increasingly sophisticated brain-implant systems.

During the NANS presentation, Pouratian stated that Orion’s long-term safety profile and functional outcomes represent an important step toward broader clinical adoption. The system received FDA breakthrough device designation in 2018, and Cortigent plans on advancing the Orion system in 2026 and working with world’s leading experts and the FDA to eventually commerce a larger pivotal trial.

The technology’s platform potential also extends beyond vision restoration. Cortical stimulation is being explored for motor recovery following stroke and other neurological applications, reflecting a broader trend toward precision neurostimulation interfaces.

Outlook: Exciting Science, Difficult Economics

The broader visual neuroprosthetics sector has been characterized by repeated cycles of innovation and financial difficulty. Over the past three decades, numerous firms—including Optobionics, Retina Implant AG, Pixium Vision, Bionic Vision Technologies, and others—have developed retinal implants but struggled with long development timelines, high costs, and uncertain reimbursement pathways.

Despite regulatory approval, retinal prostheses delivered only limited functional vision—typically light perception and basic object localization—and outcomes varied widely depending on disease stage and neural remodeling, factors that constrained both clinical adoption and commercial scalability

More recently, newer approaches have emerged. Science Corp., which took over Pixium Vision’s retinal implant, is pursuing optogenetic retinal implants and biohybrid cortical interfaces. These ongoing efforts reflect both the scientific promise and commercial complexity of artificial vision technologies.

A European firm called ReVision Implant recently received FDA breakthrough device designation for its visual prosthetic system based on cortical stimulation. And Elon Musk’s Neuralink company continues to work on its Blindsight cortical visual prosthesis based on the company BCI and robotic neurosurgery technologies. Musk said he hopes to implant the first human with the system later this year.

While Orion and others have demonstrated that meaningful visual perception can be achieved safely in profoundly blind individuals, translating such technologies into sustainable commercial products remains challenging. Nevertheless, the convergence of improved neural interface technologies, growing interest in brain-computer interfaces, and increasing clinical validation suggests that the field may be entering one of its most promising periods. For patients with no therapeutic alternatives, cortical visual prostheses offer incremental functional gains—and a compelling glimpse into the future of neurotechnology.