Moles and cancer
LASER EYE surgery is “significantly safer than a lifetime of contact lens wear,” says Allon Barsam, an expert in the field. “However, it’s important to qualify that. Contact lenses, if prescribed by a well-qualified optometrist or optician are safe, but risks can occur. I’ve had laser eye surgery myself and lots of family and friends and colleagues have, too. I have treated pilots, military, sports people…”
Barsam has been an eye surgeon for 15 years and is often consulted by industry leaders in eye-surgery technology and lens implants, including premium lens implants for cataracts. “I help them develop newer, safer, more precise and effective technology — and am able to adopt such technology early, once it has been fully evaluated and shown to be safe,” he says.Latest developments mean laser surgery can now correct reading vision problems, far sightedness and astigmatism, as well as short sightedness for which it has been used since in 1987.
“Lens replacement [to correct reading vision, short or long sightedness or astigmatism] is also more popular,” adds Barsam. This may be suggested if laser sight correction is not the best option, for example if a patient is nearing the age when they may need a cataract operation. Barsam, 40, was the first surgeon in Europe to carry out a customised “thinflap” procedure, providing faster healing and less dryness. He has also used new laser eye surgery procedures to correct corneal irregularity and was the first British surgeon to carry out laser cataract surgery and to use newest trifocal lens implant for cataract surgery or lens exchange. He splits his time 50-50 between private practice in the Harley Street area of London and at Spire Bushey in Hertfordshire and NHS practice at Luton and Dunstable Hospital, part of UCH Partners. At Luton and Dunstable, he set up a tertiary clinic dealing with complex referrals from a wide area. He has also spearheaded a large-scale study of the use of implantable contact lenses for those with high myopia.
“Eye surgery is a rapidly advancing field and I’m motivated to give my patients the best treatments available,” says Barsam. “The holy grail is a lens that will allow natural focusing at all distances like the natural lens — it is in development but we are not there yet.” Even cataract surgery with special lenses is not yet available on the NHS — meaning an NHS patient with astigmatism, for instance, cannot be fully treated.
Barsam is married to a haematologist and has four sons, from nursery to secondary-school age. He is a member of Kinloss (Finchley United) Synagogue in north west London. Born in London to an Israeli mother and British father, in his gap year he studied at the Hebrew University of Jerusalem. In Israel he also worked as a volunteer, supporting a single mother with a child with behavioural difficulties.
Afterwards, he studied at Cambridge and University College London and trained at London teaching hospitals including Moorfields, as well as in New York, where he “learned from the grandfathers of modern corneal cataract and laser eye surgery”.
He co-authored the main training textbook on ophthalmology and has written around 15 other book chapters on surgical techniques and almost 500 academic papers.
He lectures all over the world to teach other surgeons the latest techniques and is on the examiner board at the Royal College of Ophthalmologists.
“I performed about 32 ops last week,” he says “and see thousands of patients — I have big teams supporting me, thankfully.” He visits Cambodia regularly as one of a group of eye surgeons to perform cataract eye surgery on villagers living in poverty. “We fund ourselves, send money for nurses and take a week out of our schedules to go,” he says. And he still finds time to work out five times a week: “It gives me the energy to do everything else!”. Sadly, even for Barsam, something has to give. He was recently asked to compete with the Maccabi GB tennis team — but had to decline. This time round, anyway.
Computerised digital dermoscopy is a new, non-invasive technique, using digital technology along with a dermatoscope to provide a computer-assisted analysis of digital mole images. It can magnify a mole up to 70 times, making it possible to assess structural features that are not otherwise visible, increasing the accuracy of early diagnosis of melanoma and skin cancer.
In addition, the skin imaging system provides a mole analyser. Stored mole images are assessed using clinically approved pattern-recognition algorithms and this provides an immediate second opinion. This has been developed in collaboration with the University Clinic of Tuebingen, in Germany.
If you have a large number of moles, or a personal/family history of skin cancer or atypical mole syndrome, mole mapping is an easy way to keep a regular check on your moles — particularly useful if they are hard to see, for example, on your back. If you have any concerns about a mole, speak to a medical professional as soon as possible.
Celia Ellicott is a mole mapping nurse at Centennial Medical Centre, 020 3327 7777, centennialmedical.co.uk
I work out five times a week. It gives me energy ’