Mini A.R.K Database

[jayuk]

John

I think thats one of many concerns I would have around this treatment...the effects of the treatment on an already thin cornea, the effects of scarring on an ever-changing cornea, and as each cornea is different how can one be sure that incisions are made in the correct areas.....and obviously theres the issue of data..

But I would suspect that this was one of the reasons Hari has began his journey....

J

[Prue B]

I am not one to dismiss a treatment out of hand, but I would like to know what the long term is. When my mother enquired about laser, my opthal said why, you have good sight with glasses, and you enjoy reading. I can guarantee with glasses you can read in 10 years I cannot yet say that with laser, I could do it for you but are you prepared to take that risk. He is quite disparaging about the laser supermarkets, and a bit disappointed, some he says are good drs but seem more interested in the fast money than the craft.
For me the worry is long term. That only time will answer. With KC we should be used to waiting for the answers, it seems we have to for everything.

[Hari Navarro]

Hi everyone,
It does seem that some good can come out of a good ramble-- I totally agree that in the case of Mini Ark there is much that is still not known.
As we know this is a technique that is not embraced by the medical community so scientific hard facts are hard to come by.
And yes much of my discision to have ARK was based on anecdotal testomy. But for me the wheels of change where rolling far to slowly to sit back and wait for that peer reviewed, failsafe cure all.
I'm 38 years old and have two small children. Mini Ark has returned to me my sight over this last year-- as for long term prospects... I have met ark patients that have had more than ten years of great vision. If I am to be the unlucky one to destabilize then at least I gave it a shot. And as we know ARK does not preclude PK-- so what did I have to lose?
I think nothing is without risk in this world. Not so many years ago PK was the accepted last ditch 'cure'. Now as time goes by we see some of the shine being taken from its crown.
Maybe the same will be of Mini ARK?
But still I do not see why the medical community is not clambering to investigate EVERY possibility that comes our way. We have to few weapons in our arsenal.
I have to be honest it does irk me a little that Ken Pullums article is one of the first things that hits you when you enter this site. I think he has given a balanced replie, but still he is a lens specialist and hardly unbiased. The heading 'Exercise caution' is prone to condition peoples opinion before they even have chance to read it.
As for incision placement these are calculated diffrently for every patient. This is not a standarized treatment-- there is no stencil that goes with the procedure.
I truelly feel that this goes a long way toward why it is having such a hard road towards acceptance. It is not part of the 'Lazer supermarket' that Prue speaks of...
Thanks for your comments, it really is good to discuss these things with people who are going through what I did.
Regards,
Hari

[GarethB]

Hari,

Of those patients that have had mini ark and are ten years plus post op, how many had KC and to what level of severety?

[Andrew MacLean]

I'd also be keen to know what are counted as conra-indications for mini ark surgery.

[Hari Navarro]

Hi Gareth,
All of the patients had keratoconus-- I contacted as many Mini ARKer's as I could when I first decided to consider Mini ark. At that time they were all Italian, this was just over a year ago. I met a very interesting case when I was first in Rome. He had advanced KC and had gone to graft on both eyes.
His transplant was very unsuccessful with problem after problem... He then visited Prof. Lombardi and had Mini ark on his grafted cornea's. This was over 11 years ago now. He was in Rome for a general check up and was very happy with his continued results. He wore glasses but only occasionly and had been able to continues his passion for motocross and live his life normally.
As far as conra-indications for mini ark surgery Andrew, I think that now The Lombardi Clinic is avoiding mini ARK usage in advanced cases of KC. But you'd have to confirm with the clinic exactly what their criteria is. Also Down's syndrome (which has a high associated incidence of KC) is a contridiction. This is an interesting question, one that I admit I havnt given that much thought to-- I'll try and find out if there are any others.

Hari

[GarethB]

Hari,

I too will give it some thought as it would be interesting if it is possible to break down the informaion you have gatherd into measurable criterea before and after. If the before and after information is put against the same patient a simple statistical test will give an overall view if the procedure has signifcant benefits. If it is possible to break this down further regarding acceptance critera for those who are selected for the procedure it might be possible for us to see what the critac acceptance criterea are and to determine its level of significance.

This may help from a lay persons point of view as to how relevent this might be to KC and at what stage.

I know I have appeared critical, but I am still undecided on the benefits of this, so hopefully this will help me understand mare and others.

Once I have thought through what data is needed and how it should be broken down I will let you know to see if you can help with providing the information.