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Zhang S, Zhu H, Zhang L, Gao M, Liu C, Zhao Q. Effects of orthokeratology on corneal reshaping and the delaying of axial eye growth in children. Heliyon 2024; 10:e33341. [PMID: 39022009 PMCID: PMC11253518 DOI: 10.1016/j.heliyon.2024.e33341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 06/19/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Purpose To investigate the inhibition of myopia progression and axial elongation in children wearing orthokeratology (OK) lenses, as well as to evaluate the status of corneal reshaping, this study explores the relationship between changes in central corneal curvature (K-value) and e-value induced by OK lenses and axial elongation. Methods In this study, it is planned to select children aged 8-15 who wear orthokeratology lenses at the Pediatric Ophthalmology and Strabismus Clinic of the Second Affiliated Hospital of Dalian Medical University. All children will undergo slit lamp examination, visual acuity assessment, computerized refraction, intraocular pressure measurement, biometry, and corneal topography examination before lens wear and at 1 month, 3 months, and 6 months after lens wear in the pediatric ophthalmology clinic. Based on age (lower age group (8 < age ≤12 years); higher age group (12 < age ≤15 years)) and baseline equivalent spherical (SE) value (mild myopia group (-1.00 D < SE ≤ -3.25D); moderate myopia group (-3.25 D < SE ≤ -6.00 D)), four groups will be formed by pairing these factors. Suitable data will be selected according to inclusion and exclusion criteria, and different groups will be included. Data will be organized, and statistical analysis will be performed using SPSS software to obtain the results. The expected results will be discussed and analyzed. Results After wearing OK lenses, all four groups achieved good visual acuity at follow-up. At 6 months, there were no significant differences in visual acuity among the four groups (P = 0.149, >0.05). There were no significant differences in refractive error among the four groups (P = 0.066, >0.05). Baseline axial length differed significantly among the four groups (P = 0.000, <0.001), with the LM group having longer axial length than the LL group (P < 0.001, paired samples t-test), and the HM group having longer axial length than the HL group (P < 0.001, paired samples t-test). However, there were no significant differences in axial length change compared to baseline among the groups at 1 month, 3 months, and 6 months (P 1 = 0.053; P 3 = 0.557; P 6 = 0.329, >0.05). Significant differences were observed in corneal flat K-value change compared to baseline among the four groups at 1 month, 3 months, and 6 months (P 1 = 0.001, P 3 = 0.001, P 6 = 0.004, <0.05). There were no significant differences in e-value change among the groups at 1 and 3 months (P 1 = 0.205, P 3 = 0.252, >0.05), but significant differences were found in e-value change compared to baseline at 6 months (P 6 = 0.010, <0.05). Multiple regression analysis with changes in central corneal flat K-value and e-value as independent variables and axial elongation as the dependent variable showed a correlation between e-value change at 6 months and axial elongation (P = 0.004, <0.05), indicating a negative correlation. Conclusion Orthokeratology (OK) lenses effectively improve myopic children's vision by reshaping the cornea, leading to reduced central corneal curvature and flattening of its anterior surface. The effectiveness of OK lenses is not significantly affected by age or initial myopia severity. Children of varying ages and myopia levels experience similar levels of axial length control with OK lens wear. Changes in corneal shape due to OK lenses affect axial elongation, with greater changes in corneal morphology associated with smaller increases in axial length.
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Affiliation(s)
- Siqi Zhang
- Second Affiliated Hospital of Dalian Medical University, China
| | - Huailin Zhu
- Second Affiliated Hospital of Dalian Medical University, China
| | - Lan Zhang
- Second Affiliated Hospital of Dalian Medical University, China
| | - Mingjun Gao
- Second Affiliated Hospital of Dalian Medical University, China
| | - Changyang Liu
- Second Affiliated Hospital of Dalian Medical University, China
| | - Qi Zhao
- Second Affiliated Hospital of Dalian Medical University, China
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Sun Y, Peng Z, Zhao B, Hong J, Ma N, Li Y, Tang S, Xu Q, Hong H, Wang K, Fu J, Wei WB. Comparison of trial lens and computer-aided fitting in orthokeratology: A multi-center, randomized, examiner-masked, controlled study. Cont Lens Anterior Eye 2024:102172. [PMID: 38806329 DOI: 10.1016/j.clae.2024.102172] [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: 11/15/2023] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE To compare the efficacy and safety between traditional lens fitting and computer-aided fitting methods for orthokeratology (OrthoK) in the Chinese population. METHODS A multi-center, examiner-masked, randomized controlled study was conducted with a one-year follow-up period, enrolling 280 participants with spherical equivalent (SE) ranging from -0.5D to -4.0D. Participants were assigned to either the computer-aided orthokeratology fitting group (trial group) or the traditional lens fitting group (control group) using stratified randomization based on age (8 to 13 years, 13 to 18 years, and ≥ 18 years) to ensure a minimum of 30 cases in each sub-age group. Ocular examinations included visual acuity, objective and subjective refraction, corneal endothelial cell density, corneal topography, intraocular pressure, axial length, and ocular health assessment. Successful lens-correction was defined as the residual refraction with the OK lens, which should not exceed ± 0.5D, and/or an uncorrected visual acuity of no worse than 0.1 logMAR. Statistical analysis involves t-tests, analysis of variance, and Chi-squared tests. RESULTS 215 subjects were included in the statistical analysis (109 in the trial group and 106 in the control group). In both groups, compared to baseline data, the uncorrected visual acuity (UCVA) improved significantly, with SE reduced and central corneal curvature flattened greatly after wearing OrthoK lens (P < 0.05 for all). Compared to the control group, the trial group exhibited a higher successful rate in correcting UCVA (93.6 % vs. 84.0 %, P = 0.03) and slightly better correction in refraction (77.1 % vs. 66.0 %, P = 0.07) at 1-month follow-up. However, no significant differences were observed in the axial length elongation, corneal changes, or the incidence of adverse events between the two groups. CONCLUSION These findings indicate the higher efficiency and slightly better performance in correcting myopia and improving UCVA of computer-aided lens fitting approach compared to the traditional one, but similar outcomes in controlling axial elongation.
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Affiliation(s)
- Yunyun Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Zisu Peng
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China; College of Optometry, Peking University Health Science Center, Beijing, China; Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Bowen Zhao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jie Hong
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Nan Ma
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China; College of Optometry, Peking University Health Science Center, Beijing, China; Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Simeng Tang
- Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing, China
| | - Qiong Xu
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China; College of Optometry, Peking University Health Science Center, Beijing, China; Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Hui Hong
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China; College of Optometry, Peking University Health Science Center, Beijing, China; Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.
| | - Wen-Bin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China; Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing, China.
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Yang Y, Wu Q, Pan W, Wen L, Luo Z, Wu H, Ran G, Yang Z, Li X. Characteristics of the Ocular Surface in Myopic Child Candidates of Orthokeratology Lens Wear. Ophthalmol Ther 2023; 12:3067-3079. [PMID: 37665499 PMCID: PMC10640462 DOI: 10.1007/s40123-023-00793-y] [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: 06/02/2023] [Accepted: 08/09/2023] [Indexed: 09/05/2023] Open
Abstract
INTRODUCTION The purpose of this study was to investigate the characteristics of objective ocular surface parameters using non-invasive objective instruments in children with myopia who are candidates for orthokeratology lens wear. METHODS Children with myopia who are candidates for orthokeratology lens wear were retrospectively investigated. The subjects were divided into three age groups. The Keratograph 5M and LipiView interferometry were used to assess non-invasive tear meniscus height (TMH), non-invasive tear film break-up time (NIBUT), conjunctival hyperemia redness score (RS), meibomian gland loss (MGL) score, lipid layer thickness (LLT), and blink pattern analysis, including the number of partial blinks (PB) and total blinks (TB), as well as the partial blink rate (PBR). RESULTS A total of 1119 children with myopia (2070 eyes) aged 7-18 years were selected. The mean TMH, NIBUT, and LLT of the subjects was 0.21 mm, 12.45 s, and 65.28 nm, respectively. The mean RS and upper and lower MGL scores were 0.64, 1.00, and 1.06, respectively. The mean PB, TB, and PBR was 5.13, 6.46, and 0.81, respectively. Age was significantly correlated to all ocular surface parameters (p = 0.00), except for PB. NIBUT and LLT did not differ between male participants and female participants (all p > 0.05). TMH, RS, and upper and lower MGL were significantly higher in male participants than in female participants (all p < 0.01). In addition, NIBUT was positively associated with TMH (r = 0.13, p = 0.00) and LLT (r = 0.28, p = 0.00). Both upper and lower MGL were positively correlated with TMH, PB, and TB (all p = 0.00), whereas upper MGL was negatively correlated with NIBUT and LLT (all p < 0.05). TB was negatively correlated with NIBUT and LLT (all p = 0.00). PB had no relation with TMH, NIBUT, and LLT (all p > 0.05). In addition, PBR was positively correlated with NIBUT and LLT (all p = 0.00) but not with TMH, RS, or MGL (all p > 0.05). Overall, 57.00% had a TMH ≤ 0.2 mm, 43.20% had a NIBUT ≤ 10 s, 48.10% had an LLT ≤ 60 nm, and 88.10% had a PBR > 0.4. CONCLUSIONS Child orthokeratology candidates have enhanced tear secretion and increased meibomian gland deficiency with aging. In addition, the adult dry eye diagnostic criteria may apply to orthokeratology candidates aged 12-18 years but should be lower for younger candidates. Given the proportion of abnormal risk, it is necessary to assess tear film status and blink pattern by reliable and feasible objective examination before fitting orthokeratology.
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Affiliation(s)
- Yuanfang Yang
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, 410015, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, 410015, China
| | - Qinghui Wu
- Changsha Aier Eye Hospital, Changsha, 410015, China
| | - Wei Pan
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Longbo Wen
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Zhiwei Luo
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Haoran Wu
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Guangyao Ran
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
- Changsha Aier Eye Hospital, Changsha, 410015, China
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, 410015, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, 410015, China
| | - Xiaoning Li
- Changsha Aier Eye Hospital, Changsha, 410015, China.
- Aier College of Ophthalmology & Optometry, Hubei University of Science and Technology, Xianning, 437000, China.
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China.
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, 410015, China.
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, 410015, China.
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Chen Y, Liu M, Lu H, Zhang Y, Luo D, Pan H, Wan C, Szentmáry N, Shi L. Impact of Overnight Wear of Orthokeratology Lens on Thickness of Tear Film Lipid Layer in Children with Myopia. Klin Monbl Augenheilkd 2023; 240:1151-1157. [PMID: 35858655 DOI: 10.1055/a-1905-1998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND To elucidate the influence of overnight wear of orthokeratology (OOK) lenses on the thickness of the tear lipid layer (LLT). METHODS We conducted a retrospective cross-sectional study of children who visited The First Affiliated Hospital of USTC between July and September 2021. LLT and blinking dynamics were assessed. Diopters and corneal topography were also recorded. RESULTS The number of children enrolled in this program was 402 (804 eyes). One hundred and seventy-one children (342 eyes, 79 males and 92 females) aged 4 - 17 years (10.59 ± 2.54 years) who never wore OOK were included in the control group, while 231 children (462 eyes, 121 males and 110 females) aged 7 - 18 years (11.09 ± 2.24 years) who wore OOK for more than 1 week were included in the observation group. Compared to the control group with an LLT of 58.5 ± 18.19 nm, the OOK group exhibited a significant decrease in the LLT value to 54.42 ± 17.60 nm. In addition, the LLT in females was significantly thicker than that in males in both the control (male 54.78 ± 16.56 nm, female 61.70 ± 18.95 nm) and observation groups (male 51.88 ± 16.68 nm, female 57.21 ± 18.18 nm). It is worth noting that the influence of wearing OOK on the LLT value was only detected up to 18 months. Eighteen months later, there was almost no difference in LLT between the control and observation groups. We also noted that there was no change in LLT correlated to the surface regularity index/surface asymmetry index. CONCLUSION Wearing OOK can affect tear film LLT within the first 18 months after wear. More attention should be given to children wearing OOK for less than 18 months, especially males.
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Affiliation(s)
- Yuanyuan Chen
- Graduate School, Bengbu Medical College, Bengbu, China
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Ming Liu
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Huayi Lu
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yong Zhang
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Dan Luo
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Hongbiao Pan
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Chuan Wan
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Nóra Szentmáry
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Homburg (Saar), Germany
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Lei Shi
- Graduate School, Bengbu Medical College, Bengbu, China
- Department of Ophthalmology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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Yuan W, Zhao F, Liu X, Xu J. Development of corneal contact lens materials and current clinical application of contact lenses: A review. Biointerphases 2023; 18:050801. [PMID: 37756594 DOI: 10.1116/6.0002618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Unlike conventional glasses, corneal contact lenses (CLs) can directly contact the surface of the tear film through the application of biopolymer materials, to achieve therapeutic and cosmetic purposes. Since the advent of polymethylmethacrylate, a material that has gained widespread use and attention, statistically, there are now more than 150 × 106 people around the world who wear corneal contact lenses. However, the associated complications caused by the interaction of contact lenses with the ocular surface, tear film, endogenous and environmental microorganisms, and components of the solution affect nearly one-third of the wearer population. The application of corneal contact lenses in correcting vision and myopia control has been widely recognized. With the development of related materials, corneal contact lenses are applied to the treatment of ocular surface diseases, including corneal bandage lenses, drug-loaded corneal contact lenses, biosensors, and other new products, while minimizing the side effects associated with CL wear. This paper summarized the development history and material properties of CLs, focused on the current main clinical applications and mechanisms, as well as clarified the possible complications in wearing therapeutic contact lenses and the direction for improvement in the future.
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Affiliation(s)
- Weichen Yuan
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang 110005, China
| | - Fangkun Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang 110005, China
| | - Xiaoyu Liu
- Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian 116033, China
| | - Jun Xu
- Department of Ophthalmology, Dalian Third People's Hospital Affiliated to Dalian Medical University, Dalian 116033, China
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Hou J, Zhang N, Li X, Wang Z, Wang J. The Effects of Spectacles or Orthokeratology on the Tear Film in Children and Adolescents. Ophthalmol Ther 2023; 12:1913-1927. [PMID: 37140875 PMCID: PMC10287878 DOI: 10.1007/s40123-023-00719-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/17/2023] [Indexed: 05/05/2023] Open
Abstract
INTRODUCTION Myopia prevalence among adolescents is increasing annually. While orthokeratology (OK) is effective for controlling myopia progression, it may also be detrimental. We investigated tear film parameters [including tear mucin 5AC (MUC5AC) concentration] in children and adolescents with myopia treated with spectacles or OK compared with those with emmetropia. METHODS This prospective case-control study enrolled children (aged 8-12 years; 29 and 39 with myopia treated with OK and spectacles, respectively, and 25 with emmetropia) and adolescents (aged 13-18 years; 38 and 30 with myopia treated with OK and spectacles, respectively, and 18 with emmetropia). We recorded the ocular surface disease index (OSDI), visual analog scale (VAS) score, tear meniscus height (TMH), noninvasive tear breakup time (NIBUT), meibomian gland score (meiboscore), ocular redness score, and tear MUC5AC concentration in the emmetropia, spectacle (after 12 months of spectacle wearing), and OK (baseline, and after 1-, 3-, 6-, and 12-month use) groups. We observed changes from baseline to 12 months in the OK group and compared parameters among the spectacle, 12-month OK, and emmetropia groups. RESULTS The 12-month OK group differed significantly from the spectacle and emmetropia groups in most indicators among children and adolescents (P < 0.05). Differences were not noticeable between the spectacle and emmetropia groups (only PVAS < 0.05 among the children). In the OK group, the 12-month NIBUT was significantly decreased (P < 0.05) in both age groups; the upper meiboscore was increased at 6 and 12 months (both P < 0.05) among children; ocular redness scores were higher at 12 months than at baseline (P = 0.007), 1 month (P < 0.001), and 3 months (P = 0.007) among children; and the MUC5AC concentration was decreased at 6 and 12 months among adolescents, but only at 12 months among children (all P < 0.05). CONCLUSIONS Long-term OK can negatively influence the tear film in children and adolescents. Moreover, changes are masked by spectacle wearing. TRIAL REGISTRATION This trial is registered with "ChiCTR2100049384."
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Affiliation(s)
- Jingjing Hou
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Ningna Zhang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Xueyan Li
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Zijun Wang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jing Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.
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Guo Y, Liu L, Peng L, Fu J, Guo W, Tang P. Effect of overnight orthokeratology lenses on tear film stability in children. Cont Lens Anterior Eye 2023; 46:101592. [PMID: 35393267 DOI: 10.1016/j.clae.2022.101592] [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: 07/03/2021] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE To assess the tear film surface quality after orthokeratology using an automated Medmont E300 corneal topographer. METHODS Children who wore orthokeratology lenses for more than one year were selected in this retrospective study. Tear film disruption (TFD) and central tear film disruption (cTFD) were measured with Medmont E300 corneal topographer at initial and each follow-up visit after fitting with orthokeratology lenses, providing a nominal value from 0 (perfect) to 1 (poor). Tear film surface quality before and after ortho-k treatment was compared. RESULTS 145 children using orthokeratology lenses were observed. TFD and cTFD significantly increased at 1-day follow up (TFD, t = -17.3, P < 0.001; cTFD, t = -10.4, P < 0.001). This change remained consistent through to 12-months visit (TFD, F = 51.1, P < 0.001; cTFD, F = 28.0, P < 0.001). A sub-group of n = 11 children were discontinued for 1-month before being refit with OrthoK lenses of a different design. Similarly, there was a significant increase in TFD compared to pre-orthoK scans (0.172 ± 0.161), but this returned to baseline levels after ceasing lens wear (0.084 ± 0.059). A sub-group of monocular OrthoK wearers (n = 23) found that TFD and cTFD values increased in eyes with monocular lens-wearing but remained stable in the lateral eyes. CONCLUSIONS Objective measurements of tear-film quality are reduced in children after fitting with orthokeratology lenses, but return to baseline after 1-month of lens cessation. It is of importance to ensure tear film surface quality is continuously monitored throughout use of orthoK lenses.
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Affiliation(s)
- Yin Guo
- Department of Ophthalmology, Beijing Haidian Hospital and Beijing Haidian Section of Peking University Third Hospital, Beijing, China.
| | - Lizhou Liu
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Li Peng
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jia Fu
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wei Guo
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ping Tang
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Xie C, Wei R. Long-term changes in the ocular surface during orthokeratology lens wear and their correlations with ocular discomfort symptoms. Cont Lens Anterior Eye 2023; 46:101757. [PMID: 36137919 DOI: 10.1016/j.clae.2022.101757] [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: 05/31/2022] [Revised: 09/01/2022] [Accepted: 09/08/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE To evaluate the changes in ocular surface parameters during orthokeratology lens wear and determine their correlations with ocular discomfort symptoms. METHODS Fifty individuals were enrolled in this prospective pilot study. Clinical evaluation of the ocular surface included the ocular surface disease index, slit-lamp examination, Keratograph 5M, optical quality analysis system, and corneal staining. After baseline examinations, clinical tests were performed at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months after orthokeratology lens wear. Correlations between ocular discomfort symptoms and signs of ocular discomfort were evaluated. RESULTS Overall ocular surface disease index score and two subscale scores (ocular symptoms and vision-related function) significantly increased at the 3-month visit (P < 0.05), and decreased to levels close to baseline at the12-month visit (P > 0.05). The basic objective scatter index and the mean tear film objective scatter index increased, peaking at 3-month visit (P < 0.05) and gradually decreased thereafter. The modulation transfer function cut-off significantly decreased at the 3-month visit (P < 0.05). During the 12-month study period, the overall ocular surface disease index score and vision-related function score were significantly and positively correlated with the basic objective scatter index and mean tear film objective scatter index (P < 0.05). After 1 week of lens wear, Grade 1 corneal staining increased to 16.4 %, mostly involving the central and inferior cornea. CONCLUSIONS Orthokeratology lens wear increased ocular discomfort symptoms and decreased the function of tear film, mainly within 3 months of lens wear. Tear-related visual function parameters were correlated with ocular discomfort. A new parameter, tear film objective scatter index, measured with the optical quality analysis system, was more sensitive in detecting the quality and stability of tear film than traditional indicators.
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Affiliation(s)
- Caiyuan Xie
- 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, Fukang Road. 251, Nankai District, Tianjin 300384, 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, Fukang Road. 251, Nankai District, Tianjin 300384, China.
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Su B, Bao Z, Guo Y, Zheng H, Zhou J, Lu F, Jiang J. Changes in Shape Discrimination Sensitivity Under Glare Conditions After Orthokeratology in Myopic Children: A Prospective Study. Invest Ophthalmol Vis Sci 2023; 64:6. [PMID: 36626175 PMCID: PMC9838587 DOI: 10.1167/iovs.64.1.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Purpose To investigate changes in shape discrimination under mesopic conditions with and without glare after orthokeratology in myopic children. Methods This prospective study included 79 eyes of 79 myopic children (ages: 8-16 years). Shape discrimination thresholds (SDTs) were measured using radial frequency patterns, with a radial frequency of 4 cycles/360°, a peak spatial frequency of 3 cycles per degree, a contrast of 20%, and a mean radius of 1.5 degrees. SDT under mesopic conditions with and without glare was measured before orthokeratology and again at 1 week and 1 month after orthokeratology. Changes in the SDTs and their relationships to baseline ocular parameters were analyzed. Results SDTs with glare decreased significantly at 1 week (-0.08 ± 0.15 log(arcsec), P < 0.001) and 1 month (-0.09 ± 0.15 log(arcsec), P < 0.001) after orthokeratology. SDTs without glare remained stable (P = 0.81 and P = 1.00, respectively). The difference between SDTs with and without glare also decreased significantly at 1 week (-0.10 ± 0.17 log(arcsec), P < 0.001) and at 1 month (-0.08 ± 0.18 log(arcsec), P = 0.001) after orthokeratology. Based on a multivariate analysis, the greater decrease in SDT with glare after 1 month of orthokeratology was associated with a higher baseline spherical equivalent refraction. Conclusions Orthokeratology resulted in improved shape discrimination in myopic children under mesopic conditions but only when measured in the presence of glare.
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Affiliation(s)
- Binbin Su
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Zhishu Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Yue Guo
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Huihu Zheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Jiawei Zhou
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Fan Lu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Jun Jiang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China,National Clinical Research Center for Ocular Diseases, Wenzhou, China
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10
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Hui W, Xiao-feng H, Song-guo L, Jing-jing W, Xuan H, Yong T. Application of orthokeratology on myopia control and its effect on ocular surface and meibomian gland function in Chinese myopic adolescents. Front Med (Lausanne) 2022; 9:979334. [PMID: 36569150 PMCID: PMC9772008 DOI: 10.3389/fmed.2022.979334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose This study aimed to investigate the influence of orthokeratology (OK) on myopia control and ocular surface and meibomian gland function in myopic adolescents. Methods A prospective study was conducted over a 12-month period. The subjects were classified into two groups, namely, the OK lens group and the frame glasses control group. Axial length, corneal curvature, ocular surface, and meibomian gland parameters were measured at baseline, 1, 3, 6, and 12 months after wearing OK lenses. Results The axial length growth rate in the OK group was significantly slower than in the control group (P < 0.01). The naked eye vision and the ocular surface disease index (OSDI) scores recorded 1, 3, 6, and 12 months after wearing OK lenses were significantly higher than the scores recorded before wearing OK lenses. There was no significant difference in other ocular parameters at each follow-up time point compared with pre-wearing (P > 0.05). After using the OK lens for 6 months, the OSDI score and corneal fluorescein staining (CFS) score increased significantly (P < 0.001), but there were no significant differences in other parameters among the groups. No infectious keratitis occurred during the study. Conclusion These results provide evidence that the use of OK lenses can control the axial growth and progress rate of myopia compared with frame glasses. During the 12-month follow-up, although wearing OK lenses may have aggravated dry eye symptoms, each patient's ocular surface and meibomian gland function did not change significantly, indicating that the use of OK lenses is a relatively safe modality for the control of myopia in adolescents.
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Affiliation(s)
- Wang Hui
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China
| | - Hu Xiao-feng
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China
| | - Li Song-guo
- Peking University Shougang Hospital, Beijing, China
| | - Wang Jing-jing
- Beijing Tongzhou Maternity and Child Health Care Hospital, Beijing, China
| | - Huang Xuan
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China,*Correspondence: Huang Xuan,
| | - Tao Yong
- Department of Ophthalmology, Beijing Chaoyang Hospital, The Third Clinical Medical College of Capital Medical University, Beijing, China
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11
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Tse JSH, Cheung JKW, Wong GTK, Lam TC, Choi KY, So KHY, Lam CDM, Sze AYH, Wong ACK, Yee GMC, Chan HHL. Integrating Clinical Data and Tear Proteomics to Assess Efficacy, Ocular Surface Status, and Biomarker Response After Orthokeratology Lens Wear. Transl Vis Sci Technol 2021; 10:18. [PMID: 34559185 PMCID: PMC8475286 DOI: 10.1167/tvst.10.11.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose This study evaluated the efficacy and ocular surface status of Breath-O Correct, novel orthokeratology (OK) lenses, worn overnight for 3 months. Lens-induced changes in the tear proteome were evaluated. Methods Thirty-one subjects, aged 19 to 26 years with refractive error from -1.00 to -5.00 D, were randomly assigned 1:1 to the treatment or control group. Refraction, visual acuity, corneal integrity, biomechanics and endothelial health, ocular surface changes, and subjective symptoms were assessed at the baseline, one-month, and three-month visits. The tear proteome was characterized over time using sequential window acquisition of all theoretical ion spectra mass spectrometry. Results Lenses improved uncorrected visual acuity and reduced spherical powers with similar efficacy to other OK lenses. Significant reductions (P < 0.05) in corneal hysteresis (11.12 ± 1.12 to 10.38 ± 1.36 mm Hg) and corneal resistance factor (11.06 ± 1.32 to 9.90 ± 1.45 mm Hg) were observed in the treatment group after one month of lens wear, whereas other assessed factors remained unchanged. Thirteen and eight differentially expressed proteins were found after one month and three months of lens wear, respectively. Two proteins (proline-rich protein 27 and immunoglobulin V regions) were differentially expressed at both visits. Conclusions Over a three-month period, Breath-O Correct lenses were overall safe, well tolerated, efficacious in refractive power reduction, and comparable with other OK lenses. Furthermore, their use caused only minor noninflammatory protein expression changes in the tear proteome. Translational Relevance This study investigated the safety of orthokeratology contact lenses on the ocular surface in molecular aspects and standard clinical parameters.
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Affiliation(s)
- Jimmy S. H. Tse
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Jimmy K. W. Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
- Centre for Eye and Vision Research (CEVR), Hong Kong
| | - Gigi T. K. Wong
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Thomas C. Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
- Centre for Eye and Vision Research (CEVR), Hong Kong
| | - Kai Yip Choi
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Katherine H. Y. So
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Christie D. M. Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Andes Y. H. Sze
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Angel C. K. Wong
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Gigi M. C. Yee
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Henry H. L. Chan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
- Centre for Eye and Vision Research (CEVR), Hong Kong
- University Research Facilities in Behavioral and Systems Neuroscience (UBSN), The Hong Kong Polytechnic University, Hong Kong
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12
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Wang D, Wen D, Zhang B, Lin W, Liu G, Du B, Lin F, Li X, Wei R. The Association between Fourier Parameters and Clinical Parameters in Myopic Children Undergoing Orthokeratology. Curr Eye Res 2021; 46:1637-1645. [PMID: 34096430 DOI: 10.1080/02713683.2021.1917619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To explore how Fourier parameters are associated with axial length growth (ALG) and clinical parameters in children who underwent orthokeratology.Materials and Methods: A total of 267 children received orthokeratology. Baseline cycloplegic autorefraction was performed. Axial length was measured at baseline and one year after the lens dispatch, and the difference was defined as ALG. Corneal topography was performed at the same two visits. Central treatment zone (CTZ) was identified from the difference between the two tangential maps, and its center distance to corneal center was defined as decentration. A relative refractive corneal power (RCRP) map was derived by subtracting the center value from every point on the one-year axial map. It was decomposed into 3 Fourier components: a mean (F0), a single-cycle sinewave (F1), and a double-cycle sinewave (F2). Linear regressions were used to reveal the association between ALG and these parameters.Results: At baseline, the age was 10.18 ± 1.48 year, spherical equivalent (SE) was - 3.10 ± 1.15D, astigmatism was 1.17 ± 0.58D, and axial length was 24.69 ± 0.81 mm. The mean ALG was 0.181 ± 0.22 mm. In multiple regression, ALG was negatively associated with F1 (p < .001), not F0 and F2. Amplitude-wise, F0 and F1 were correlated with decentration (p < .01) and SE (p < .01), and F2 was associated with astigmatism (p < .001). Direction-wise, F1 was correlated with decentration (p < .001) and F2 was associated with astigmatism (p < .001).Conclusions: Among Fourier parameters, F0 and F1 were negatively associated with ALG in myopic children undergoing orthokeratology. Their associations to SE and CTZ decentration may partially explain the effect on ALG retardation.
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Affiliation(s)
- Di Wang
- 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, People's Republic of China
| | - Dejia Wen
- 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, People's Republic of China
| | - Bin Zhang
- College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Weiping Lin
- 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, People's Republic of China
| | - Guihua Liu
- 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, People's Republic of 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, People's Republic of China
| | - Fang Lin
- Eye Hospital Tianyi Yuanjing, Tianjin Medical University, Tianjin, People's Republic of China
| | - Xiaorong Li
- 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, People's Republic of 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, People's Republic of China
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13
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Xu J, Tao C, Mao X, Lu X, Bao J, Drobe B, Chen H. Blur Detection Sensitivity Increases in Children Using Orthokeratology. Front Neurosci 2021; 15:630844. [PMID: 33790734 PMCID: PMC8006440 DOI: 10.3389/fnins.2021.630844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/24/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose To investigate changes in blur detection sensitivity in children using orthokeratology (Ortho-K) and explore the relationships between blur detection thresholds (BDTs) and aberrations and accommodative function. Methods Thirty-two children aged 8–14 years old who underwent Ortho-K treatment participated in and completed this study. Their BDTs, aberrations, and accommodative responses (ARs) were measured before and after a month of Ortho-K treatment. A two forced-choice double-staircase procedure with varying extents of blur in three images (Tumbling Es, Lena, and Street View) was used to measure the BDTs. The participants were required to judge whether the images looked blurry. The BDT of each of the images (BDT_Es, BDT_Lena, and BDT_Street) was the average value of the last three reversals. The accommodative lag was quantified by the difference between the AR and the accommodative demand (AD). Changes in the BDTs, aberrations, and accommodative lags and their relationships were analyzed. Results After a month of wearing Ortho-K lenses, the children’s BDT_Es and BDT_Lena values decreased, the aberrations increased significantly (for all, P ≤0.050), and the accommodative lag decreased to a certain extent [T(31) = 2.029, P = 0.051]. Before Ortho-K treatment, higher-order aberrations (HOAs) were related to BDT_Lena (r = 0.463, P = 0.008) and the accommodative lag was related to BDT_Es (r = −0.356, P = −0.046). After one month, no significant correlations were found between the BDTs and aberrations or accommodative lags, as well as between the variations of them (for all, P ≥ 0.069). Conclusion Ortho-K treatment increased the children’s level of blur detection sensitivity, which may have contributed to their good visual acuity.
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Affiliation(s)
- Jingjing Xu
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China.,WEIRC, Wenzhou Medical University-Essilor International Research Center, Wenzhou, China
| | - Chunwen Tao
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Xinjie Mao
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China.,WEIRC, Wenzhou Medical University-Essilor International Research Center, Wenzhou, China
| | - Xin Lu
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Jinhua Bao
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China.,WEIRC, Wenzhou Medical University-Essilor International Research Center, Wenzhou, China
| | - Björn Drobe
- WEIRC, Wenzhou Medical University-Essilor International Research Center, Wenzhou, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Hao Chen
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China.,WEIRC, Wenzhou Medical University-Essilor International Research Center, Wenzhou, China
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14
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Yang N, Bai J, Liu L. Low concentration atropine combined with orthokeratology in the treatment of axial elongation in children with myopia: A meta-analysis. Eur J Ophthalmol 2021; 32:221-228. [PMID: 33678055 DOI: 10.1177/1120672121998903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To evaluate the effect of low concentration atropine combined with Orthokeratology (OK) lens compared with the OK lens on the changes of axial length in children with moderate and low myopia by meta-analysis. METHODS Databases such as PubMed, Web of Science, Embase, and Cochrane Library were comprehensively searched to collect related studies on atropine combined with the OK lens in the treatment of children with moderate and low myopia. The retrieval time was from the establishment of the database to December 2020. The standardized mean difference (SMD) and its 95% confidence interval (CI) were selected as the effect to analyze the changes of the axial length of the eye axis in children with low and moderate myopia treated with low concentration atropine combined with OK lens. RESULTS A total of eight articles were included in this study. Compared with OK lens treatment, low concentration atropine combined with the OK lens significantly slowed down the axial elongation of low and moderate myopia, SMD = -0.68(95% CI: -0.86--0.50, p < 0.05). According to the subgroup analysis of treatment time, when the treatment time was less than or equal to 6 months, SMD = -0.63(95% CI: -0.88--0.37, p < 0.05), when the treatment time was 1 year, SMD = -0.76(95% CI: -1.08--0.43, p < 0.05), and when the treatment time was 2 years, SMD = -0.69(95% CI: -1.07--0.31, p < 0.05). CONCLUSION Low concentration atropine combined with the OK lens is more effective than the OK lens in the treatment of children with low to moderate myopia in reducing axial elongation.
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Affiliation(s)
- Ning Yang
- Your Bright Eye Clinic of Chengdu Hi-tech Zone, Chengdu, Sichuan, China
| | | | - Li Liu
- Your Bright Eye Clinic of Chengdu Hi-tech Zone, Chengdu, Sichuan, China
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15
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Tao Z, Wang J, Zhu M, Lin Z, Zhao J, Tang Y, Deng H. Does Orthokeratology Wearing Affect the Tear Quality of Children? Front Pediatr 2021; 9:773484. [PMID: 35118029 PMCID: PMC8804288 DOI: 10.3389/fped.2021.773484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/14/2021] [Indexed: 11/13/2022] Open
Abstract
Orthokeratology is currently known as one of the most effective methods of myopia control in the process of rapid deterioration of the global myopia prevalence. As orthokeratology is widely used, it is necessary to evaluate its complications reasonably and accurately. Eye surface problems in children, such as dry eyes, have received increasing attention. At present, there is no conclusive evidence on how orthokeratology affects the ocular surface, especially the tears. To our knowledge, this is the first study to explore the relationship between orthokeratology lenses and tears through meta-analysis. However, it is still challenging to get a convincing conclusion and a higher level of evidence in this meta-analysis. Reasons for this include limitation of study design, lack of clarity on important confounding factors, lack of appropriate statistical tools, and other biases. This paper will analyze the dilemma existing in the current research from different perspectives to provide meaningful information for future studies in this field.
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Affiliation(s)
- Zhengyang Tao
- The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Jiao Wang
- Department of Strabismus and Pediatric Ophthalmology, Shenzhen Eye Hospital, TheClinical Medical College of Shenzhen University, Shenzhen, China
| | - Minjuan Zhu
- Department of Strabismus and Pediatric Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, The Second Clinical Medical College of Jinan University, Shenzhen, China
| | - Zhihong Lin
- Department of Strabismus and Pediatric Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, The Second Clinical Medical College of Jinan University, Shenzhen, China
| | - Jun Zhao
- Department of Ophthalmology, The Second Clinical Medical College of Jinan University, Longhua Branch Institute of Shenzhen People's Hospital, Shenzhen, China
| | - Yu Tang
- Department of Strabismus and Pediatric Ophthalmology, Shenzhen Eye Hospital Affiliated to Jinan University, The Second Clinical Medical College of Jinan University, Shenzhen, China
| | - Hongwei Deng
- Department of Strabismus and Pediatric Ophthalmology, The Jinan University of Shenzhen Eye Hospital, Shenzhen University of Medicine, Shenzhen, China
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16
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Tear Lipid Layer Thickness in Children after Short-Term Overnight Orthokeratology Contact Lens Wear. J Ophthalmol 2020. [DOI: 10.1155/2020/3602653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Meibomian gland lipid secretion is important to the stability of the tear film and ocular surface comfort. Changes in the tear film’s lipid layer thickness (LLT) after orthokeratology treatment may reflect underlying changes to the meibomian gland function. The purpose of this study was to investigate the features of the tear lipid layer in normal children and the effects of short-term orthokeratology treatment. Altogether, 163 myopic children (age: 10.7 ± 1.9 years, 8–15 years; 71 males) with no contact lens use history were enrolled in this study, of whom 56 were successfully fitted with orthokeratology lenses and completed the 1-month study. The tear film’s LLT (average, maximum, and minimum) and blinking pattern were measured by a LipiView® interferometer in 163 participants at baseline and in 56 orthokeratology participants at 1 week and 1 month after overnight lens wear. Results show that LLT (average) was 58.09 ± 21.66 nm in Chinese normal children. LLT was significantly correlated with rate of partial blinks at every follow-up (all
). Compared to baseline, the LLT (average and minimum) and partial blinks (number and rate) at 1 week and 1 month after orthokeratology treatment both significantly increased, and the increase of LLT was correlated with elevation of rate of partial blinks. In conclusion, LLT was shown to be elevated after short-term overnight orthokeratology treatment and was related to change in rate of partial blinks. Further studies are needed to clarify the long-term effect and the underlying mechanism.
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17
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Cho WH, Fang PC, Yu HJ, Lin PW, Huang HM, Kuo MT. Analysis of tear film spatial instability for pediatric myopia under treatment. Sci Rep 2020; 10:14789. [PMID: 32901095 PMCID: PMC7478966 DOI: 10.1038/s41598-020-71710-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/19/2020] [Indexed: 02/08/2023] Open
Abstract
In Taiwan, the prevalence of myopia in children between 6 and 18 years old is over 80%, and high myopia accounts for over 20%, which turned out to be in the leading place worldwide. Orthokeratology and low-dose atropine are proven treatments to reduce myopia progression, though the potential corneal disturbances remain an issue in young populations. The alteration of the tear film is widely discussed but there is no consensus to date, so we aim to investigate the tear film spatial instability in children with myopia control using atropine or orthokeratology. Thirty-eight treatment-naïve participants and 126 myopic children under treatments were enrolled. The ocular surface homeostasis, spatial distribution of tear break-up, and high-order aberrations (HOAs) of the corneal surface were assessed. We found out that myopic children treated with either atropine or orthokeratology showed ocular surface homeostasis similar to that in treatment-naïve children. Nevertheless, children treated with orthokeratology presented higher HOAs (p < 0.00001) and a tendency of the first tear break-up zone at the inner half of the cornea (p = 0.04). This unique spatial instability of the tear film associated with myopia treatment might provide a more focused way of monitoring the pediatric tear film instability.
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Affiliation(s)
- Wan-Hua Cho
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Po-Chiung Fang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hun-Ju Yu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pei-Wen Lin
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsiu-Mei Huang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Tse Kuo
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Lai HY, Kuo MT, Fang PC, Lin CC, Chien CC, Cho WH, Chen A, Lai IC. Tracking the Reflective Light Particles Spreading on the Cornea: An Emerging Assessment for Tear Film Homeostasis. Transl Vis Sci Technol 2019; 8:32. [PMID: 31183248 PMCID: PMC6549563 DOI: 10.1167/tvst.8.3.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 04/15/2019] [Indexed: 02/05/2023] Open
Abstract
Purpose To implement an emerging noninvasive approach for assessing the dynamic tear film (TF) homeostasis. Methods The video records of dynamic TF from 12 healthy orthokeratology lens wearers were obtained by a clinically available TF analyzer and decomposed as image sequences. The trajectories of TF particles were analyzed by two tracking models, the full-span model (FSM) and the fixed-duration model (FDM). FSM tracked a particle for a complete opening blink cycle, while FDM tracked 1 second of the same cycle. A power-law fitting operation \begin{document}\newcommand{\bialpha}{\boldsymbol{\alpha}}\newcommand{\bibeta}{\boldsymbol{\beta}}\newcommand{\bigamma}{\boldsymbol{\gamma}}\newcommand{\bidelta}{\boldsymbol{\delta}}\newcommand{\bivarepsilon}{\boldsymbol{\varepsilon}}\newcommand{\bizeta}{\boldsymbol{\zeta}}\newcommand{\bieta}{\boldsymbol{\eta}}\newcommand{\bitheta}{\boldsymbol{\theta}}\newcommand{\biiota}{\boldsymbol{\iota}}\newcommand{\bikappa}{\boldsymbol{\kappa}}\newcommand{\bilambda}{\boldsymbol{\lambda}}\newcommand{\bimu}{\boldsymbol{\mu}}\newcommand{\binu}{\boldsymbol{\nu}}\newcommand{\bixi}{\boldsymbol{\xi}}\newcommand{\biomicron}{\boldsymbol{\micron}}\newcommand{\bipi}{\boldsymbol{\pi}}\newcommand{\birho}{\boldsymbol{\rho}}\newcommand{\bisigma}{\boldsymbol{\sigma}}\newcommand{\bitau}{\boldsymbol{\tau}}\newcommand{\biupsilon}{\boldsymbol{\upsilon}}\newcommand{\biphi}{\boldsymbol{\phi}}\newcommand{\bichi}{\boldsymbol{\chi}}\newcommand{\bipsi}{\boldsymbol{\psi}}\newcommand{\biomega}{\boldsymbol{\omega}}{\rm{MMS}}\left( t \right) = {\rm{\alpha }} \times {t^{ - {\rm{\beta }}}}\end{document} was used to extract homeostasis markers based on the tracking model for each subject. Results Comparing two tracking models (N = 6), only one subject had statistical difference in averaged momentary moving speed (MMS; P = 0.0488), while none had significant difference in averaged momentary moving direction (MMD). However, both models showed good correlations in average MMS (ρ = 0.94, P = 0.0048) and MMD (ρ = 1.00, P < 0.0001) and all extracted homeostasis markers [α, β, MMS(0.1), and MMS(2.0)]. Assessing interblink reliability in these markers under FDM tracking (N = 12), only one subject in the MMS (0.1) and another subject in the MMS (2.0) were outside 95% limits of agreement, respectively. Conclusions FDM is a good alternative to FSM and has tracking properties of higher efficiency and easier implementation. The homeostasis markers under FDM tracking showed a good interblink consistence; therefore this approach will be a promising method for analyzing dynamic TF homeostasis in future practice. Translational Relevance FDM analytical architecture can practice the past experimental platform on a TF analyzer to obtain homeostasis markers of TF.
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Affiliation(s)
- Hung-Yin Lai
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Tse Kuo
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Po-Chiung Fang
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chi-Chang Lin
- Department of Chemical and Materials Engineering, Tunghai University, Taichung, Taiwan
| | - Chun-Chih Chien
- Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wan-Hua Cho
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Alexander Chen
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ing-Chou Lai
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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The Influence of Overnight Orthokeratology on Ocular Surface and Meibomian Gland Dysfunction in Teenagers with Myopia. J Ophthalmol 2019; 2019:5142628. [PMID: 30805209 PMCID: PMC6360595 DOI: 10.1155/2019/5142628] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/20/2018] [Accepted: 09/14/2018] [Indexed: 12/26/2022] Open
Abstract
Purpose The aim of this study was to investigate the effect of overnight orthokeratology (OOK) on ocular surface and meibomian gland dysfunction in teenagers with myopia. Methods A total of 59 subjects were recruited in this prospective study. The following tests were performed before and after 1, 3, 6, 12, and 24 months of OOK lens wear, including ocular surface disease index (OSDI) questionnaire, slit-lamp examination, and Keratograph 5M. Results No infectious keratitis occurred during the study. OSDI scores increased gradually and reached the maximum at 6 months of OOK wear (P < 0.001). The meniscus height was significantly increased at 1 and 3 months after the initiation of OOK (P=0.006, P=0.035). The corneal fluorescein staining at 1, 3, 6, 12, and 24 months after wearing OOK were all increased than the prewearing level with significant difference (P=0.014, P=0.036, P < 0.001, P < 0.001, and P=0.008, respectively). The first and the average tear film NIKBUT were all higher than the prewearing level, but there was no significant difference between every follow-up time points (P > 0.05). The lid margin abnormalities were significantly increased (P=0.003, P=0.038, and P=0.015) at 6, 12, and 24 months after the initiation of OOK. There was no significant difference in the meibomian gland orifice scores at each follow-up time points compared to the prewearing level (P > 0.05). The meibomian gland lipid secretion scores after wearing OOK were higher than those of the prewearing level, however, without statistically significant difference (P > 0.05). No significant differences of the degree of difficulty of lipid excretions were detected after the initiation of OOK (P > 0.05). There was no significant difference in meibomian gland dropout scores between all follow-up time points and the prewearing level (P=1.000). Conclusion OOK increased the symptoms of dry eye and decreased the function of tear film by affecting the meniscus height and BUT. OOK did not affect the function of meibomian glands.Clinical Study registration number: ChiCTR18000185708.
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Wang J, Yang D, Bi H, Du B, Lin W, Gu T, Zhang B, Wei R. A New Method to Analyze the Relative Corneal Refractive Power and Its Association to Myopic Progression Control With Orthokeratology. Transl Vis Sci Technol 2018; 7:17. [PMID: 30533280 PMCID: PMC6269134 DOI: 10.1167/tvst.7.6.17] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/09/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose We present a new method for analyzing relative corneal refractive power (RCRP) in children undergoing orthokeratology and explore its potential association to effective myopic control Methods A total of 55 children aged 8 to 12 years participated in the study. Axial growth was calculated as the difference in axial length before and 1 year after orthokeratology. Growth <0.30 mm was considered as effective control. Corneal topography was obtained before and 4 months after lens dispatch. The topography was divided into 36 10° slices and the maximal RCRP (mRCRP) in each was calculated and fitted into a model that integrated the effects of mean refractive power (M), corneal asymmetry (f1), and astigmatism (f2). The relationship between the probability of achieving effective control and the modulation of mRCRP was analyzed with logistic regression. Results A total of 45 subjects achieved effective control, but for 10 the treatment was ineffective. The M-values were not different between the groups. Modulations of mRCRP were significantly larger in the effective than the ineffective group (1.17 vs. 0.64 diopters [D] for f1, P = 0.02; 0.85 vs. 0.35 D for f2, P = 0.03). The probability to achieve effective control increased with modulation of mRCRP (P = 0.02). With a peak mRCRP > 4.5 D, a subject had an above 80% chance to achieve effective control. Conclusions The new method reveals that how the combination of spherical equivalent (SE), corneal asymmetry, and astigmatism determines modulation of the mRCRP and a large amplitude of modulation is associated with a higher probability of effective myopic control. Translational Relevance Our finding enables clinicians to estimate the outcome early and provides new insights to lens design.
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Affiliation(s)
- Jinghui Wang
- School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Dan Yang
- School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Hua Bi
- College of Optometry, Nova Southeastern University, Davie, FL, USA
| | - Bei Du
- School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Weiping Lin
- School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Tianpu Gu
- School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Bin Zhang
- College of Optometry, Nova Southeastern University, Davie, FL, USA
| | - Ruihua Wei
- School of Optometry and Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
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Liu G, Jin N, Bi H, Du B, Gu T, Zhang B, Wei R. Long-Term Changes in Straylight Induced by Overnight Orthokeratology: An Objective Measure Using the Double-Pass System. Curr Eye Res 2018; 44:11-18. [PMID: 30198800 DOI: 10.1080/02713683.2018.1514056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: To map the time course of changes in intraocular straylight of the human eye 1 year after initial lens wearing for orthokeratology treatment using the objective double-pass technique. Materials and Methods: A total of 35 subjects (19 males and 16 females) completed the study. The mean age was 11.46 ± 2.33 years (range, 8-16 years). All subjects were fitted with spherical four-zone orthokeratology lenses following the procedures recommended by the lens manufacturer. The subjects were required to wear the lens for at least eight consecutive hours at night. After lens removal during the daytime, objective scattering index (OSI) was evaluated using the double-pass technique (OQAS-II, Visiometrics, Terrassa, Spain) prior to lens dispatch (baseline), followed by evaluations at 1 week, 1 month, 6 months, and 12 months after the initial lens wearing. Longitudinal changes were fitted to a model containing both an impairing and recovery component, and the results were based on an extrapolation between the visits. Results: OSI rose quickly following lens wearing, reaching its highest level (double that of baseline values) by approximately 1.47 months. However, the recovery phase was slow and modest. One year after the initial lens wearing, OSI exhibited a 20% recovery from the peak level, but remained 63% higher than the baseline level. Conclusions: Intraocular straylight immediately increased flowing lens wearing, and this change reaches maximal level around 1 month after lens wearing. Slow but significant recoveries of optical quality subsequently followed.
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Affiliation(s)
- Guihua Liu
- a School of Optometry and Ophthalmology , Tianjin Medical University Eye Hospital , Tianjin , China
| | - Nan Jin
- a School of Optometry and Ophthalmology , Tianjin Medical University Eye Hospital , Tianjin , China
| | - Hua Bi
- b College of Optometry , Nova Southeastern University , Davie , FL , USA
| | - Bei Du
- a School of Optometry and Ophthalmology , Tianjin Medical University Eye Hospital , Tianjin , China
| | - Tianpu Gu
- a School of Optometry and Ophthalmology , Tianjin Medical University Eye Hospital , Tianjin , China
| | - Bin Zhang
- b College of Optometry , Nova Southeastern University , Davie , FL , USA
| | - Ruihua Wei
- a School of Optometry and Ophthalmology , Tianjin Medical University Eye Hospital , Tianjin , China
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