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Leopards don't really live knee deep in sand. Their native habitat is rocky areas, with hard packed clay type soil, gravel and some sand. They can dive after an insect and not get a mouth full of sand.
In captive environments, the sand is usually piled deep, 1/4 inch or even deeper. On top of that, the commonly used calcium based sands are coarser than the wind blown sand found in the wild. The natural sand they have at home is smooth, while the calcium type you buy is crushed lime stone, or other calcium 'rocks' with sharper edges and corners. If you've ever dripped water on calci-sand you'll see it clumps. Imagine what a few pieces of that can do when inside the gecko's intestines - it clumps. Individual pieces might make it through the gecko harmlessly, but not the clumps. Also, being rougher and larger grained, the pieces get caught in the loops and bends of the intestines.
Adult geckos with their larger intestines are safer on sand than babies. Wild geckos can avoid sand if they want to, they can hunt in rock crevices and the hard packed soil without eating the substrate. If you have that layer of loose sand in the enclosure, the gecko has no other choice. Using a feeding bowl adds a measure of safety, but if the insect escapes, it's back to hunting on sand. Crickets are hard to keep inside the bowl, and even mealworms can escape. Then there's also a good chance the gecko might drop the insect in the sand. It might already be a bit damp from being partially chewed (it's own body fluids escaping from the bite marks), sand sticks to it damp body and again you've got your gecko eating sand.
Many people have used sand successfully, but many more haven't been so lucky. Impaction isn't always fatal, but the vast majority of cases are. It's a slow agonizing death, something I really don't want to put my geckos through.
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