Since the 1980s, refractive surgery has quickly evolved. Radial keratotomy gave way to PRK, which led to the development of LASIK, corneal rings, and other refractive technologies. The interest in refractive surgery continues to grow today.

In 1988, during my presidency, the 7-year-old European Intraocular Implant Club (EIIC) revamped its image and became the European Society of Cataract and Refractive Surgeons (ESCRS). The original EIIC was a composite of national implant societies including the UK Cataract and Refractive Surgeons Society.

At the time it became the ESCRS, there was an international trend to move toward including refractive surgery coursework in society and organization meetings. Now, the ESCRS membership originates from two categories: those who have joined (1) individually and (2) through their national societies. These societies, mainly from northern Europe, pay a collective subscription to the ESCRS on behalf of their members. As time passed, eastern and southern Europeans have also become increasingly involved in the membership of our society.

Regardless of the societal name, refractive surgery had always been included in our symposia series. Therefore, the only difference between the EIIC and the ESCRS is that refractive surgery became a publicly acknowledged component of the society. This decision was easy for the ESCRS Board to reach, because we acknowledged that implants—the founding feature of our society—were the key component of refractive surgery. Therefore, our society rapidly evolved beyond purely cataract work. We wanted to recognize that there was—and still is—an intertwined marriage of cataract and refractive surgery.

Lens implants not only changed cataract surgery, but they also marked the beginning of modern refractive surgery. Inevitably, implants opened the door for refractive lens exchange. So, in 1988, as we formally added refractive surgery into the society, we decided to increase the amount of refractive surgery courses we offered. It now accounts for 50% of each program. Approximately 10 years ago, we also added a winter ESCRS meeting, specifically designated to refractive surgery.

Our membership has responded positively to these changes, because it fulfills their needs for education. Because there is no formal refractive education, surgeons must learn techniques through meetings, coursework, discussion groups, symposia, workshops, and wet labs. They receive these media when attending an ESCRS meeting, which are always well attended.

MEETING OF THE MINDS
There are two important aspects to the ESCRS: (1) the formal meeting scenarios during the symposia and free paper series and (2) meetings of the minds during coffee breaks, lunches, and dinners. During these informal times, surgeons are free to discuss their own thoughts and ideas on refractive surgery and other topics. This has proved to be monumental in the evolution of refractive surgery. In every sphere of refractive surgery—phakic IOLs, refractive lens exchange, cataract lens implantation (which is a refractive procedure), corneal procedures, and presbyopic techniques—the platforms for developing, discussing, and evaluating techniques are forums like the ESCRS or American Society of Cataract and Refractive Surgery (ASCRS).

Our current membership is approximately 4,000 surgeons. The bottom line is that the ESCRS is a society that appeals to the widespread European population. We decided to include refractive surgery in the society's title to reflect the evolution of ophthalmology. Since its conception, the ESCRS has aided in creating and evolving standards of care across Europe, and I think that it should be commended for these efforts. This has been, and will continue to be, its main goal and achievement.

Emanuel Rosen, BSC, MD, FRCS(Ed), FRCOphth, practices at Rosen Eye Associates Salford Quays, in Manchester, UK. He is coeditor of the Journal of Cataract & Refractive Surgery, board member of the ESCRS, and consultant ophthalmic surgeon and visiting professor at the Department of Vision Sciences at the University of Manchester. He is also the author of several textbooks in ophthalmology and articles in the peer-reviewed ophthalmic literature, as well as the former president of the ESCRS and the EIIC. Professor Rosen may be reached at louise_brennan@btinternet.com.