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Wu J, Zhang X, Wang L, Zhang P, Guo X, Xie P. Altering optical zone diameter, reverse curve width, and compression factor: impacts on visual performance and axial elongation in orthokeratology. Cont Lens Anterior Eye 2024; 47:102136. [PMID: 38503665 DOI: 10.1016/j.clae.2024.102136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 02/08/2024] [Accepted: 03/04/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE To investigate the effects of modifications in back optical zone diameter (BOZD), reverse curve width (RCW), and compression factor (CF) on refractive error changes and axial elongation in myopic children undergoing orthokeratology (ortho-k) over a 12-month period. METHOD In this retrospective study, data from 126 myopic children undergoing ortho-k fitting were analyzed. Subjects were categorized into four distinct groups based on lens design parameters: Group A (BOZD 6.0 mm, RCW 0.6 mm, CF 0.75 D); Group B (BOZD 6.0 mm, RCW 0.6 mm, CF 1.25 D); Group C (BOZD 5.4 mm, RCW 0.9 mm, CF 1.25 D); and Group D (BOZD 5.0 mm, RCW 1.1 mm, CF 1.25 D). The study evaluated uncorrected visual acuity (UCVA), corneal topography, and axial length (AL) at intervals, using Linear Mixed Models (LMMs) for time-based changes, and ANOVA or Kruskal-Wallis tests for group differences in AL elongation. A multivariable regression analysis identified factors independently associated with AL elongation. RESULTS Within the first day and week, all four groups displayed significant improvements in UCVA and alterations in corneal curvature, which subsequently stabilized. Although UCVA variations between groups were subtle, Group D had less corneal curvature change than Groups A and B initially and exhibited significantly less AL elongation after one year. No significant difference in corneal curvature change or AL elongation was observed between Group C and the other groups. Multiple regression analysis indicated that older baseline age, greater baseline spherical equivalent refractive error, and smaller BOZD were associated with less AL elongation. CONCLUSION The study reveals a positive correlation between BOZD and axial length growth over the 12-month period. A pure 0.5 D CF increment demonstrates a nonsignificant impact. This study provides new ideas into optimizing the parameters of ortho-k lenses.
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Affiliation(s)
- Jinfang Wu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Xinyu Zhang
- Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Linlin Wang
- Beijing Internet Eyecare Optometry & Ophthalmology Clinic, Beijing, 100027, China
| | - Peipei Zhang
- Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Xi Guo
- Beijing Internet Eyecare Optometry & Ophthalmology Clinic, Beijing, 100027, China.
| | - Peiying Xie
- Beijing Internet Eyecare Optometry & Ophthalmology Clinic, Beijing, 100027, China.
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Xiong R, Wang W, Tang X, He M, Hu Y, Zhang J, Du B, Jiang Y, Zhu Z, Chen Y, Zhang S, Kong X, Wei R, Yang X, He M. Myopia Control Effect of Repeated Low-Level Red-Light Therapy Combined with Orthokeratology: A Multicenter Randomized Controlled Trial. Ophthalmology 2024:S0161-6420(24)00308-7. [PMID: 38763303 DOI: 10.1016/j.ophtha.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/21/2024] Open
Abstract
PURPOSE To investigate the efficacy and safety of repeated low-level red-light(RLRL) therapy combined with orthokeratology(Ortho-k) among the children who, despite undergoing Ortho-k treatment, exhibited an axial elongation of at least 0.50mm over 1 year. DESIGN Multicenter, randomized, parallel-group, single-blind clinical trial (ClinicaTrials.gov,NCT04722874). PARTICIPANTS Eligible children were aged 8-13 years with a cycloplegic spherical equivalent refraction of -1.00 to -5.00 diopters in the initial Ortho-k fitting examination and had annual axial length (AL) elongation ≥ 0.50 mm despite undergoing Ortho-k for 1 year. A total of 48 children were enrolled from March 2021 to January 2022, and the final follow-up was completed in March 2023. METHODS Children were randomly assigned to the RLRL combined with Ortho-k(RCO) or the Ortho-k group in a 2:1 ratio. The Ortho-k group wore Ortho-k at least 8 hours per night, while the RCO group received daily RLRL therapy twice a day for 3 minutes in addition to Ortho-k wearing. MAIN OUTCOME MEASURES The primary outcome was AL change measured at 12 months relative to baseline. The primary analysis was conducted in children who received the assigned intervention and completed at least 1 post-randomization follow-up using the modified intention-to-treat principle. RESULTS A total of 47(97.9%) children were included in the analysis (30 in the RCO group and 17 in the Ortho-k group). The mean axial elongation rate before the trial was 0.60mm/year in the RCO group and 0.61mm/year in the Ortho-k group. After 12 months following the intended intervention, the adjusted mean AL changes were -0.02mm(95% CI, -0.08 to +0.03 mm) in the RCO group and 0.27mm(0.19-0.34 mm) in the Ortho-k group. The adjusted mean difference in AL change was -0.29mm(-0.44 to -0.14mm) between the RCO and Ortho-k groups. The percentage of children achieving an uncorrected visual acuity greater than 20/25 was similar in the RCO (64.3%) and Ortho-k (65.5%) groups (Chi2 test, P=0.937). CONCLUSIONS Combining RLRL therapy with Ortho-k may offer a promising approach to optimize axial elongation control among myopic children. This approach also potentially allows children to achieve satisfactory visual acuity, reducing the daytime dependence on corrective eyewear.
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Affiliation(s)
- Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xianghua Tang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Meinan He
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Jian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yu Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; Department of Ophthalmology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; Center for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Yanping Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Shiran Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xiangbin Kong
- Ophthalmology, Department of Surgery, The Second People's Hospital of Foshan, Foshan, Guangdong, China.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China.
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong; Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong.
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Martínez-Plaza E, Zamora Castro C, Molina-Martín A, Piñero DP. Safety, Efficacy, and Visual Performance of an Orthokeratology Lens with Increased Compression Factor. J Clin Med 2024; 13:587. [PMID: 38276091 PMCID: PMC10815969 DOI: 10.3390/jcm13020587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/03/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
The aim was to evaluate the safety, efficacy, and visual performance of an orthokeratology lens with an increased compression factor (ICF) of 1.25 D in a 3-month follow-up. Thirty-six myopic patients (5 males and 31 females; 24.2 ± 5.8 years) were fitted with Alexa AR (Tiedra Farmacéutica S.L., Madrid, Spain) contact lenses (CLs) and twenty participants finished the follow-up. Visual acuity (VA), subjective refraction, primary spherical and primary coma aberrations, keratometry, central pachymetry, and ocular surface evaluation were performed at baseline and after 1 night, 1 week, 1 month, and 3 months of CL wear. The differences among visits were analyzed using a repeated-measures analysis of variance or the Friedman test. The spherical equivalent decreased (p ≤ 0.005), and the uncorrected VA improved (p < 0.001) until the first week. Corneal and ocular aberrations showed a significant increase (p ≤ 0.02). A significant decrease (p < 0.001) was found for keratometry values. No significant changes were observed in either central pachymetry or ocular surface parameters among study visits. In conclusion, an orthokeratology CL with an ICF of 1.25 D provides good safety, efficacy, and visual performance in a 3-month follow-up. Seven days of orthokeratology wear are enough to achieve the full myopic compensation, resulting in satisfactory VA.
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Affiliation(s)
- Elena Martínez-Plaza
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain; (E.M.-P.); (C.Z.C.); (A.M.-M.)
- University of Valladolid, 47001 Valladolid, Spain
| | - Cecilia Zamora Castro
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain; (E.M.-P.); (C.Z.C.); (A.M.-M.)
| | - Ainhoa Molina-Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain; (E.M.-P.); (C.Z.C.); (A.M.-M.)
| | - David P. Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain; (E.M.-P.); (C.Z.C.); (A.M.-M.)
- Department of Ophthalmology, Vithas Medimar International Hospital, 03016 Alicante, Spain
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Chiu YC, Tsai PC, Lee SH, Wang JH, Chiu CJ. Systematic Review of Myopia Progression after Cessation of Optical Interventions for Myopia Control. J Clin Med 2023; 13:53. [PMID: 38202060 PMCID: PMC10779574 DOI: 10.3390/jcm13010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Despite high discontinuation rates for myopia optical interventions, limited attention has been given to the potential rebound effects post-discontinuation. This systematic review aims to assess the extent of the rebound effects following the cessation of common clinical optical myopia-control interventions in children. A comprehensive search of PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov was conducted from inception to October 2023. The rebound effects, defined as changes in the axial length or spherical equivalent during and after treatment cessation, were categorized into four levels. These studies encompassed 703 participants and spanned from 2019 to 2023, with durations of treatment and cessation ranging from 6 months to 3.5 years and from 2 weeks to 5 years, respectively. This review, encompassing 14 studies, revealed a predominant strong rebound effect in orthokeratology (8 studies), a weak rebound effect in multifocal soft contact lenses (4 studies), and a variable rebound effect in peripheral-plus spectacle lenses (2 studies). Notably, with the increasing cessation duration, the rebound effects diminished, potentially linked to the reversal of choroidal thickening and the disappearance of peripheral myopic defocus. In conclusion, a temporal trend of rebound effects exists in all three myopia optical interventions, possibly contributing to their myopia control mechanisms.
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Affiliation(s)
- Yu-Chieh Chiu
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Ping-Chiao Tsai
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Ssu-Hsien Lee
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Jen-Hung Wang
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan;
| | - Cheng-Jen Chiu
- Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien 970, Taiwan
- Department of Ophthalmology, Hualien Tzu Chi Hospital, the Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
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Li J, Hu J, Li X, Tang J, Li Y, Wang K, Zhao M. Long-term variations and influential factors of the treatment zone of wearing orthokeratology lenses. Cont Lens Anterior Eye 2023; 46:101867. [PMID: 37286433 DOI: 10.1016/j.clae.2023.101867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/01/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE To investigate the variation trend of the treatment zone (TZ) during 12 months of Orthokeratology (Ortho-K) from the perspective of the treatment zone size (TZS), decentration (TZD) and the weighted Zernike defocus coefficient of the treatment zone (Cweighteddefocus). METHODS 94 patients were included in this retrospective study, who were fitted with a 5-curve vision shaping treatment (VST) lens (n = 44) or a 3-zone corneal refractive therapy (CRT) lens (n = 50). The TZS, TZD and Cweighteddefocus up to 12 months were analyzed. RESULTS TZS (F(4,372) = 10.167, P<0.001), TZD (F(4,372) = 8.083, P<0.001) and Cweighteddefocus (F(4,372) = 7.100, P<0.001) were significantly increased with time during overnight Ortho-K treatment. The TZS increased sharply from 1 week to 1 month of overnight Ortho-K (F = 25.479, P <.001) and stayed smooth then. It showed growing tendency from 6 to 12 months (F = 8.407, P =.005). The TZD (F = 16.637, P <.001) and Cweighteddefocus (F = 13.401, P <.001) increased significantly until 1 month and kept stable until 12 months (all P>0.05). The univariant linear regression analysis showed that TZS of the last visit was correlated with baseline myopia (β = 0.219, P =.034). Also, the greater final Cweighteddefocus was correlated with higher baseline myopia (β = -0.589, P<0.001) and higher corneal astigmatism (β = -0.228, P =.007) at the onset of lens wear with the multiple linear regression. CONCLUSION The TZS, TZD and Cweighteddefocus kept stable after 1 month of Ortho-K while the TZS had an increasing trend after 6 months. Children with higher myopic eyes or higher corneal astigmatism at baseline tended to have smaller TZS and greater Cweighteddefocus at 12 months.
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Affiliation(s)
- Jingxin Li
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China
| | - Jie Hu
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China
| | - Xuewei Li
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China
| | - Jiyang Tang
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China
| | - Yan Li
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China.
| | - Mingwei Zhao
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China
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Yang Y, Wu Q, Tang Y, Wu H, Luo Z, Gao W, Hu Z, Hou L, Wang M, Yang Z, Li X. Short-term application of diquafosol ophthalmic solution benefits children with dry eye wearing orthokeratology lens. Front Med (Lausanne) 2023; 10:1130117. [PMID: 37521335 PMCID: PMC10374404 DOI: 10.3389/fmed.2023.1130117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/20/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose This aim of this study was to evaluate the effect of 3% Diquafosol Ophthalmic Solution (DQS) on children with dry eye from wearing overnight orthokeratology (OrthoK) lenses. Methods Myopic children aged 8-18 years with dry eye syndrome were enrolled in this prospective observational study, and they were grouped according to their OrthoK treatment history for at least 1 year. All participants received DQS 4 times per day for 1 month. The following indicators were measured at baseline 1 month after treatment: the Dry Eye Questionnaire-5 (DEQ-5), non-invasive tear meniscus height (TMH), non-invasive tear film break-up time (first and average, NIBUT-F and NIBUT-A), meibomian gland score (MG score), conjunctival hyperemia redness score (R-scan), and blink pattern analysis. Results A total of 104 participants (189 eyes) including 40 OrthoK wearers (72 eyes) and 64 Orthok candidates (117 eyes) completed the study. Of all, after DQS treatment for 1 month, DEQ-5 scores reduced from 5.54 ± 3.25 to 3.85 ± 2.98 (t = -3.36, p = 0.00). TMH increased from 0.20 ± 0.05 mm to 0.21 ± 0.05 mm (t = 2.59, p = 0.01), NIBUT-F and NIBUT-A were prolonged from 6.67 ± 4.71 s to 10.32 ± 6.19 s and from 8.86 ± 5.25 s to 13.30 ± 6.03 s (all p = 0.00), respectively. R-scan decreased from 0.69 ± 0.28 to 0.50 ± 0.25 (t = -9.01, p = 0.00). Upper MG scores decreased from 1.04 ± 0.32 to 0.97 ± 0.36 (t = -2.14, p = 0.03). Lower MG scores, partial blink rate, partial blinks, and total blinks did not change significantly. Both break-up time (BUT) and R-scan improved significantly after DQS treatment for 1 month (all p = 0.00) in OrthoK candidates and OrthoK wearers. Among the OrthoK wearers, TMH and dry eye symptoms increased significantly (all p = 0.00) but did not increase in OrthoK candidates (p > 0.05). There were no adverse events related to DQS. Conclusion Diquafosol Ophthalmic Solution was effective for children wearing overnight orthokeratology in relieving dry eye symptoms and improving ocular surface parameters, which may help improve children's OrthoK wearing tolerance and compliance.
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Affiliation(s)
- Yuanfang Yang
- Aier School of Ophthalmology, Central South University, Changsha, China
- Aier Institute of Optometry and Vision Science, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
| | - Qinghui Wu
- Changsha Aier Eye Hospital, Changsha, China
| | - Yao Tang
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Haoran Wu
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Zhiwei Luo
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Wenyu Gao
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Ziqi Hu
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Lijun Hou
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Min Wang
- Shanghai Aier Eye Hospital, Shanghai, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, China
- Aier Institute of Optometry and Vision Science, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
- Changsha Aier Eye Hospital, Changsha, China
| | - Xiaoning Li
- Aier Institute of Optometry and Vision Science, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
- Changsha Aier Eye Hospital, Changsha, China
- Aier College of Ophthalmology and Optometry, Hubei University of Science and Technology, Xianning, China
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Ruan J, Zhang Y, Chen Y. Influence of overnight orthokeratology on tear film and meibomian glands in myopic children: a prospective study. BMC Ophthalmol 2023; 23:136. [PMID: 37013481 PMCID: PMC10071684 DOI: 10.1186/s12886-023-02883-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/24/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Orthokeratology lenses, which are worn overnight, are recommended for reducing myopia progression. They lie on the cornea and can influence the ocular surface by temporarily reshaping the corneal surface through a reverse geometry design. This study investigated the effect of overnight orthokeratology lenses on tear film stability and meibomian gland status in children aged 8-15 years. METHODS This prospective, self-controlled study included 33 children with monocular myopia who were prescribed orthokeratology lenses for at least one year. The experimental group (ortho-k group) comprised 33 myopic eyes. The control group comprised the emmetropic eyes of the same participants. Tear film stability and meibomian gland status were measured using a Keratograph 5M (Oculus, Wetzlar, Germany). Paired t-tests and Wilcoxon signed-rank tests were used to compare the data between the two groups. RESULTS At the one-year visit, the non-invasive first tear film break-up time (NIBUTf) values were 6.15 ± 2.56 s and 6.18 ± 2.61 s in the experimental and control groups, respectively. The lower tear meniscus height was 18.74 ± 0.05 μm and 18.65 ± 0.04 μm in these groups, respectively. No significant difference was observed in loss of meibomian glands or non-invasive average tear film break-up time between the experimental and control groups using Wilcoxon signed-rank tests. CONCLUSIONS The stability of the tear film and meibomian gland status were not significantly affected by wearing orthokeratology lenses overnight, indicating that continuous use of orthokeratology lenses for 12 months has a minimal effect on the ocular surface. This finding can help guide the clinical management of tear film quality with respect to the use of orthokeratology contact lenses.
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Affiliation(s)
- Jing Ruan
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Yu Zhang
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Huayuan Road, Haidian District, Beijing, 100191, China.
| | - Yueguo Chen
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Huayuan Road, Haidian District, Beijing, 100191, China.
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Orthokeratology in adults and effect on quality of life. Cont Lens Anterior Eye 2023; 46:101824. [PMID: 36898875 DOI: 10.1016/j.clae.2023.101824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE To determine changes in various ocular parameters of adults wearing orthokeratology (ortho-k) lenses and their levels of satisfaction and quality of life (QoL) after commencing treatment. METHODS Adults aged 18-38 years, with mild to moderate myopia and astigmatism < 1.50D, were wearing ortho-k lenses for one year. Data collection, which included history taking, refraction, axial length (AL), corneal topography, corneal biomechanics, and biomicroscopy examination, was performed at baseline and every 6 months during the study period. The level of satisfaction with the treatment and QoL was determined via questionnaires. RESULTS Forty-four subjects completed the study. AL was shortened significantly at the 12-month visit: AL -0.03 (-0.45 to 0.13) mm compared to baseline (p < 0.05). A significant number of subjects in both groups presented with overall and central corneal staining, but the majority were mild (Grade 1). Central endothelial cell density was reduced by 40/mm2 (loss rate 1.4 %) (p < 0.05). High scores were obtained in the satisfaction questionnaire, with no significant differences between visits. At the 12-month visit, NEI-RQL-42 total score, dependence on correction, activity limitation, appearance, and satisfaction with the treatment all significantly increased compared to baseline values. CONCLUSIONS Results suggest that ortho-k can be an effective and safe myopia correction technique for adults with low to moderate myopia, improving daytime vision without serious adverse events. Satisfaction with ortho-k lens wear was high, particularly those who were dependent on vision correction and found spectacles or contact lenses limiting specific activities or cosmetically undesirable.
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Lau JK, Wan K, Cho P. Orthokeratology lenses with increased compression factor (OKIC): A 2-year longitudinal clinical trial for myopia control. Cont Lens Anterior Eye 2023; 46:101745. [PMID: 35995721 DOI: 10.1016/j.clae.2022.101745] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 07/28/2022] [Accepted: 08/06/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE To investigate the effectiveness of orthokeratology (ortho-k) lenses and corneal changes with increased compression factor for myopia control over a 2-year period. METHODS Young participants (age: 6-<12 years), with low myopia (0.50-4.00 D) and low astigmatism (≤1.25 D), were recruited and allowed to choose to wear either single-vision spectacles or ortho-k lenses (randomly assigned to compression factor of either 0.75 or 1.75 D). Axial length and cycloplegic refraction were measured at six monthly intervals for two years by a masked examiner. The myopia control effectiveness was determined by axial elongation. RESULTS A significant number of control (63 %) dropped out, mainly due to concern about myopia progression (58 %). A total of 75 participants (mean age: 9.3 ± 1.0 years; control: n = 11, ortho-k [0.75 D]: n = 29, ortho-k [1.75 D]: n = 35) completed the study. Considering ortho-k groups only, the mean axial elongation of participants wearing ortho-k lenses of conventional compression factor (0.75 D) and increased compression factor (1.75 D) were 0.53 ± 0.29 and 0.35 ± 0.29 mm, respectively, over the 2-year study period. The between-group differences in corneal health were not significant at all visits. CONCLUSION Participants wearing ortho-k lenses of increased compression factor further slowed axial elongation by 34%, when compared with the conventional compression factor without compromising corneal health. Further investigations are warranted to confirm the potential mechanism of an increased compression factor for improved myopia control effectiveness.
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Affiliation(s)
- Jason K Lau
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Kin Wan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Wu J, Fang W, Xu H, Liu X, Zhao D, Rong Q. The Biomechanical Response of the Cornea in Orthokeratology. Front Bioeng Biotechnol 2021; 9:743745. [PMID: 34708026 PMCID: PMC8542762 DOI: 10.3389/fbioe.2021.743745] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Orthokeratology has been widely used to control myopia, but the mechanism is still unknown. To further investigate the underlying mechanism of corneal reshaping using orthokeratology lenses via the finite element method, numerical models with different corneal curvatures, corneal thicknesses, and myopia reduction degrees had been developed and validated to simulate the corneal response and quantify the changes in maximum stress in the central and peripheral corneal areas during orthokeratology. The influence of the factors on corneal response had been analyzed by using median quantile regression. A partial eta squared value in analysis of variance models was established to compare the effect size of these factors. The results showed central and peripheral corneal stress responses changed significantly with increased myopia reduction, corneal curvature, and corneal thickness. The target myopia reduction had the greatest effect on the central corneal stress value (partial eta square = 0.9382), followed by corneal curvature (partial eta square = 0.5650) and corneal thickness (partial eta square = 0.1975). The corneal curvature had the greatest effect on the peripheral corneal stress value (partial eta square = 0.5220), followed by myopia reduction (partial eta square = 0.2375) and corneal thickness (partial eta square = 0.1972). In summary, the biomechanical response of the cornea varies significantly with the change in corneal conditions and lens designs. Therefore, the orthokeratology lens design and the lens fitting process should be taken into consideration in clinical practice, especially for patients with high myopia and steep corneas.
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Affiliation(s)
- Jinfang Wu
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Wenxuan Fang
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Huiwen Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Xiaode Liu
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China.,X Lab, the Second Academy of CASIC, Beijing, China
| | - Dongliang Zhao
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
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Chen S, Jin Z, Zheng G, Ye S, Wang Y, Wang W, Wang Y, Zhu D, Shen M, Lu F. Diurnal variation of corneal elasticity in healthy young human using air-puff optical coherence elastography. JOURNAL OF BIOPHOTONICS 2021; 14:e202000440. [PMID: 33389817 DOI: 10.1002/jbio.202000440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/15/2020] [Accepted: 12/30/2020] [Indexed: 06/12/2023]
Abstract
Due to the disruption of intraocular pressure (IOP) and central corneal thickness (CCT), diurnal variation in normal young human corneal elasticity is not clear. Using the custom-built air-puff optical coherence elastography, one eye of 21 normal subjects is enrolled randomly to measure the central corneal elasticity, IOP, and CCT in different time points within a day. Based on the multi-level model, the corneal elastic modulus is found to have a linear positive relation with IOP (P < .01) but not CCT (P = .175) and time point (P = .174-.686). A new indicator, corneal elasticity change rate, is proposed to present the magnitude of corneal elasticity change caused by 1 mmHg IOP, which can correct the interference effect of IOP. The results show that the corneal elasticity in the normal young human does not have the characteristics of diurnal variation under IOP control. Furthermore, IOP plays an important role in the corneal elasticity, and corneal elasticity change rate can increase the comparability of results between individuals.
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Affiliation(s)
- Sisi Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zi Jin
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Biomedical Engineering, College of Engineering, Peking University, Wenzhou, Beijing, China
| | - Gu Zheng
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shuling Ye
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yiyi Wang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weicheng Wang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuanyuan Wang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Dexi Zhu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Meixiao Shen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fan Lu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
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12
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Guo B, Lau JK, Cheung SW, Cho P. Repeatability and reproducibility of manual choroidal thickness measurement using Lenstar images in children before and after orthokeratology treatment. Cont Lens Anterior Eye 2021; 45:101484. [PMID: 34303626 DOI: 10.1016/j.clae.2021.101484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To investigate the repeatability and reproducibility of choroidal thickness measurements using Lenstar images in young myopic children before and after one-month orthokeratology (ortho-k) treatment. METHOD Ocular biometry of 39 subjects were performed using the Lenstar 900. The first five measurements with maximum differences of 0.02 mm in axial length in the right eyes were saved and used for measurement of choroidal thickness. Subfoveal choroidal thickness were manually measured by identifying the signals from the retinal pigmented epithelium layer and chorioscleral interface. Repeatability was determined by comparing measurements of the same images made by the same observer on two separate occasions (four weeks apart), while reproducibility was calculated by comparing measurements of the same images made by two independent observers. Data was analysed using intra-class correlation coefficients (ICC) and non-parametric Bland and Altman plots. RESULTS The choroidal peaks could not be identified in all five measurements in all subjects. On average, only 71% subjects had at least four definable images. Compared with the use of fewer than four images, reliability using an average of four definable images improved statistically, but remained clinically unacceptable (>10 µm), although pre- and post-ortho-k ICC values were good to excellent for repeatability (0.867 and 0.975, respectively) and excellent and good for reproducibility (0.959 and 0.868, respectively). Non-parametric pre- and post-ortho-k limits of agreement (2.5% and 97.5% percentiles) obtained were -45.8 to 79.3 µm and -30.3 to 9.5 µm, respectively for repeatability, and -29.0 to 33.5 µm and -21.8 to 70.0 µm, respectively for reproducibility. CONCLUSION Choroidal thickness measurements using the Lenstar did not show good reliability, despite the high ICC values, non-parametric Bland and Altman plots demonstrated a wide variability of measurement errors. Any changes in subfoveal choroidal thickness, measured by Lenstar, of <80 µm may not represent real changes.
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Affiliation(s)
- Biyue Guo
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region.
| | - Jason K Lau
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
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He Y, Liu L, Vincent SJ. Compression Factor and Visual Performance in Adults Treated With Orthokeratology. Eye Contact Lens 2021; 47:413-419. [PMID: 33974574 DOI: 10.1097/icl.0000000000000796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To investigate the effect of compression factor on visual performance in orthokeratology (ortho-k). METHODS Myopic adults were fitted with ortho-k lenses with either a 0.75 diopter (D) or 1.75 D compression factor. Higher-order aberrations (HOAs), corneal topography, and responses to the National Eye Institute/Refractive Error Quality of Life Instrument-42 questionnaire were measured at baseline and 6-month and 12-month follow-up along with a satisfaction questionnaire. Subjective refraction, high-contrast, and low-contrast visual acuity were measured at baseline and 1-day, 1-week, 6-month, and 12-month follow-up. RESULTS Forty-four myopic (mean spherical equivalent refraction: -3.66±0.84 D) adults (median age 25 years) completed the 12-month follow-up. After ortho-k lens wear, levels of satisfaction of vision after waking were significantly higher than vision before sleep for both compression factors (both P<0.01). The increased compression factor (ICF) resulted in less myopia at the 1-week visit (P=0.04) and better high-contrast unaided visual acuity at the 1-day visit (P=0.03) compared with the conventional compression factor (CCF). No other significant differences were observed for the compression factor for treatment zone diameter, lens decentration, or any subjective measurements. Individual HOA terms , , , and were significantly higher in the CCF group (0.75 D) (all P<0.05). The HOA visual Strehl ratio decreased significantly after lens wear (P<0.001) but did not vary with the compression factor. CONCLUSIONS An ICF did not result in clinically significant differences in subjective refraction, visual acuity, unaided vision, or the total ocular HOA profile compared with a CCF (0.75 D) in myopic adults after long-term ortho-k lens wear.
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Affiliation(s)
- Yuanhao He
- Department of Optometry and Visual Science (Y.H.), West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology (L.L.), West China Hospital, Sichuan University, Chengdu, China; and Contact Lens and Visual Optics Laboratory (S.J.V.), Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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14
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Wan K, Yau HT, Cheung SW, Cho P. Corneal thickness changes in myopic children during and after short-term orthokeratology lens wear. Ophthalmic Physiol Opt 2021; 41:757-767. [PMID: 33878198 DOI: 10.1111/opo.12824] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/08/2021] [Indexed: 01/02/2023]
Abstract
PURPOSE To evaluate thickness changes in the central and mid-peripheral cornea (CCT and mPCT), corneal epithelium (CET and mPET) and stroma (CST and mPST) of myopic children during and after short-term orthokeratology (ortho-k) lens wear, with conventional (CCF, 0.75 D) and increased compression factors (ICF, 1.75 D). METHODS This was a self-controlled case series study. Subjects wore a CCF lens in one eye and an ICF lens in the other. Anterior segment optical coherence tomography images were captured weekly for 1 month during lens wear and for 2 weeks after discontinuing lens wear. CCT and CET (central 3-mm cornea) and mPCT and mPET (within a 4-6 mm diameter annulus) were measured. Stromal thickness (ST) was determined by subtracting epithelium thickness (ET) from corneal thickness (CT). The repeatability of the analytical software was also investigated on age-matched spectacle-wearing subjects (n = 98). RESULTS Excluding three outliers (>3 S.D.s), the coefficient of repeatability and intraclass correlation coefficients of 98 spectacle-wearing subjects ranged from 2.63 to 4.64 μm and from 0.90 to 0.99, respectively. For the weekly-change study, CCT and CET in both eyes were significantly thinner after lens wear (p < 0.001) and CET thinning in the ICF eyes were significantly higher (p < 0.02). CCT changes were mainly contributed by CET. CST, mPCT, mPET and mPST changes were not significant (p > 0.20) in either eye. CT (all sublayers) rebounded to baseline values 2 weeks after discontinuing lens wear (0.99 > p > 0.12). CONCLUSIONS Significant reductions in CT and ET, but not ST, were observed within 1 month of ortho-k lens wear. Wearing ICF lenses resulted in a higher reduction in CET. Corneal thickness changes were reversible after discontinuing lens wear.
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Affiliation(s)
- Kin Wan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Hing Tuen Yau
- Information Technology Services, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
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15
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Vincent SJ, Cho P, Chan KY, Fadel D, Ghorbani-Mojarrad N, González-Méijome JM, Johnson L, Kang P, Michaud L, Simard P, Jones L. CLEAR - Orthokeratology. Cont Lens Anterior Eye 2021; 44:240-269. [DOI: 10.1016/j.clae.2021.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/25/2022]
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Hu P, Zhao Y, Chen D, Ni H. The safety of orthokeratology in myopic children and analysis of related factors. Cont Lens Anterior Eye 2020; 44:89-93. [PMID: 32912740 DOI: 10.1016/j.clae.2020.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/27/2020] [Accepted: 08/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the safety of overnight orthokeratology (OK) wear and explore whether factors such as age, refraction and allergic conjunctivitis (AC) history were associated with corneal adverse events (AEs) incidence. METHODS Medical records of consecutive patients who started OK for myopia correction and continued for more than one year were retrospectively reviewed. Clinical data including sex, baseline age, spherical equivalent refraction (SER), and related medical histories were retrieved. A total of 489 eyes from 260 patients (age: 8-15 years; SER: -1.00 to -6.00 D) were included. Corneal adverse events were the primary outcome. The generalized estimating equations model was used to evaluate the effects of sex, age, SER, and allergic conjunctivitis history on corneal AE incidence over the one-year period. RESULTS A total of 111 eyes (22.7%) had corneal AE during the one-year follow-up (corneal staining [n = 106], corneal infiltration [n = 5]) and the incidence of significant AE was 6.9%. The corneal AE incidence was associated with age (OR = 0.874, 95%CI = 0.781-0.978, p = 0.019); SER (OR=0.632, 95%CI=0.531-0.754, p < 0.001); and AC (OR=1.706, 95%CI=1.017-2.860, p = 0.043). High refraction was the key risk factor for significant AE (OR=0.542, 95%CI=0.401-0.732, p < 0.001). CONCLUSIONS Orthokeratology is a safe option for children with myopia. Younger age, higher myopia, and AC were risk factors for corneal AE in OK wearers. Whereas, only higher myopia was a risk factor for significant AE.
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Affiliation(s)
- Peike Hu
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Eye Center, Hangzhou, Zhejiang, China
| | - Yingying Zhao
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Eye Center, Hangzhou, Zhejiang, China
| | - Duya Chen
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Eye Center, Hangzhou, Zhejiang, China
| | - Hailong Ni
- The Second Affiliated Hospital, Zhejiang University School of Medicine, Eye Center, Hangzhou, Zhejiang, China.
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Wan K, Lau JKK, Cheung SW, Cho P. Orthokeratology with increased compression factor (OKIC): study design and preliminary results. BMJ Open Ophthalmol 2020; 5:e000345. [PMID: 32420450 PMCID: PMC7223350 DOI: 10.1136/bmjophth-2019-000345] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 03/02/2020] [Accepted: 04/17/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To present the study design and the baseline data of a prospective cohort study investigating the safety, refractive correction and effectiveness of myopia control in subjects fitted with orthokeratology (ortho-k) lenses of different compression factors. METHODS AND ANALYSIS This study is a 2-year longitudinal, double-masked, partially randomised study. Myopic children aged between 6 and 10 years are recruited and they may choose to participate in either the ortho-k or spectacle-wearing group. Subjects in the ortho-k group are randomly assigned to wear ortho-k lenses of either conventional compression factor (CCF, 0.75 D) or increased compression factor (ICF, 1.75 D). For the ortho-k subjects, the time and between-group effects within the first month of lens wear were analysed. RESULTS Sixty-nine ortho-k subjects (CCF: 34; ICF: 35) and 30 control subjects were recruited. There were no significant differences in baseline demographic data among the three groups of subjects (p>0.19). At the 1-month visit, the first fit success rates were 97% and 100% in the CCF and ICF ortho-k group, respectively. A higher percentage of ICF subjects could achieve full correction (CCF: 88.2%; ICF: 94.3%). The change in axial length was significantly higher in the ICF group (CCF, 0.003 mm; ICF, -0.031 mm) (p<0.05). No significant between-group differences in daytime vision or in the coverage and depth of corneal staining between the two ortho-k groups (p>0.05) were observed at any visit. CONCLUSION ICF did not compromise the corneal integrity and the lens centration within the first month of lens wear. The preliminary performance of ortho-k lenses with ICF of 1.00D shows that it was safe to be used in the longer term for the investigation of myopia control. TRIAL REGISTRATION NUMBER NCT02643342.
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Affiliation(s)
- Kin Wan
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jason Ki-Kit Lau
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Sin Wan Cheung
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
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Ren Q, Yang B, Liu L, Cho P. Orthokeratology in adults and factors affecting success: Study design and preliminary results. Cont Lens Anterior Eye 2020; 43:595-601. [PMID: 32371038 DOI: 10.1016/j.clae.2020.03.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To report the study design and one month's preliminary results of a randomized, single-masked, one-year prospective study of orthokeratology (ortho-k) in adults wearing lenses of different compression factors. METHODS Adults aged 18-38 years, with myopia of -0.75 to -5.00 D and astigmatism < 1.50 D, were recruited and randomly assigned into two groups: a conventional compression factor or Jessen Factor (CCF) group (compression factor = 0.75 D) and an increased (extra 1.00D) compression factor (ICF) group. Clinical outcomes, including spherical equivalent refraction (SER) reduction, visual acuity, corneal hysteresis (CH) and corneal resistance factor (CRF), and signs and symptoms were collected at the one-month follow-up visit. Indicators of the level of satisfaction and quality of life after commencing treatment were determined via a satisfaction questionnaire and the NEI-RQL-42 questionnaire. RESULTS Baseline data from 26 CCF and 24 ICF participants were analysed and no significant differences were observed between the two groups (p > 0.05). The first fit success rates were 90 % for CCF group and 83 % for the ICF group, SER reductions were 97 % and 95 % for the CCF and ICF group, respectively, with uncorrected high-contrast visual acuity of -0.06 (-0.18 to 0.42) and 0.00 (-0.16 to 0.52), respectively (p > 0.05) at the 1-month visit. Overall, the incidence of corneal staining was 77 % in the CCF and 79 % in ICF group; central corneal staining was 15 % and 33 %, respectively. However, the differences of corneal staining between the groups did not reach significance in any visit (p > 0.05). The main complaint from participants was glare (both groups). No significant differences in CRF and CH were found in the first month (p > 0.05). Both groups recorded high scores in the level of satisfaction questionnaire, with no significant differences between groups (p > 0.05). Compared with baseline scores, 1-month NEI-RQL-42 subscales of dependence on correction, appearance, and satisfaction with correction significantly increased, and the glare score significantly decreased in both groups (all p < 0.05). CONCLUSIONS The majority of participants were satisfied with the treatment and no serious corneal adverse effects were observed. These results demonstrate that ortho-k lenses of default and increased compression factor (1D) demonstrated similar clinical performance and ortho-k can be a safe and well-accepted option for myopia correction in adults, but long-term observation is warranted.
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Affiliation(s)
- Qiangemai Ren
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China.
| | - Bi Yang
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
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