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One To Watch | July/Aug '19

One to Watch: Vasilios F. Diakonis, MD, PhD

Dr. Diakonis is a Cornea and Cataract Specialist at the Eye Institute of West Florida in Tampa.

1. Please share with us your background.

My family is originally from Karpathos, a small but beautiful Greek island in the south Aegean Sea (Figure). I was born in New York to first-generation immigrants and completed high school in Montreal. I attended medical school at the University of Crete in Greece, where I also completed a 4-year PhD program, focusing on corneal refractive surgery and corneal healing under the supervision of Ioannis Pallikaris, MD, PhD. After the completion of my residency at the University Hospital of Heraklion in Greece, I crossed the Atlantic once again for a 6-month research fellowship at the Bascom Palmer Eye Institute in Miami, followed by a 1.5-year clinical fellowship in cornea and external diseases.

Currently, I enjoy seeing patients at the Eye Institute of West Florida. I am also passionate about conducting research and publishing papers, mainly to answer my own questions but also to provide information to other physicians that may improve their patient care. In addition to work, I enjoy going back home to Greece and being surrounded by my family and childhood friends, either fishing or enjoying a good meal.

Figure. Dr. Diakonis’ family is originally from Karpathos, Greece, a small island in the south Aegean Sea. Photo credit: Dimitris Spanos

2. What drew you to ophthalmology and, specifically, to your field of interest?

My initial encounter with ophthalmology was involuntary. My father owned a restaurant that was close to a dog training facility for the blind, and the dogs and their owners used to have lunch there. As a teenager, I was thrilled—not for the blind, but because of the dogs. Spending time with the guide dogs also meant spending time and conversing with their owners, an experience that probably entered my subconscious.

Medicine was a career I long wanted to pursue, and I ended up at the right university to do so, as its professor of ophthalmology was like a rock star. Prof. Pallikaris, the inventor of LASIK as we know it today, has an extremely charismatic personality that attracts, motivates, and supports young scientist in pursuing their dreams. I requested to meet with Prof. Pallikaris a few months before my medical school graduation, and, after 10 minutes of talking with him, I started an 8-year path toward my PhD and residency. As for why I chose cornea and anterior segment, the explanation is simple: When you work with a team that focuses on that area and your research expertise is also in that area, the choice is easy.

3. Please describe your current position.

For the past 2 years, I have been a cornea and cataract specialist at the Eye Institute of West Florida in Tampa. Because I have a special interest in CXL, I take care of our patients with keratoconus. I also care for patients with dry eye disease, and I am fortunate to have access to almost every diagnostic and treatment modality available (serum drops, intense pulsed light therapy, meibomian gland imaging and treatments, etc.). Finally, I see cataract patients and am fortunate to work in a practice that offers state-of-the-art cataract surgery using 3D visual displays, two femtosecond laser platforms, bimanual phacoemulsification with 1.6-mm corneal incisions, intraoperative aberrometry, and a variety of premium IOLs. I also continue to conduct research at our institute and in collaboration with colleagues and friends around the globe.

4. Who are your mentors?

I am fortunate to have worked with many physicians and researchers worldwide. There are three individuals in particular who had, and continue to have, a significant impact on my development as an ophthalmologist. As mentioned above, one person who played a significant role in my mentoring is Prof. Pallikaris. He provided me with great opportunity and, due to his innovative nature, taught me to think outside the box and to always remain inquisitive.

Additionally, George D. Kymionis, PhD, was—and is—my point of reference. He taught me how to conduct research and introduced me to the clinical and surgical world of ophthalmology. He is methodical and inspiring, and these qualities were especially important to me at the beginning of my ophthalmology endeavors. Finally, my fellowship mentor Sonia H. Yoo, MD, provided me with continuous support and trust, making me a better clinician and surgeon. I am truly thankful to all those mentioned and not mentioned here, and I hope to be blessed in the future to help younger colleagues in the same way I was. 

5. What has been the most memorable experience of your career thus far?

Prior to my surgical rotation in residency, I visited India for a 5-week surgical training program. That was a memorable experience that was both culturally and scientifically fulfilling. As a medical professional in a developing country, I could see the impact that my work had on patients and society as a whole. India is a country with a deep history and culture. Its population exceeds 1 billion, and half of its residents are poor and homeless. To understand the magnitude of this issue, consider that number is the sum of all European and American residents combined. Nevertheless, Indians are thankful and hopeful. Overall, it was a humbling and memorable trip that I would recommend to everyone, and I hope to repeat it in the future.

6. What are some new technological advances that you have found particularly exciting? Which advances in the pipeline are you most enthusiastic or curious about?

In the cataract world, I am looking forward to more precise IOL calculations and improved refractive and visual outcomes. The Holy Grail of presbyopia correction remains unfound, as there is not yet a technology to simulate the physiologic, dynamic accommodation capabilities of the natural crystalline lens. I anticipate that, in the near future, presbyopia will no longer be a concern. Furthermore, I believe that the advent of stem cell and gene therapy will make corneal transplantation obsolete. 

7. What is the focus of some of your research?

Lately, I have been focused on femtosecond laser cataract surgery, with a specific interest in lenticular and corneal astigmatism correction. We now have technology (astigmatism axis registration, femtosecond laser-assisted arcuate keratotomies, etc.) to correct astigmatism at the time of cataract surgery and provide spectacle independence to our patients. We will need more defined nomograms for corneal astigmatism correction as we move toward refractive cataract surgery. I am also conducting some basic research on corneal elasticity and evaluating the stiffening effect demonstrated by different CXL approaches.

8. What is a typical day in your life? What keeps you busy, fulfilled, and passionate?

I don’t yet have a family due to my intense workload and constant traveling, so my typical day focuses mainly on ophthalmology. My weekdays are spent in clinic and in surgery. Usually, over the weekends, I try to do activities with friends in order to keep my sanity. My daily routine keeps me busy, but what drives me forward are new ideas about surgical and nonsurgical interventions that may have an impact on the way we practice and on patient care. 

9. What advice can you offer to individuals who are just now choosing their career paths after finishing residency or fellowship?

Most importantly, do what you like to do. Once training is complete, we’re required to work as physicians for a long period of time; the best way to spend that time is by doing something that gets us out of beds in the morning. And, just to note, liking something is different than understanding it. Those in training should spend time with physicians working in their field of interest to see if it is something they truly want to do for the rest of their lives.

After training, the main practice pathways in ophthalmology are the private sector and academia. The choice of which setting to enter typically centers on the individual’s desires and priorities. But, at the end of the day, a good balance between work and personal life should be the ultimate goal, as happiness cannot be achieved in a single dimension.

10. Tell us about an innovative procedure you are performing or a new imaging/diagnostic tool that has improved your practice.

Phototherapeutic keratectomy in conjunction with CXL has been an important addition to my practice. This minimally invasive approach enables us to aim not only for stabilization of ectasia but also for improvement in visual performance. Taking advantage of the corneal epithelium masking over the apex of the cone, performing a 50-μm phototherapeutic keratectomy prior to CXL helps us to achieve regularization of the corneal surface.

Neda Shamie, MD | Section Editor