It’s been over a decade since a new general-purpose excimer laser was approved by the U.S. Food and Drug Administration. Earlier this year, the drought came to an end with the approval of the Teneo Excimer Laser Platform (Bausch + Lomb) in January. Here, we’ll take a look at the new machine.


Teneo’s Background

The Technolas Teneo 317 Model 2 is indicated for myopia and myopic astigmatism LASIK, treating up to -10 D of myopic astigmatism, with sphere between -1 D and cylinder between zero and -3 D, according to the company.1 The technology may offer updated levels of accuracy, efficiency and usability. The company says the laser is a “fast, small, technologically advanced machine.”

George Waring, IV, MD, founder and medical director of Waring Vision Institute in Mt. Pleasant, South Carolina, performs a LASIK procedure with the newly FDA-approved Technolas Teneo 317 Model 2.

The platform has been available in 50-plus countries for a number of years and now United States-based surgeons have their chance to access its features. We spoke with George Waring IV, MD, founder and medical director of Waring Vision Institute in Mt. Pleasant, South Carolina, and Y. Ralph Chu, MD, founder and medical director of Chu Vision Institute and Chu Surgery Center in Minneapolis, who were among the FDA trial participants. They say it’s about time this technology made its way to the United States.

“As an industry, we haven’t seen approval of a new excimer laser by the FDA in well over a decade,” Dr. Waring says. “The recent FDA approval of the Teneo for myopia and myopic astigmatism is a landmark event representing positive energy around innovation in excimer laser technology in the United States.”

Dr. Chu adds, “It’s great now that we’re able to access the same technologies that our colleagues overseas have. This technology is a pretty significant advancement to me in terms of speed of treatment and accuracy of treatment. As a surgeon, we want ease of use, ergonomics, speed, and safety—all of which provide great outcomes. That’s what’s been exciting about getting this new laser option.”

Dr. Waring describes some of the new device’s key features. “Number one, the form factor of the laser requires significantly less space and is streamlined and significantly smaller than the other lasers that are commercially available in the United States,” he says. “That leads to improved space efficiency and ergonomic flexibility.”

According to the company, the Teneo is the smallest excimer laser unit currently available in the United States, clocking in at 6.8 sq. ft. 

“Number two, the laser has an open, airy feel, and an advanced design, which is appreciated by our patients and staff alike,” continues Dr. Waring. “It’s a more comfortable procedure with an ergonomic bed as well.” Not only does the patient bed swing out for easier access to patients of all sizes, but the surgical microscope also swivels 360 degrees to adapt to the surgeon’s ergonomics. The microscope also includes five magnification settings with a 50-percent boost at each level.

The speed of the laser—500 Hz repetition rate and a truncated Gaussian beam profile—is “the fastest ablation time of all excimer lasers available in the United States at approximately 1.2 seconds per diopter,” according to the company.

The Teneo’s eye-tracking capability, which the company says operates at 1,740 Hz and has “iris-recognition illumination and digital coaxial camera for real-time active z-tracking,” are among its most unique features highlighted by Dr. Chu and Dr. Waring.  

Surgeons say the touchscreen interface is intuitive.

“I love that the tracker has x, y and z directions, which is terrific,” Dr. Chu says. “You can center the treatment on the visual axis vs. the pupillary center. This is very important with hyperopic corrections (which it’s not approved for in the United States).”

New technology can be daunting, especially for surgeons who’ve been comfortable with their current laser platform, but the surgeons we spoke with say the Teneo is user-friendly. “One of the most exciting things about it is the intuitive user interface,” says Dr. Waring of Teneo’s customizable graphical interface with a touchscreen. “The Teneo platform is much more like an Apple computer or a Tesla and it’s an intuitive and simple user interface that’s easy for staff to use. The efficiency of treatments leads to a more enjoyable experience for staff and patients, and we think potentially quicker recovery as well because there’s less time for the stromal bed and LASIK flap to be exposed during these treatments.”

According to Bausch + Lomb, the Teneo is the smallest excimer laser available in the United States at 6.8 sq. ft.

“Technologically it feels very advanced,” Dr. Chu says. “In terms of the surgeon interface, it has a cockpit feel to it. I think the eye-tracking system, the speed of the laser and the results are the most impressive things. It’s a big step forward.”

To further save time, it comes with an internal nomogram. “It still allows for physician adjustments, but it doesn’t require external adjustments through the use of external nomograms or physician adjustments,” Dr. Waring says. “That tremendously streamlines the workflow, where you simply plug in the manifest refraction and treat off of that. This is how the FDA studies were designed and it provided exceptional results.” (Results have been submitted for peer review and are forthcoming.)

Some studies have been conducted and published in other countries, including a retrospective study2 of 135 eyes in 80 patients who underwent PRK for high astigmatism (-8 D or higher) with the Teneo 317 Model 2 excimer laser. Researchers examined the clinical results after six months. Spherical power averaged from -8.04 ± 0.90 D before surgery to -0.18 ± 0.55 D six months after surgery. Cylinder averaged from 1.74 ± 0.93 D preop to 0.51 ± 0.29 D six months postop. The average corneal thickness was measured at 543.67 ± 22.14 µm before surgery and 457.19 ± 26.34 µm six months postop.

Surgeons are looking forward to learning more about this laser’s potential for hyperopic patients as well. “Given the beam profile and the efficiencies, the studies for hyperopia are ongoing and appear very promising,” Dr. Waring says. “We’re highly optimistic about the indications that are being pursued across the refractive spectrum.

“It’s never been a better time to be a refractive surgeon or a refractive patient because we now have really notable improvements across a full spectrum of vision-correction procedures,” Dr. Waring continues. “We’re encouraged to see the advancements in excimer laser vision technology to continue to be able to provide visual freedom to more and more individuals in a safe and effective manner.” 

Dr. Chu and Dr. Waring are consultants for Bausch + Lomb.


1. Bausch + Lomb receives FDA approval for Teneo excimer laser platform for myopia and myopic astigmatism LASIK Vision correction surgery. Accessed February 20, 2024.

2. Kim I. Clinical results of refractive correction laser keratectomy using Technolas Teneo317 Model 2 M2 Excimer Laser in Patients with Very High Myopia. Presented at the Korean Academy of Ophthalmology conference. April 2 & 3, 2022.