Looking Back on Emanuel Rosen’s Contribution to Ophthalmology

Consultant Ophthalmologist Manchester UK, Co-founder and co-editor Journal Cataract & Refractive Surgery, Chairman of ESCRS EuroTimes, Founder and chief medical editor of ESCRS EuroTimes, Founder and past president of the ESCRS, Past president of UKISCRS and IIIC, Lifetime Achievement Award from International Society of Refractive Surgery

By Philippe Sourdille MD, past president of the ESCRS

The ESCRS is Emanuel’s lifetime achievement. From the very beginning up to current times, he created, managed, and increased the influence of our society.

I first met him in 1969 at a congress in Jerusalem organised by Professor Michaelson. We both had just completed our residency, and his special interest at that time was to illustrate clinical situations of the eye through an innovative photographic approach. To be in Jerusalem months after the Six-Day War was a very emotional time for all participants. We were staying in the King David Hotel, where colleagues from 15 nations presented their work on the anterior and posterior segments of the eye. Emanuel’s work, despite his young age, was one of the meeting’s highlights.

The late 1960s and early 1970s were a hard time for intraocular implants. Some painful first-generation results had created a most difficult situation for our field. Two great Dutch colleagues, Cornelius Binkhorst and Jan Worst, were the forefront in defence of iris fixation as a safe approach for implants. Their innovative creativity and dedication paved the way to the gradual acceptance of implants.

Emanuel was one of the few surgeons to follow the new trail. At that time, microsurgery was not routine, phacoemulsification was far from general acceptance, and some famous names in ophthalmology were campaigning against all types of intraocular implants. Emanuel displayed a vision for the long term and a strong character to get us through these times.

In 1981, Cornelius Binkhorst created the European Implant Club, and international meetings were organised every year in different countries. Emanuel was named president in 1989.

In 1991, the meeting was held in Paris, Dan Lebuisson and myself in charge. English was the official language at the Paris meeting, with simultaneous translation in French. This was the first time when an ophthalmological meeting in France was not held in French. Some of my French colleagues considered that as a relighting of Joan of Arc’s bûcher, and we had to face some harsh criticisms!

Despite these difficulties, the Congress in La Defense was a great success, with more than 400 participants from all over Europe and America. This was a very large audience in a still pioneering and struggling field. Manual extracapsular cataract extraction competed with phacoemulsification. Implants were made of PMMA and needed a large incision. Intracapsular fixation had just been described. Refractive surgery was mostly radial keratotomy, with mentions of the first LASIK and laser surgery procedures.

After the meeting, we had a debriefing session with Emanuel, Ulf Stenevi, and Paddy Condon. The results were positive by all means: scientific value, audience participation and interest, industry support, financial success. But the general feeling was that we had to improve and stabilise the organisation. The historical words of Emanuel then were: «Should we reinvent the wheel every year, should we not have a permanent office and a board?». A unanimous yes was the answer and Paddy proposed working with Agenda Communications, a company based in Dublin. This started a decades-long effective and fruitful collaboration with Mary d’Ardis, Carol Fitzpatrick, Susan Little, and their staff.

The official language for the next meeting was then expected to be controversial, especially in France. Emanuel raised the point and turned to me, asking for my advice. The answer was: «Whether you like it or not, English is not a foreign language, it’s a survival language!». Emanuel added: «Coming from a French man, we can take that» and this was the end of the discussion. Emanuel was acclaimed first president of the newly named European Society of Cataract and Refractive Surgery, ESCRS.

In 1996, merging the European and the American journals of cataract and refractive surgery was another strategic change, initiated and realised by Emanuel and Steve Obstbaum. To date, this is still one of the few successful mergings of American and European journals. Confidence and friendship were the leading forces in this amazing adventure, where the two initiators’ charisma played a major role in bringing together colleagues of different cultures.

In 1996, during an ASCRS meeting in Seattle, Emanuel, Michael Blumenthal, and myself decided to hold an ESCRS winter session dedicated to refractive surgery. At that time, no official European society held a scientific and educational comprehensive program in the winter months. Our first meeting took place in Spain. Despite great presentations, it was close to disaster, with only 87 pioneers participating. We survived this failure, and the winter meeting has become very successful from thereon.

Creating the ESCRS, merging the journals, and creating a cataract and refractive educational programme are three milestones of our society where Emanuel Rosen played a leading role. Up until the end of his life as journal editor, officer of the society, and active participant in all our meetings, he was our companion. Our debt to him is huge.

The first four ESCRS presidents, from right to left: Emanuel Rosen, Philippe Sourdille, Michael Blumenthal, Thomas Neuhann.