A Series of Groundbreaking Procedures in Ophthalmology

The 2025 ESCRS Annual Congress in Copenhagen celebrated the 30th anniversary of femtosecond laser eye surgery with an interactive exhibition detailing the remarkable evolution of this essential tool.

A reception at the Congress included a live interview with some of the pioneering ophthalmic surgeons who developed these remarkable applications. Guests included Ron Kurtz MD; Tibor Juhasz MD, PhD; and Burkhard Dick MD, PhD.

European surgeons who played an important part in the development of femtosecond eye surgery were also present, including Zoltán Nagy MD, PhD, who performed the first femtosecond laser cataract procedure, and Imola Ratkay-Traub MD, PhD, who performed the first femtosecond laser LASIK procedure in a sighted eye.

“When Tibor and Ron began to explore femtosecond laser applications, some people said ‘you will never use a laser for cataract or glaucoma surgery’. Some of those people are now pretending they always knew it would work,” Professor Dick joked.

A serendipitous event at the University of Michigan, US, in 1993 eventually led to the development of the new tool for ocular surgery. During an experiment at the College of Engineering, a graduate student’s eye was accidentally exposed to a series of stray femtosecond laser pulses. The resulting retinal burns were noted to be highly localised, eventually sparking interest in the laser’s potential for medical applications. Collaboration with the university’s Center for Ultrafast Optical Science (CUOS) ultimately included Gérard Mourou (Nobel Prize in Physics, 2018), Dr Kurtz, Prof Juhasz, and others, with an initial focus on potential applications for corneal surgery.

“When Ron and I met, we realised we had a lot in common,” Prof Juhasz recalled. “Rather than competing, we decided it would be better to join forces, so I moved to Michigan and we started to work together. In about three years, we had a product that was stable enough, small enough, and reliable enough.”

By 1995, this team was able to demonstrate that femtosecond lasers could be used to perform lamellar resections of the cornea with minimal damage to the surrounding tissue. In subsequent reports, the team demonstrated flap creation (for LASIK), keratomileusis (for lenticule extraction), and other potential surgical procedures as alternatives to procedures that used the mechanical microkeratome.

Between 1997 and 2001, a team at IntraLase led by Drs Kurtz, Juhasz, Christopher Horvath, and others developed the first commercial femtosecond laser platform to enhance the safety, accuracy, and precision of LASIK procedures. The femtosecond laser was shown to create a more precise and predictable flap that was thinner and more uniform.

“We did the first (femto) capsulotomy, and it really succeeded,” Prof Nagy said. “Then we proceeded to do the lens fragmentation, the corneal incision, and the astigmatic correction on the cornea. Gradually, within a couple of years, it became what I think is a perfect procedure.”

Today, the role of the femtosecond laser continues to expand to FLACS, SMILE, CAIRS, LIRIC, and glaucoma procedures, demonstrating how a lot of dedicated research can lead to transformative advancements in patient care.

“When we first started, we had the idea that we would start in the cornea and go all the way back to the retina. I still believe this will be the case,” predicted Dr Kurtz.

A video of the Copenhagen interview will appear in the Heritage Archive section of the ESCRS website as well as the ESCRS YouTube channel.

Ron Kurtz MD is co-founder of IntraLase and current president and CEO of RxSight, maker of the light-adjustable lens.

Tibor Juhasz MD, PhD is co-founder of IntraLase, current CEO of ViaLase, and professor of biomedical engineering at the University of California, Irvine, US.

H Burkhard Dick MD, PhD, FEBOS-CR is professor of ophthalmology and chairman at Ruhr University Eye Hospital Bochum, Germany, and incoming president of ESCRS.

Zoltán Nagy MD, PhD is director of the department of ophthalmology, Semmelweis University, Budapest, Hungary.

Imola Ratkay-Traub MD, PhD is medical director of the Danube Bend Medical Center, Szentendre, Hungary.