NEW YORK – Dr. Anthony Pilavas is an ophthalmologist in Astoria and is affiliated with multiple hospitals in the New York area, including Lenox Hill Hospital and New York Eye and Ear Infirmary of Mount Sinai. He received his medical degree from Aristotle University of Thessaloniki School of Medicine. Before the age of 34, he opened his own office in Astoria, equipped with the latest technology, examining patients, and performing various treatments.
His son, Dr. John Pilavas, followed in his father’s footsteps, which is rare today, and both are experts in eye surgery, especially Photorefractive Keratectomy (PRK) and laser-assisted in situ keratomileusis, more commonly known as LASIK.
Both are engaged in research and writing as well. Dr. John Pilavas teaches at Nassau University Medical Center. The father and son, both fluent in Greek, spoke with the National Herald at their offices, 25-09 31st Ave in Astoria.
Dr. Anthony Pilavas was born in Chios and came to America at the age of ten. After high school, he attended the Aristotle University of Thessaloniki Medical School.
His son, however, was born in Lexington, Kentucky when his father was a specialist in the ophthalmology department at the University of Kentucky, and grew up in New York. The younger Dr. Pilavas credits Saint Demetrios School in Astoria, summers in Chios, and volunteer work at the Skylitsios Hospital in Chios, for his perfect Greek.
This hospital was built in 1883 and bears the surname of the brothers Zannis, John, and Matthaios Skylitsis, who at that time donated £6,100.
Asked why he chose the Aristotle University Medical School, Dr. Anthony Pilavas said that there were many factors that led him to this decision.
“The first reason was because in Greece you are allowed to enter medical school right after high school, while in the United States you must first finish 4 years of college. The second reason was financial, because in Greece, Medical School is completely free of charge.”
Referring to the difficulties he faced in the homeland, he said there was a difficulty with the language.
“I left Greece very young, just ten years old, so my Greek was at a 4th grade level. So I experienced a language problem going to the Aristotle University Medical School, but once again it turned out that with hard work anything can be done. Having great determination and love for the subject of my work, I managed to overcome the obstacles in my way.”
Asked why he chose ophthalmology, he explained that “it is a specialty that gives you the opportunity to deal both with eye pathology and surgery.
“At the same time, it is a specialty that has made tremendous leaps in technology. Incredible progress has been made in the past three decades. Among these are refractive surgery PRK and LASIK.”
“We are moving towards a time when the patient will undergo an operation and will then no longer need to wear glasses. We have not reached this point quite yet, but we are on the way,” he added.
About what has changed in the past three decades, Dr. Pilavas noted, “Knowledge has been enriched and deepened, while surgeries have changed radically. When we started the first surgery, patients wore thick glasses and we reached the point of inserting lenses. Several surgeries now in 2018 are done in outpatient clinics, while the patient was previously required to stay in the hospital for 4 to 5 days.”
With regard to eye diseases, he underlined that they now have better and more effective methods of dealing with them.
“There is LASIK, with which you can correct the problem and the patient gets rid of glasses. John is a specialist in refractive surgery, which aims at getting rid of eyeglasses and correcting astigmatism. After LASIK surgery, the patient mostly does not need to wear glasses or contact lenses.”
Asked if the interventions corrected vision problems permanently, Dr. Pilavas said that “all of these interventions are mostly for the long term. Besides, let us not forget that nothing in life is permanent. There are changes we have to adapt to.
“For example, a laser surgery for a 25-year-old corrects vision for distance. At 45 years old, problems reading often appear. So you need a new intervention to correct presbyopia (inability to focus on near objects which often begins in middle age). In addition, there are cornea interventions recently approved by the FDA aimed at correcting presbyopia.”
As far as contact lenses and eyeglasses are concerned, “it is a matter of personal choice for each patient. Contact lenses are often worn instead of glasses. Therefore, when someone would prefer not to wear eyeglasses then we recommend contact lenses to the patient to improve his condition and see more clearly. Similar results can also be achieved with laser procedures (LASIK, PRK).
“For keratoconus, a disorder that results in the thinning of the cornea, the FDA has approved, about two years ago, a method for treating and stabilizing it.
“John is an expert in this method and using one of the most modern tools that have been approved in recent years. We have it in our clinic and we are doing surgery to stabilize keratoconus.”
Concerning transplantation, Dr. Pilavas said, “A great revolution is taking place.”
“In the past, an entire transplant had to be done, and now it can be just the inner section of the cornea. John is an expert on these issues,” he added.
For removing cataracts, “We are using the new method with the laser, which has been approved for a long time, and surgeries are done at the New York Eye and Ear Infirmary, 14th Street and 2nd Avenue in Manhattan, for three years, equipped with a new laser machine which has significantly simplified the operation.
“The surgery is done in two stages. In the first one the cataract is laser-crushed and then the patient is taken into the surgery where the cataract is completely removed. Its advantage is that surgery is simplified and, of course, we can say it’s easier.”
He added, “Another advantage of the laser is the reduction of astigmatism in the removal of the cataract. If we deal with the removal of the cataract in time, the surgery is painless, simple, and the results better.”
“Many of the elderly are afraid of surgery and wait until the cataract is so far-advanced, it actually makes the surgery even more difficult.”
As for the recovery period after an operation, it is “patient-dependent.”
“If the patient is diabetic, healing takes longer. It also depends on how each eye reacts to the operation. We can say without the slightest doubt that the recovery time of the patient after surgery has been significantly reduced,” Dr. Pilavas added.
Ophthalmological exams are done in the office, while surgeries are performed at the hospital as an outpatient procedure.
“Simple surgery can also be done in the clinic. The treatment for the keratoconus is done in the clinic. Cataract surgery is necessarily done in the operating room.”
Anesthesia is done locally with drops that remove sensitivity and pain, but a sedative is also provided to help keep the patient calm.
The duration of the surgery depends on the ailment being treated. The cataract operations, for example, take only a short time.
Postoperative monitoring also depends on the patient’s overall health status.
“In the case of a diabetic patient, the monitoring is more intense. We take a picture of the eye, we look at the bottom, we see the retina, the macula, and in cases where no changes happen, a simple monitoring is enough.
“In cases where there are changes, laser treatment can be done in the clinic to cauterize vessels that either drain liquid or blood. In special, complicated cases we refer the patient to colleagues who deal exclusively with those cases. Ophthalmology has been divided into many sub-disciplines and patients are referred accordingly.
Dr. Pilavas explained that there is the neuro-ophthalmological sub-specialty dealing with the retina and the vitreous. We also have ophthalmoplastics, as well as colleagues dealing with special and advanced cases of glaucoma.
Dr. John Pilavas is a graduate of St. Demetrios School in Astoria, Georgetown University, and the University of Louisville School of Medicine. He completed his internship in Internal Medicine at Lenox Hill Hospital – Manhattan Eye, Ear, Throat, and served as Chief Resident at Nassau University Medical Center – SUNY Stonybrook. Dr. Pilavas is an ophthalmologist specializing in PRK and LASIK surgeries.
Asked why he chose this specialty, he said, “After medical school I wanted to become a surgeon. And one of the first surgeries I had seen was a transplantation of the cornea. I was impressed because after the transplant you can restore the patient’s vision.”
“We are very lucky in America. For example, if I urgently need to perform a transplant, it can be done in a few hours. We have an eye bank. In Greece, from what I am aware of, there are no eye banks,” Dr. Pilavas said.
He noted that the same rules apply to transplants of other organs which also require special treatment after surgery to minimize the possibility of tissue rejection.
“It all depends on the reason for the transplant,” he added.
Dr. Pilavas pointed out that there are cases where the transplant may last a lifetime, but there are also cases where the patient may later on require a new transplant.
He also spoke about the patient’s age when undergoing refractive surgery noting that there are many patients age 20-30 and many more age 60-70.
About surgical procedures to correct vision- myopia, presbyopia, and astigmatism, Dr. Pilavas said they are done after age 21 when the condition of the eye is stable.
In conclusion, Dr. John Pilavas, said, “Worthy of discussion are the advances in cataract surgery after which patients no longer need to rely on glasses as much or at all and the use of special intraocular lenses to treat astigmatism and presbyopia.”