Miller made several spectacular stops throughout the game, including a sprawling save on New York's Marc-Andre Bergeron with nine minutes left in regulation with Buffalo up by 2. But he was more concerned with his gaffe that led to Mike Sillinger's goal seven minutes earlier that cut Buffalo's lead to 4-3.
Skating 25 feet out of his crease, Miller's clearing attempt went right on the stick of New York forward Trent Hunter. Hunter missed the gaping net, but Sillinger put the puck in about 10 seconds later while Miller scrambled to recover.
"We have a long way to climb over the next few months, and our margin of error isn't like it was the last few years," Miller said. "I think we can be better, myself included. Personally I want to be a go-to kind of goalie. I've been good enough to get us 12 or 13 wins, but that's not good enough right now."
Last season's Presidents' Trophy winners entered the game just three points in front of last-place Washington in the Eastern Conference.
"I was happy early in the game, but those mistakes like the third goal, I really want to minimize," Miller said.
Islanders coach Ted Nolan did everything he could to shake his team from its doldrums, including juggling lines and sitting defenseman Bryan Berard for the final two periods. New York came in ranked last in the NHL with 63 goals and has scored three or fewer in 19 straight games.
"I've given guys plenty of opportunities, but patience can only go so long," Nolan said. "We're in a business. You have to produce and you have to play hard."
Rick DiPietro, making his fifth consecutive start, finished with 36 saves.
"They put a lot of traffic in front," DiPietro said. "That was effective."
Pratt scored the lone goal in the first period, netting his first since being signed by Buffalo at the beginning of November.
Lydman made it 2-0 at 4:04 of the middle frame with his first of the season, netting the first of five combined goals in the period.
Kotalik pushed Buffalo's lead to 3-0 with his ninth 56 seconds later, ripping a one-timer from the left circle past DiPietro.
New York responded 77 seconds later when Satan scored his eighth during the Islanders' five-on-three advantage, but Roy restored Buffalo's three-goal edge with his team-leading 11th at 9:34.
Roy's goal, a slick redirect of Kotalik's shot from the left circle, also came during a two-man advantage.
Park cut the lead to 4-2 with three minutes left in the second, lifting a rebound over Miller's right shoulder.
After Sillinger made it 4-3, Hecht countered with his 10th on a backhand shot that went between DiPietro's legs at 8:14.
"We made more mistakes and made more turnovers but we got better results," Buffalo coach Lindy Ruff said. "It's funny how it goes."
Islanders left winger Ruslan Fedotenko missed his second straight game because of a shoulder injury. ... The teams will close out their four-game season series next Wednesday on Long Island. ... The game marked the end of the Islanders' four-game road trip. ... Sabres forward Jason Pominville had three assists, and Maxim Afinogenov had two. ... Miller, making his third straight start and eighth consecutive appearance, improved to 2-3 in his last five starts against the Islanders.
Copyright by STATS LLC and The Associated Press
Arena: First Niagara Center Location: Buffalo, New York
Referees: Brad Meier, Dean Morton Linesmen: Jonny Murray, Vaughan Rody
Attendance: 18,690 (100.0% full)
Team Stat Comparison
Power Play Goals
Power Play Opportunities
Shots on Goal
Nolan Pratt (1)
Assists: Maxim Afinogenov, Paul Gaustad
Toni Lydman (1)
Assists: Maxim Afinogenov, Nathan Paetsch
Ales Kotalik (9)
Assist: Jason Pominville
Miroslav Satan (8)
(Power Play) Assists: Mike Sillinger, Marc-Andre Bergeron
Derek Roy (11)
(Power Play) Assists: Ales Kotalik, Jason Pominville
Richard Park (4)
Assists: Sean Bergenheim, Radek Martinek
Mike Sillinger (7)
Assists: Andy Hilbert, Trent Hunter
Jochen Hecht (10)
Assists: Jason Pominville, Tim Connolly