5 Questions with Matteo Piovella, MD

1. What techniques will have the greatest impact on vision in the near future?
Due to the fact that about 40% of people suffer from myopia, presbyopia, or astigmatism, any technology that can correct refractive errors will have great value. I believe that multifocal and phakic IOLs, conductive keratoplasty and the excimer laser—are all important tools for those who currently rely on spectacles, contacts, or other means, to improve their vision. Additionally, new multifocal IOLs are extremely exciting for the many people older than 50 years who undergo cataract surgery.

It is not hard to understand how any of these technologies positively impact the lives of patients.

2. Can you please explain how you became involved in ophthalmology?
I knew from an early age that I wanted to study medicine, however, I was not sure what particular specialty I wanted to focus on.

During my studies, I developed a lung condition that greatly affected my endurance. I knew I wanted to become a surgeon, but I no longer had the stamina to perform long and intense surgeries. I realized I would be much more apt to perform a 10-minute cataract surgery, compared with an 8-hour heart surgery.

It was at that point that I opted for a career in ophthalmology. Years later, I do not think I could have made a better choice.

3. What do you feel are some of the most promising developments in ophthalmology?
The field of ophthalmology has seen some great advancement since ophthalmologists performed the first cataract surgeries. In the past, cataract surgery was so dangerous that people waited until they were quite blind before they even considered the procedure.

The technology behind IOLs is helping people to preserve their eyesight, which is especially important as life expectancy continues to increase.

4. As a surgeon do you have any heroes or role models who you have looked up to or tried to follow their lead?
Sir Harald Ridley, MD, and Benedetto Strampelli, MD, have inspired me in many ways. Dr. Strampelli was the first doctor to insert an IOL in Italy more than 50 years ago. What I like about Dr. Strampelli and Sir Harald Ridley is that that even though they had marvelous ideas, they faced many difficulties in their work due to a lack of technology.

Dr. Strampelli was the first Italian to use the IOL, but he was also the first to make a judgment that IOLs were dangerous. Because of that claim, Italy saw very little progress in IOL implantations for the next 20 years. It was interesting that his criticism stopped the progress of the IOL in my country.

It is even more remarkable to me that once Italian doctors began to embrace implanting IOLs, we were able to equal the United States and Japan in our technique and abilities, in only approximately 15 years.

5. What has been the toughest decision you've had to make as a surgeon?
Many ophthalmologists are inspired to develop new technologies or become pioneers in their field. I, however, prefer not to be the first to do something. For me, the most difficult decision came in 1990, when Steven L. Trokel, MD, and I were working on a new multizone technique effective for laser vision treatment.

It was a nerve-wracking experience to transfer theoretical studies on correcting high myopias, to a clinical application. It was extremely stressful for me the first time I applied the new technology to a patient, because there is always some risk and doubt about the outcome. Making the decision to proceed with a potentially risky clinical application on healthy eyes, was one of the biggest challenges I ever faced.