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Sánchez-García A, Molina-Martin A, Ariza-Gracia MÁ, Piñero DP. Analysis of Treatment Discontinuation in Orthokeratology: Studying Efficacy, Safety, and Patient Adherence Over Six Months. Eye Contact Lens 2024; 50:395-400. [PMID: 38886923 DOI: 10.1097/icl.0000000000001110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
PURPOSE This study aimed to evaluate the efficacy, safety, and participant compliance of orthokeratology treatment for the correction of myopic refractive errors over a six-month prospective study and to define the potential reasons for early treatment discontinuation. METHODS A total of 32 participants with low-to-moderate myopia were fitted with the spherical model of corneal refractive therapy (CRT) orthokeratology lenses (Paragon Vision Sciences) and followed over six months, with specific attention to alterations in refractive error, corneal topography, and epithelial thickness. Concurrently, participant feedback and reasons for any treatment discontinuation were documented. RESULTS Significant changes in refractive error and in corneal topography were observed, with approximately 50% of the refractive error being corrected on the first night of use and 100% by the first two weeks ( P <0.001). Central epithelial thickness experienced substantial thinning, reducing to 15.65±4.49 μm (67.38%) ( P <0.001) after 6 months of lens use. Six participants withdrew from this study for varied reasons, including unmet visual expectations and difficulty adhering to the lens-wearing regimen. Notably, the dropout group exhibited higher baseline low-order aberrations and less prolate corneas than those who persisted with the treatment ( P <0.05). CONCLUSIONS Orthokeratology with CRT is efficacious and safe for the correction of low-to-moderate myopia in adults, but a portion of patients discontinue the treatment in the first 6 months of contact lens wear. Special care should be taken when recommending orthokeratology in patients with higher levels of myopia and corneas with less prolate shape, providing more realistic expectations and even changing to dual axis or more sophisticated designs.
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Affiliation(s)
- Alicia Sánchez-García
- Department of Optics (A.S.-G., A.M.-M., D.P.P.), Pharmacology and Anatomy, University of Alicante, Alicante, Spain; ARTORG Center for Biomedical Engineering Research (M.Á.A.-G), University of Bern, Bern, Switzerland; and Department of Ophthalmology (IMQO-Oftalmar) (D.P.P.), Vithas Medimar International Hospital, Alicante, Spain
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Cheng Z, Meng J, Ye L, Wang X, Gong Y, Liu X. Changes in the Objective Vision Quality of Adolescents in a Mesopic Visual Environment After Wearing Orthokeratology Lenses: A Prospective Study. Eye Contact Lens 2024; 50:384-394. [PMID: 38968599 PMCID: PMC11335078 DOI: 10.1097/icl.0000000000001111] [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] [Accepted: 05/15/2024] [Indexed: 07/07/2024]
Abstract
PURPOSE This study aimed to investigate changes in objective vision quality in mesopic environments in teenagers with myopia after wearing orthokeratology (OK) lenses. METHODS This prospective clinical study included 45 patients (80 eyes) who received OK lenses at the First Affiliated Hospital of Jinan University from March 2021 to September 2021. An Optical Path Difference-Scan III refractive power/corneal analyzer was used to determine the corneal topographic parameters (corneal e, corneal Q, surface asymmetry index (SAI), and surface regularity index (SRI)), higher-order aberrations (HOAs), axial length (AL) change, lens decentration, induced astigmatism, target power, and Strehl ratio (SR) in a mesopic visual environment after wearing OK lenses for 6 months. In addition, corneal morphological parameters, HOAs, and SR were analyzed in a mesopic visual environment. Finally, we investigated the correlations among corneal morphology, HOAs, AL change, lens decentration, induced astigmatism, and SR. RESULTS The SAI value was significantly higher ( P <0.01), and the corneal e was significantly lower ( P <0.01), in a mesopic visual environment after wearing OK lenses for 1 week than baseline. A significant increase was observed in total HOAs and spherical aberrations, compared with before the OK lenses were worn ( P <0.01). In addition, SR in the mesopic visual environment decreased significantly after wearing the lenses ( P <0.01). No significant differences were observed ( P >0.05) among the 1-week, 1-month, 3-month, and 6-month follow-up findings. After 6 months, AL and lens decentration did not differ significantly compared with before ( P >0.05), whereas induced astigmatism significantly increased ( P <0.05). Negative correlations were observed between corneal Q, SAI, SRI, HOAs, induced astigmatism, and SR, and positive correlations were found between corneal e, AL change, lens decentration, and SR, after wearing OK lenses. KEY POINTS • Wearing orthokeratology lenses significantly altered corneal morphology and HOAs in myopic teenagers within 1 week. • The changes that we observed in the eyes of adolescents with myopia after wearing orthokeratology lenses decreased vision quality in mesopic environments. • Strehl ratio is significantly correlated with multiple parameters, including HOAs, AL change, and lens decentration. CONCLUSIONS In teenagers with myopia wearing OK lenses, significant changes in vision quality and corneal morphology were observed, leading to increased aberrations and affecting optical imaging quality. Furthermore, SR is significantly correlated with multiple parameters, including HOAs, AL change, and lens decentration. REGISTRATION NUMBER This study is registered with the United States Clinical Trials Registry under registration number NCT04929119.
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Affiliation(s)
- Zhi'ang Cheng
- Department of Ophthalmology (Z.C., J.M., L.Y., X.W., Y.G., X.L.), The First Affiliated Hospital of Jinan University, Guangzhou Guangdong, China; Department of Ophthalmology (L.Y.), Dongguan Tungwah Hospital, Dongguan Guangdong, China; and Department of Ophthalmology (J.M., X.L.), The Affiliated Shunde Hospital of Jinan University, Foshan Guangdong, China
| | - Jing Meng
- Department of Ophthalmology (Z.C., J.M., L.Y., X.W., Y.G., X.L.), The First Affiliated Hospital of Jinan University, Guangzhou Guangdong, China; Department of Ophthalmology (L.Y.), Dongguan Tungwah Hospital, Dongguan Guangdong, China; and Department of Ophthalmology (J.M., X.L.), The Affiliated Shunde Hospital of Jinan University, Foshan Guangdong, China
| | - Linyu Ye
- Department of Ophthalmology (Z.C., J.M., L.Y., X.W., Y.G., X.L.), The First Affiliated Hospital of Jinan University, Guangzhou Guangdong, China; Department of Ophthalmology (L.Y.), Dongguan Tungwah Hospital, Dongguan Guangdong, China; and Department of Ophthalmology (J.M., X.L.), The Affiliated Shunde Hospital of Jinan University, Foshan Guangdong, China
| | - Xinyu Wang
- Department of Ophthalmology (Z.C., J.M., L.Y., X.W., Y.G., X.L.), The First Affiliated Hospital of Jinan University, Guangzhou Guangdong, China; Department of Ophthalmology (L.Y.), Dongguan Tungwah Hospital, Dongguan Guangdong, China; and Department of Ophthalmology (J.M., X.L.), The Affiliated Shunde Hospital of Jinan University, Foshan Guangdong, China
| | - Yiqiang Gong
- Department of Ophthalmology (Z.C., J.M., L.Y., X.W., Y.G., X.L.), The First Affiliated Hospital of Jinan University, Guangzhou Guangdong, China; Department of Ophthalmology (L.Y.), Dongguan Tungwah Hospital, Dongguan Guangdong, China; and Department of Ophthalmology (J.M., X.L.), The Affiliated Shunde Hospital of Jinan University, Foshan Guangdong, China
| | - Xiaoyong Liu
- Department of Ophthalmology (Z.C., J.M., L.Y., X.W., Y.G., X.L.), The First Affiliated Hospital of Jinan University, Guangzhou Guangdong, China; Department of Ophthalmology (L.Y.), Dongguan Tungwah Hospital, Dongguan Guangdong, China; and Department of Ophthalmology (J.M., X.L.), The Affiliated Shunde Hospital of Jinan University, Foshan Guangdong, China
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Craig JP, Barsam A, Chen C, Chukwuemeka O, Ghorbani-Mojarrad N, Kretz F, Michaud L, Moore J, Pelosini L, Turnbull AMJ, Vincent SJ, Wang MTM, Ziaei M, Wolffsohn JS. BCLA CLEAR Presbyopia: Management with corneal techniques. Cont Lens Anterior Eye 2024; 47:102190. [PMID: 38851946 DOI: 10.1016/j.clae.2024.102190] [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] [Indexed: 06/10/2024]
Abstract
Corneal techniques for enhancing near and intermediate vision to correct presbyopia include surgical and contact lens treatment modalities. Broad approaches used independently or in combination include correcting one eye for distant and the other for near or intermediate vision, (termed monovision or mini-monovision depending on the degree of anisometropia) and/or extending the eye's depth of focus [1]. This report reviews the evidence for the treatment profile, safety, and efficacy of the current range of corneal techniques for managing presbyopia. The visual needs and expectations of the patient, their ocular characteristics, and prior history of surgery are critical considerations for patient selection and preoperative evaluation. Contraindications to refractive surgery include unstable refraction, corneal abnormalities, inadequate corneal thickness for the proposed ablation depth, ocular and systemic co-morbidities, uncontrolled mental health issues and unrealistic patient expectations. Laser refractive options for monovision include surface/stromal ablation techniques and keratorefractive lenticule extraction. Alteration of spherical aberration and multifocal ablation profiles are the primary means for increasing ocular depth of focus, using surface and non-surface laser refractive techniques. Corneal inlays use either small aperture optics to increase depth of field or modify the anterior corneal curvature to induce corneal multifocality. In presbyopia correction by conductive keratoplasty, radiofrequency energy is applied to the mid-peripheral corneal stroma, leading to mid-peripheral corneal shrinkage and central corneal steepening. Hyperopic orthokeratology lens fitting can induce spherical aberration and correct some level of presbyopia. Postoperative management, and consideration of potential complications, varies according to technique applied and the time to restore corneal stability, but a minimum of 3 months of follow-up is recommended after corneal refractive procedures. Ongoing follow-up is important in orthokeratology and longer-term follow-up may be required in the event of late complications following corneal inlay surgery.
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Affiliation(s)
- Jennifer P Craig
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand; College of Health & Life Sciences, Aston University, Birmingham, UK.
| | | | - Connie Chen
- Department of Optometry, Chung Shan Medical University, Taichung City, Taiwan
| | - Obinwanne Chukwuemeka
- Cornea, Contact Lens and Myopia Management Unit, De-Lens Ophthalmics Family and Vision Care Centre, Abuja, Nigeria
| | - Neema Ghorbani-Mojarrad
- School of Optometry and Vision Science, University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, UK
| | | | | | | | | | - Andrew M J Turnbull
- Royal Bournemouth Hospital, University Hospitals Dorset, UK; Faculty of Life and Health Sciences, Ulster University, UK
| | - Stephen J Vincent
- Optometry and Vision Science, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Michael T M Wang
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Mohammed Ziaei
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - James S Wolffsohn
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand; College of Health & Life Sciences, Aston University, Birmingham, UK
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Janarthanan SD, Samiyullah K, Madheswaran G, Ballae Ganeshrao S, Watt K. Exploring the impact of optical corrections on visual functions in myopia control-a scoping review. Int Ophthalmol 2024; 44:47. [PMID: 38337138 PMCID: PMC10858094 DOI: 10.1007/s10792-024-02937-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/17/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE Myopia is controlled optically with peripheral defocus spectacles, multifocal contact lenses, or orthokeratology lenses. However, it is unknown which optical correction will improve visual performance. This scoping review aimed to identify and summarize studies on various visual functions using optical corrections for myopia control. METHODS To develop the search strategy, population (Myopia), concept (visual performance), and context (unrestricted race/region) were used. PubMed, SCOPUS, Cochrane Library, and Web of Science databases were searched using the keywords myopia, contrast sensitivity, high and low contrast visual acuity, stereopsis, and optical correction of myopia control. This scoping review protocol was registered in the Open Science Framework registry and followed the framework for scoping review outlined by the Joanna Briggs Institute. RESULTS Eight studies (n = 8) met the inclusion criteria and were included in the review. Four were conducted in Europe, two were conducted in China, and one was conducted in Japan and Singapore. Five studies were randomized controlled trials, out of which three used contact lenses and two studies used peripheral defocus spectacles lenses. Studies ranged from one day to 2 years. Three studies that used orthokeratology lenses were prospective study designs. Among the studies that used orthokeratology lenses and contact lenses, two studies measured the contrast sensitivity function with CSV1000 (Vector Vision) under mesopic and photopic conditions, with and without glare. Two studies measured the central and peripheral contrast sensitivity using psychophysics experiments. High and low contrast visual acuity was measured using the Freiburg Vision Test (n = 1) and ETDRS charts (n = 3), and stereopsis was assessed using a random dot stereogram (n = 1). The studies showed a reduction in central and peripheral contrast sensitivity function and low contrast acuity when treated with multifocal contact lenses, orthokeratology lenses, and peripheral defocus lenses compared with single-vision lenses. CONCLUSION This scoping review found a reduction in central and peripheral contrast sensitivity function, as well as low contrast visual acuity when using various optical corrections for myopia control, while high-contrast visual acuity remained the same. The impact of visual functions may not influence the effectiveness of myopia control. Eye care practitioners should provide awareness to the parent and patient population about the potential visual impact of recent designs for optical corrections of myopia control.
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Affiliation(s)
- Salai Dhavamathi Janarthanan
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Kaleem Samiyullah
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Shonraj Ballae Ganeshrao
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kathleen Watt
- School of Optometry and Vision Science, Faculty of Medicine and Health, Univeristy of New South Wales, Sydney, Australia
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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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Chen X, Yang B, Wang X, Ma W, Liu L. The alterations in ocular biometric parameters following short-term discontinuation of long-term orthokeratology and prior to subsequent lens fitting: a preliminary study. Ann Med 2023; 55:2282745. [PMID: 37988719 PMCID: PMC10836244 DOI: 10.1080/07853890.2023.2282745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE To investigate the alterations in biometric parameters among Chinese adolescents over an extended period of wearing orthokeratology lenses, as well as the subsequent changes after a one-month cessation of lens usage prior to the secondary lens fitting. METHODS Twenty-four myopic patients aged 7-14 were enrolled in this 37-month prospective observational study. Ocular biometric parameters were measured in the study. Ocular biometric parameters were assessed, and the utilization of Generalized Estimating Equations (GEE) was employed in the analysis to address the correlation between the two eyes of each participant. RESULTS The axial length (AL) increased by 0.55 mm after 36 months of lens wearing and further increased to 0.62 mm at the 37-month follow-up compared to the initial measurement. The differences in AL elongation per month between the 37-month time point and the 12-, 24-, and 36-month marks of lens wearing were found to be statistically significant (p12-month = 0.001; p24-month = 0.003; p36-month = 0.001). Following the cessation of lens wear for 1 month, there was no significant complete recovery observed in the flat and steep keratometry values. However, the intraocular pressure and anterior chamber depth returned to their baseline levels. CONCLUSIONS The AL elongation undergoes alterations during temporary discontinuation of lenses, with the flat and steep keratometry measurements remaining significantly flatter compared to the baseline. However, the intraocular pressure and anterior chamber depth return to their initial levels after one month of lens cessation.
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Affiliation(s)
- Xiaohang Chen
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Bi Yang
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Xue Wang
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Ma
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, 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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Turnbull PRK, Goodman LK, Phillips JR. Dual-focus contact lenses for myopia control modify central retinal electrophysiology in humans. Ophthalmic Physiol Opt 2023; 43:1100-1109. [PMID: 37184059 DOI: 10.1111/opo.13163] [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: 01/27/2023] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Dual-focus contact lenses create two focal planes, one providing a clear retinal image while the other imposes myopic defocus on the retina to slow myopia progression. This study used global-flash multifocal electroretinogram (gmfERG) response amplitudes to compare central versus peripheral retinal responses under dual-focus conditions and to assess the optimal degree of myopic defocus compared with a single-vision control lens. METHODS Twenty participants each underwent three gmfERG trials, wearing a spectacle correction over dual-focus contact lenses with plano central power and peripheral secondary focal powers of either +2.00D, +4.00D or a plano single-vision lens. We compared amplitudes and latencies of the gmfERG direct and induced components (DC and IC) within participants, between the three different contact lens powers and at different retinal eccentricities (gmfERG ring). RESULTS We observed significant differences in the gmfERG responses between the single-vision and dual-focus contact lenses. Overall, DC amplitudes peaked between zero and +2.00D secondary power, while IC amplitudes were maximal between +2.00D and +4.00D. Compared with the single-vision control, the greatest increase in DC and IC amplitudes while wearing dual-focus lenses occurred within the central 10° of the retina. There was no interaction effect between gmfERG ring (eccentricity) and secondary power, and no difference in the latency of the gmfERG responses between different powers. CONCLUSION We found that dual-focus contact lenses with a +2.00D secondary power are close to that expected to induce the greatest increase in gmfERG responses relative to a single-vision lens. Dual-focus lenses produced the highest DC and IC response amplitudes relative to a single-vision lens in the central 10° of the retina. This suggests that dual-focus contact lenses slow myopia progression by modifying central rather than peripheral retinal activity.
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Affiliation(s)
- Philip R K Turnbull
- Myopia Laboratory, School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Lucy K Goodman
- Myopia Laboratory, School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - John R Phillips
- Myopia Laboratory, School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
- Department of Optometry, Asia University, Taichung, Taiwan
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Al-Mahrouqi H, Cheung IMY, Angelo L, Yu TY, Gokul A, Ziaei M. Therapeutic non-ectasia applications of cornea cross-linking. Clin Exp Optom 2023; 106:580-590. [PMID: 36690333 DOI: 10.1080/08164622.2022.2159790] [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: 04/05/2022] [Revised: 08/28/2022] [Accepted: 10/10/2022] [Indexed: 01/25/2023] Open
Abstract
Corneal cross-linking is a photopolymerization technique traditionally used to strengthen corneal tissue. Corneal cross-linking utilizes riboflavin (vitamin B2) as a photosensitizer and ultraviolet-A light (UVA) to create strong covalent bonds within the corneal stroma, increasing tissue stiffness. Multiple studies have demonstrated corneal cross-linking's effectiveness in treating corneal ectasia, a progressive, degenerative, and non-inflammatory thinning disorder, as quantified by key tomographic, refractive, and visual parameters. Since its introduction two decades ago, corneal cross-linking has surpassed its original application in halting corneal ectatic disease and its application has expanded into several other areas. Corneal cross-linking also possesses antibacterial, antienzymolytic and antioedematous properties, and has since become a tool in treating microbial keratitis, correcting refractive error, preventing iatrogenic ectasia, stabilising bullous keratopathy and controlling post keratoplasty ametropia. This review provides an overview of the current evidence base for the therapeutic non-ectasia applications of cornea cross-linking and looks at future developments in the field.
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Affiliation(s)
| | | | - Lize Angelo
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Tzu-Ying Yu
- Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
| | - Akilesh Gokul
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Mohammed Ziaei
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
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Lian RR, Sella R, Chen S, Afshari NA. Changes in corneal tomography following corneal refractive therapy discontinuation in a patient with history of long-term use. Am J Ophthalmol Case Rep 2022; 26:101450. [PMID: 35295195 PMCID: PMC8918721 DOI: 10.1016/j.ajoc.2022.101450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/12/2022] [Accepted: 02/20/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
| | | | | | - Natalie A. Afshari
- Corresponding author. 9415 Campus Point Drive, La Jolla, CA, 92093, USA.
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Zhao L, Jing L, Li J, Du X. Changes in corneal densitometry after long-term orthokeratology for myopia and short-term discontinuation. PLoS One 2022; 17:e0263121. [PMID: 35120161 PMCID: PMC8815901 DOI: 10.1371/journal.pone.0263121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 01/12/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose
To quantify changes in corneal densitometry after long-term orthokeratology treatment in myopic children and to analyze the reversibility one month after discontinuation.
Methods
Seventy-four myopic subjects aged 8–16 years, who wore orthokeratology lenses for two years, were divided into relatively steep- (lens movement within 1.0–1.5 mm, thirty-six participants) and flat-fitting groups (lens movement within 1.5–2.0 mm, thirty-eight participants). Based on refractive errors, they were divided into low and moderate myopia groups (thirty-seven participants in each group). Corneal densitometry was performed using Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) at each follow-up timepoint. Repeated-measures analysis of variance was used to compare the parameters before and after orthokeratology.
Results
The corneal densitometry values over the 0–10 mm diameter area increased from 12.84±1.38 grayscale units (GSU) at baseline to 13.59±1.42 GSU after three-month orthokeratology (P = .001) and reached 14.92±1.45 GSU at two years (P < .001). An increase in densitometry began at one month (P = .001) over the 0–2 mm annulus compared with that at three months over the 2–6 mm and 6–10 mm zones (P = .002,.014). The densitometry values significantly increased at three months in the relatively steep-fitting group (P = .003) and at one year in the relatively flat-fitting group (P = .001). After discontinuation of orthokeratology for one month, the values showed no significant decrease.
Conclusions
Long-term orthokeratology treatment causes a small but statistically significant increase in corneal densitometry values. During the first year, the onset of these changes was related to the fitting mode. Corneal densitometry values showed no significant reduction after one-month discontinuation.
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Affiliation(s)
- Lianghui Zhao
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
- Weifang Medical University, Weifang, China
| | - Lili Jing
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Jie Li
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Xianli Du
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
- * E-mail:
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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] [Grants] [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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Nakamura Y, Hieda O, Yokota I, Teramukai S, Sotozono C, Kinoshita S. Comparison of myopia progression between children wearing three types of orthokeratology lenses and children wearing single-vision spectacles. Jpn J Ophthalmol 2021; 65:632-643. [PMID: 34292425 DOI: 10.1007/s10384-021-00854-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 05/28/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate factors related to myopia progression in children wearing either orthokeratology (OK) lenses or single-vision spectacles (SVS) for 2 years. STUDY DESIGN Pooled-analysis retrospective intervention study. METHODS This study involved 105 school-aged children wearing SVS who participated in the multi-center Myovision Study and 89 school-aged children wearing one of 3 OK lens types [Menicon Z Night (M, n = 27), αORTHO®-K (A, n = 32), and Emerald™ (E, n = 30)]. In the OK-lens patients, last examination was performed at ≥ 3-weeks post lens-wear discontinuation. Of the subjects, 102 SVS-Group and 79 OK-Group (M: n = 24, A: n = 28, and E: n = 27) children completed all examinations. A relationship between refractive error (RE) change and 7 factors (correction methods, baseline age, baseline RE, baseline axial length, gender, right or left eye, and follow-up period) was derived by multiple regression modeling. Via those same methods, we investigated the relationship between RE change and 7 factors including 3 OK-lens corrections. RESULTS Related influence factors were correction method (0.85 D myopia reduction in the OK Group, P < 0.001), baseline age (0.16 D myopia reduction in older-age patients, P < 0.001), and baseline RE (0.12 D myopia reduction per 1 D myopia, P = 0.01). No relationship was found between RE change and OK-lens type. No serious adverse events occurred. CONCLUSION Regardless of OK lens design, myopia progression in school-aged children was suppressed. The effect was examined not only via axial-length elongation but also RE change, and the myopia control effect by OK lenses was found to be 0.85 D over the 2-year period.
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Affiliation(s)
- Yo Nakamura
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan.
| | - Osamu Hieda
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Teramukai
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan
| | - Shigeru Kinoshita
- Department of Frontier Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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14
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Nti AN, Berntsen DA. Optical changes and visual performance with orthokeratology. Clin Exp Optom 2021; 103:44-54. [DOI: 10.1111/cxo.12947] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 12/24/2022] Open
Affiliation(s)
- Augustine N Nti
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, USA,
| | - David A Berntsen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, USA,
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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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16
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Pérez-Corral J, Cardona G, Piñero DP, Aradilla Y, García M. Should Overnight Orthokeratology Patients Wear Their Lenses During Their Afternoon Nap? Eye Contact Lens 2021; 47:91-97. [PMID: 32701767 DOI: 10.1097/icl.0000000000000732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to evaluate changes in visual acuity, corneal curvature, elevation, pachymetry, and objective quality of vision of experienced orthokeratology patients using their contact lenses during a simulated 30-min afternoon nap. METHOD Twelve patients aged 30.8±8.3 years were recruited for the study, with a history of overnight orthokeratology of 27.4±23.0 months. Patients were instructed to close their eyes for 30 min while wearing their contact lenses or without lenses. Anterior corneal curvature, elevation, and corneal pachymetry were assessed with the Pentacam Scheimpflug System at 17 predefined corneal locations, and the HD Analyzer (Terrassa, Spain) was used to measure objective quality of vision. Measurements were conducted before eye closure (baseline), immediately after eye opening/lens removal (M1), and 30 min later (M2). RESULTS No statistically significant differences were found in anterior corneal curvature and elevation between baseline values and M1 or M2, with and without contact lenses. Corneal swelling at M1 was greater without contact lenses (change in central corneal thickness of 2.3%±3.1%, P=0.001) than with contact lenses (1.7%±1.3%, P<0.001). Recovery at M2 was slower when lenses were worn. A statistically significant improvement in objective quality of vision and visual acuity was found only when patients napped with their lenses. CONCLUSIONS Even if no significant changes were found in corneal curvature and elevation, patients of overnight orthokeratology may benefit from using their contact lenses during their afternoon nap in terms of objective quality of vision and visual acuity.
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Affiliation(s)
- Joan Pérez-Corral
- Department of Optics and Optometry (J.P.-C., G.C.), Universitat Politècnica de Catalunya, School of Optics and Optometry, Terrassa, Spain; Department of Optics, Pharmacology, and Anatomy (D.P.P.), University of Alicante, Alicante, Spain; and Department of Contact Lenses (Y.A., M.G.), Institut Català de Retina, Barcelona, Spain
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17
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Sánchez-García A, Ariza MA, Büchler P, Molina-Martin A, Piñero DP. Structural changes associated to orthokeratology: A systematic review. Cont Lens Anterior Eye 2020; 44:101371. [DOI: 10.1016/j.clae.2020.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/31/2020] [Accepted: 10/03/2020] [Indexed: 12/16/2022]
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Wan K, Lau JKK, Cheung SW, Cho P. Refractive and corneal responses of young myopic children to short-term orthokeratology treatment with different compression factors. Cont Lens Anterior Eye 2020; 43:65-72. [DOI: 10.1016/j.clae.2019.10.134] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 09/09/2019] [Accepted: 10/20/2019] [Indexed: 02/06/2023]
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Abstract
OBJECTIVE To investigate the lens decentration (LD) of orthokeratology (ortho-k) and the association between pretreatment corneal topographic parameters and LD of the ortho-k. METHODS Fifty right eyes of 50 myopes wearing ortho-k lenses were included in the prospective study. Corneal topography was conducted pretreatment to get topographic corneal parameters, including flat-K (K1); steep-K (K2); corneal astigmatism (CA), CA at 0 to 3 mm (3 mm-CA), 3 to 5 mm (5 mm-CA), 5 to 7 mm (7 mm-CA); surface asymmetry index (SAI); surface regularity index; the curvature of best-fit sphere; the diameter of cornea (DC); the distance from the corneal center to the corneal vertex (CCCV); flat eccentricity (E1), steep eccentricity (E2), and E1/E2 (E ratio); and the corneal curvature differences between the nasal and temporal quadrants at 0 to 3 mm (3 mm-Knt), and the corneal curvature differences between the superior and inferior quadrants at 0 to 3 mm (3 mm-Ksi), 5 mm-Knt (at 3-5 mm), 5 mm-Ksi (at 3-5 mm), 7 mm-Knt (at 5-7 mm), and 7 mm-Ksi (at 5-7 mm). The relationship between these cornea topographic parameters and LD of the ortho-k was tested using stepwise multiple linear regression models. RESULTS The mean magnitude of LD was 0.51±0.23 mm (0.06-1.03 mm). According to the stepwise analysis, 4 factors were associated with the overall LD (P<0.01): SAI (β=0.252), CCCV (β=0.539), 5 mm-CA (β=-0.268), and 3 mm-Ksi (β=-0.374); 5 factors were associated with the horizontal LD (P<0.01): DC (β=0.205), CCCV (β=0.881), 3 mm-CA (β=-0.217), 5 mm-Knt (β=0.15), and 3 mm-Ksi (β=-0.18); and 3 factors were associated with the vertical LD (P<0.01): SAI (β=0.542), 5 mm-CA (β=-0.188), and 3 mm-Ksi (β=-0.213). CONCLUSION Lens decentration is most common, but in most cases, the amount of LD is moderate and acceptable. The magnitude of LD can be predetermined by topographic corneal parameters. Surface asymmetry index, CCCV, 5 mm-Knt, and 3 mm-Ksi may be more preferable parameters in terms of the assessment of LD of ortho-k.
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Yin Y, Zhao Y, Wu X, Jiang M, Xia X, Chen Y, Song W, Hu S, Zhou X, Young K, Wen D. One-year effect of wearing orthokeratology lenses on the visual quality of juvenile myopia: a retrospective study. PeerJ 2019; 7:e6998. [PMID: 31179186 PMCID: PMC6545229 DOI: 10.7717/peerj.6998] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 04/22/2019] [Indexed: 11/20/2022] Open
Abstract
Objective To study the one-year effect of wearing orthokeratology (OK) lenses on the visual quality of juvenile myopia. Methods The right eyes of 36 juvenile myopias were retrospectively studied in this work. Q-value, e-value, corneal curvature, strehl ratio (SR), modulation transfer function (MTF) and wavefront aberration (WA) were compared before and at 1, 3 and 12 months after wearing OK lenses. The SR, MTF and WA of cornea, internal optic and ocular were analyzed separately. The spherical and cylinder diopter, vision acuity, compensating factor (CF) and compensative rate (CF%) were compared before and at 12 months after wearing OK lenses. Results (1) The vision of LogMAR increased and the corneal curvature decreased significantly after wearing OK lenses. There was no significant difference for the e-value before and after wearing OK lenses. The Q-value increased at 1 month but decreased at 3 and 12 months remarkably. (2) The ocular and internal optic SR and MTF increased significantly at 1 month and then remained stable. The MTF in different spacial frequencies increased after wearing OK lenses. There was no significant difference for the corneal SR before and after wearing OK lenses, and the corneal MTF decreased significantly after wearing OK lenses. (3) For the ocular, the total higher order aberration (HOA), spherical, coma and trefoil aberrations increased, and the total aberration, total lower order aberration (LOA) and defocus aberration decreased obviously except astigmatism. The corneal aberrations increased significantly after wearing OK lenses except astigmatism. For the internal optic, the total aberration, total LOA and defocus aberration decreased, and the total HOA, coma and trefoil aberration increased significantly except the astigmatism and spherical aberrations. (4) The CF and CF% of total aberration, total LOA, total HOA and coma aberrations increased, and those of astigmatism and spherical decreased at 12 months. Conclusions Orthokeratology is effective in correcting the refractive error and improving the vision quality of juvenile myopia over the one-year follow-up period.
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Affiliation(s)
- Yewei Yin
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
| | - Yang Zhao
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
| | - Xiaoying Wu
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
| | - Mengyang Jiang
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
| | - Xiaobo Xia
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
| | - Yao Chen
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
| | - Weitao Song
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
| | - Shengfa Hu
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
| | - Xia Zhou
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
| | - Kelly Young
- Department of Veterans Affairs, Miami, United States of America
| | - Dan Wen
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
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Abstract
The purpose of this article is to provide a review of existing literature describing complications with contemporary contact lenses and their management. It is envisioned that this will serve as a useful summary of noninfectious and infectious complications associated with contact lens wear.
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Increased Corneal Toricity after Long-Term Orthokeratology Lens Wear. J Ophthalmol 2018; 2018:7106028. [PMID: 30425855 PMCID: PMC6218724 DOI: 10.1155/2018/7106028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/12/2018] [Accepted: 09/19/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To investigate the change in corneal toricity and associated refractive astigmatism after discontinuation of long-term orthokeratology (ortho-k) lens wear. Methods This study investigated 136 subjects aged between 6 and 14 (9.1 ± 1.5) years old at the commencement of ortho-k treatment, who had been undergoing overnight ortho-k treatment for 24 to 72 (37.4 ± 11.9) months. Corneal refractive power and manifest refraction were measured and compared before ortho-k and 1 month after discontinuation of ortho-k lens wear. Changes in corneal curvature were analyzed. Corneal curvature data from a historical longitudinal study were used as control. Results Compared to pre-ortho-k values, the corneal curvature became significantly flatter in the flatter meridian (-0.22 ± 0.27 D, P < 0.001) and steeper in the steeper meridian (0.06 ± 0.34 D, P=0.032) after cessation of ortho-k lens wear, resulting in a significant increase in corneal toricity (0.28 ± 0.43 D, P < 0.001), which is associated with an increase in refractive astigmatism (0.57 ± 0.57 D, r=0.465, P < 0.001). The amount of residual corneal flattening in the flatter meridian is significantly affected by the length of ortho-k treatment (t=-2.965, P=0.004) and the baseline age of subject (t=-2.841, P=0.005), but not by the baseline spherical or cylindrical refractive error (both P > 0.05). In the historical control group, there is no significant change in the corneal curvature over two years in children wearing spectacle lenses (both meridians, P > 0.05). Change of corneal toricity was more significant in the ortho-k group than in the spectacle control group (P=0.001). Conclusions Long-term ortho-k lens wear increases corneal toricity after discontinuation of the treatment, which is associated with an increase in refractive astigmatism. A more pronounced change in corneal toricity was found in subjects who were younger to start ortho-k and have been in a longer period of treatment. This trial is registered with http://www.chictr.org.cn (ChiCTR-TNRC-11001210).
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Queirós A, Villa-Collar C, Amorim-de-Sousa A, Gargallo-Martinez B, Gutiérrez-Ortega R, González-Pérez J, González-Méijome JM. Corneal morphology and visual outcomes in LASIK patients after orthokeratology: A pilot study. Cont Lens Anterior Eye 2018; 41:507-512. [PMID: 30217386 DOI: 10.1016/j.clae.2018.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 09/03/2018] [Accepted: 09/04/2018] [Indexed: 11/18/2022]
Abstract
A STATEMENT OF SIGNIFICANCE For the first time, this study shows that corneas that previous undergone orthokeratology treatment do not respond differently to LASIK compared with previous soft contact lens wear experience. PURPOSE To evaluate and compare the corneal morphology and visual outcomes of long-term soft and orthokeratology (OK) contact lens fitting in wearers undergoing corneal refractive surgery (LASIK) for myopia correction. METHODS Sixteen (16) myopic patients wearing hydrophilic soft contact lens (SCL, n = 8 subjects, control group) and OK (n = 8 subjects, OK group) lenses who undergone LASIK were retrospectively evaluated. Preoperative fitting of contact lenses and one year postoperative were studied using Pentacam (Oculus, Inc. GmbH, Wetzlar, Germany). Corneal pachymetry and volume, corneal topography, anterior and posterior surface elevation data and the anterior surface aberrometry of the cornea were recorded and used for fitting. RESULTS Age, refractive error and topographic parameters before LASIK did not showed statistically significant differences between the two study groups. LASIK post-treatment results showed identical changes in both control and OK groups and did not show significant differences in all the parameters evaluated. The changes on corneal parameters and HOA due to refractive surgery intervention were not different between Control and OK group (p > 0.050). CONCLUSIONS Corneal changes due to OK treatment are reversible after its discontinuation. The present study gives an overview of how OK does not impair future LASIK surgery for the correction of myopia and does not influence the success/results of such intervention. These findings suggest that OK CL wear does not change corneal biomechanics and does not compromise a possible LASIK refractive surgery. Although this is a pilot study and there is a need of evaluate this results/changes in future studies.
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Affiliation(s)
- António Queirós
- Clinical & Experimental Optometry Research Lab. Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal.
| | - César Villa-Collar
- Optics and Optometry Department, Faculty of Health Sciences, Universidad Europea, Madrid, Spain
| | - Ana Amorim-de-Sousa
- Clinical & Experimental Optometry Research Lab. Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
| | | | | | - Javier González-Pérez
- Ocular Surface and Contact Lens Research Laboratory, Faculty of Optometry, University of Santiago de Compostela, Spain
| | - José M González-Méijome
- Clinical & Experimental Optometry Research Lab. Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
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Influence of Overnight Orthokeratology on Corneal Surface Shape and Optical Quality. J Ophthalmol 2017; 2017:3279821. [PMID: 29098084 PMCID: PMC5642882 DOI: 10.1155/2017/3279821] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/06/2017] [Accepted: 09/14/2017] [Indexed: 01/15/2023] Open
Abstract
Purpose To investigate the changes of corneal surface shape and optical quality during orthokeratology. Methods 49 eyes of 26 patients (10.63 ± 2.02 years old) who underwent overnight orthokeratology for myopia were prospectively examined. The corneal surface shape parameters, including surface regularity index (SRI) and surface asymmetry index (SAI), were attained with an OPD-III SCAN. The higher-order aberrations and higher-order Strehl ratios were calculated under a 3 mm pupil diameter before orthokeratology, 1 month, 3 months, and 6 months after orthokeratology. A P value of less than 0.05 was statistically significant. Results Months after orthokeratology, SRI and SAI were both showing a significant increase in comparison with those before orthokeratology (P < 0.001). After orthokeratology, for a 3 mm pupil, the higher-order Strehl ratio presented a reduction of 0.217 μm (P < 0.001), and the higher-order aberration root mean square (HOA RMS) showed a mean increase of 0.100 μm (P < 0.001). There were significant increases in spherical aberration (P < 0.001) and coma (P = 0.044) after orthokeratology. Trefoil showed a slight reduction at month 6 after orthokeratology, but there was no statistical significance (P = 0.722). Conclusion Overnight orthokeratology for a correction of myopia resulted in a significant improvement in refractive error but increased corneal irregularity and ocular higher-order aberrations, especially in spherical aberration.
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Kang P, Swarbrick H. Discontinuation of long term orthokeratology lens wear and subsequent refractive surgery outcome. Cont Lens Anterior Eye 2017; 40:436-439. [PMID: 28712892 DOI: 10.1016/j.clae.2017.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/12/2017] [Accepted: 07/04/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE To report a case of lens discontinuation in a long term orthokeratology (OK) lens wearer and describe regression in refraction, corneal topography, and corneal thickness over 408days after lens discontinuation. Furthermore, the outcome of subsequent LASIK treatment is also reported. CASE REPORT A 41year old Caucasian female who had been previously wearing OK lenses for 13 years discontinued lens wear in the left eye to consider refractive surgery in that eye. The greatest changes in subjective and objective refractions, corneal topography and thickness occurred during the first 28days after lens discontinuation. Subjective refraction did not reach baseline values, but corneal topography parameters returned to pre-OK values after 408days of no lens wear. The patient then received successful refractive surgery treatment in that eye, achieving uncorrected visual acuity of 0.00 LogMAR units, and residual refractive error within ±0.50D of emmetropia. CONCLUSION The period of lens discontinuation required for long term OK lens wearers before refractive surgery is likely to vary between individuals and the patient described in this case report required a significant period of lens discontinuation of at least one year before being considered suitable for refractive surgery.
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Affiliation(s)
- Pauline Kang
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Helen Swarbrick
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, 2052, Australia
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Faria-Ribeiro M, Belsue RN, López-Gil N, González-Méijome JM. Morphology, topography, and optics of the orthokeratology cornea. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:75011. [PMID: 27435895 DOI: 10.1117/1.jbo.21.7.075011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 06/20/2016] [Indexed: 05/27/2023]
Abstract
The goal of this work was to objectively characterize the external morphology, topography, and optics of the cornea after orthokeratology (ortho-k). A number of 24 patients between the ages of 17 and 30 years (median=24 years) were fitted with Corneal Refractive Therapy® contact lenses to correct myopia between −2.00 and −5.00 diopters (D) (median=−3.41 D). A classification algorithm was applied to conduct an automatic segmentation based on the mean local curvature. As a result, three zones (optical zone, transition zone, and peripheral zone) were delimited. Topographical analysis was provided through global and zonal fit to a general ellipsoid. Ray trace on partially customized eye models provided wave aberrations and retinal image quality. Monozone topographic description of the ortho-k cornea loses accuracy when compared with zonal description. Primary (C40) and secondary (C60) spherical aberration (SA) coefficients for a 5-mm pupil increased 3.68 and 19 times, respectively, after the treatments. The OZ area showed a strong correlation with C40 (r=−0.49, p<0.05) and a very strong correlation with C60 (r=0.78, p<0.01). The OZ, as well as the TZ, areas did not correlate with baseline refraction. The increase in the eye’s positive SA after ortho-k is the major factor responsible for the decreased retinal optical quality of the unaccommodated eye.
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Affiliation(s)
- Miguel Faria-Ribeiro
- University of Minho, Clinical and Experimental Optometry Research Laboratory, Center of Physics, School of Sciences (Optometry), Campus de Gualtar, Braga 4710-057, Portugal
| | - Rafael Navarro Belsue
- Consejo Superior de Investigaciones Científicas and Universidad de Zaragoza, Instituto de Ciencia de Materiales de Aragón, Facultad de Ciencias, P. Cerbuna, 12, Zaragoza 50009, Spain
| | - Norberto López-Gil
- Universidad of Murcia, Facultad de Óptica y Optometría, Edificio 35 (Campus de Espinardo), Murcia 30100, Spain
| | - José Manuel González-Méijome
- University of Minho, Clinical and Experimental Optometry Research Laboratory, Center of Physics, School of Sciences (Optometry), Campus de Gualtar, Braga 4710-057, Portugal
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Zhu MJ, Feng HY, He XG, Zou HD, Zhu JF. The control effect of orthokeratology on axial length elongation in Chinese children with myopia. BMC Ophthalmol 2014; 14:141. [PMID: 25417926 PMCID: PMC4280707 DOI: 10.1186/1471-2415-14-141] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 11/13/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To retrospectively compare axial elongation in children with different degrees of myopia wearing spectacles and undergoing ortho-k treatment. METHODS The medical records of 128 patients who were fitted with spectacles or orthokeratology (ortho-k) lenses in our clinic between 2008 and 2009 were reviewed. Ortho-k group comprised 65 subjects and 63 subjects wearing spectacles were included in the control group. Subjects were also divided into low-myopia, moderate-myopia and high-myopia groups, based on the basic spherical equivalent refractive error. Axial length periodically measured over 2-year of lens wear and changes in axial length were compared between treatment groups and between subgroups with different degrees of myopia. RESULTS The control group exhibited more changes in axial length than the ortho-k group at both 12 months (0.39 ± 0.21 mm vs 0.16 ± 0.17 mm, p <0.001) and 24 months (0.70 ± 0.35 mm vs 0.34 ± 0.29 mm, p <0.001). Axial length elongation was estimated to be slower by about 51% in the ortho-k group. Similar results were found for the subgroups (49%, 59% and 46% reductions, respectively). In the group with low and moderate myopia, the annual increases in axial length were significantly different between the ortho-k and control groups during both the first ( Low myopia: 0.19 ± 0.17 mm vs 0.40 ± 0.18 mm, p = 0.001; Moderate myopia: 0.14 ± 0.18 mm vs 0.45 ± 0.22 mm, p <0.001) and second ( Low myopia: 0.18 ± 0.14 mm vs 0.32 ± 0.19 mm, p = 0.012; Moderate myopia: 0.18 ± 0.16 mm vs 0.34 ± 0.30 mm, p = 0.030) years. In the high myopia groups, significant differences were only found between the ortho-k and control groups during the first year (0.16 ± 0.18 mm vs 0.34 ± 0.22 mm, p = 0.004). The 2-year axial elongation was significantly associated with initial age (p <0.001) and treatment (p <0.001), but not with gender, initial refractive error, initial axial length, initial corneal curvature. CONCLUSIONS This 2-year study indicates that ortho-k contact lens wear is effective for reducing myopia progression in children with low, moderate and high myopia.
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Affiliation(s)
| | | | | | | | - Jian-Feng Zhu
- Shanghai Eye Disease Prevention & Treatment Center, No, 380 Kangding Road, Jingan District, Shanghai 200040, China.
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Short-Term Changes in Ocular Biometry and Refraction After Discontinuation of Long-Term Orthokeratology. Eye Contact Lens 2014; 40:84-90. [DOI: 10.1097/icl.0000000000000014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
PURPOSE To investigate the effect of lens fenestrations on the performance of orthokeratology lenses. METHODS Twenty-two subjects (aged 11 to 31 years) were fitted with identical reverse geometry orthokeratology lenses in the two eyes. One eye was randomly designated to wear a lens with three 0.20 mm fenestrations at 120° intervals placed at the junction of the reverse and alignment curves. The lens for the other eye was not fenestrated. Subjects were reviewed at 1 week, 1 month, 3 months, 6 months, and 1 year after fitting. Data were collected on refraction, visual performance, incidences and severity of corneal staining, lens binding, and corneal pigmented arc. RESULTS Fifteen subjects achieved full correction in OU. There were no statistically significant differences in refractive and corneal changes, visual performance, incidences and severity of corneal staining and corneal pigmented arc formation between the two eyes. The incidence of lens binding was consistently higher in eyes wearing non-fenestrated lenses but was not statistically significant. Severity of lens binding, however, was statistically significant at the 1-, 3-, 6- and 12-month visits, with the non-fenestrated lenses causing more severe binding. CONCLUSIONS The addition of fenestrations to orthokeratology lenses has no effect on the efficacy of the treatment or outcomes in low to moderate myopic subjects. However, the severity of lens binding is reduced. Fenestrating reverse geometry lenses may be of assistance in cases where lens binding is a problem.
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Chew FLM, Yong CK, Mas Ayu S, Tajunisah I. The association between various visual function tests and low fragility hip fractures among the elderly: a Malaysian experience. Age Ageing 2010; 39:239-45. [PMID: 20065356 DOI: 10.1093/ageing/afp259] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND hip fractures are an increasing source of morbidity and mortality in older people. The role of visual function tests such as visual impairment, stereopsis, contrast sensitivity and visual field defects in low fragility hip fractures in Asian populations is not well understood. OBJECTIVE to determine the association between various visual function tests and low fragility hip fractures in an Asian population. DESIGN case-control study. SETTING University Malaya Medical Centre, Kuala Lumpur, Malaysia. SUBJECTS 108 cases aged > or = 55 years admitted with low fragility fractures and 108 controls (matched for age, gender and race). METHODS both cases and controls underwent a detailed ophthalmological examination, which included visual acuity, stereopsis, contrast sensitivity and visual field testing. RESULTS poorer visual acuity (odds ratio, OR = 4.08; 95% confidence interval, CI: 1.44, 11.51), stereopsis (OR = 3.60, 95% CI: 1.55, 8.38), contrast sensitivity (OR = 3.34, 95% CI: 1.48, 7.57) and visual field defects (OR = 11.60, 95% CI: 5.21, 25.81) increased the risk of fracture. Increased falls were associated with poorer visual acuity (OR = 2.30, 95% CI: 1.04, 5.13), stereopsis (OR = 2.11, 95% CI: 1.03, 4.32), contrast sensitivity (OR = 2.12, 95% CI: 1.05, 4.30) and visual field defects (OR = 3.40, 95% CI: 1.69, 6.86). CONCLUSION impaired visual acuity, stereopsis, contrast sensitivity and visual field defects are associated with an increased risk of low fragility hip fractures. We recommend that all patients aged > or = 55 should have an annual ophthalmological examination that includes visual acuity, contrast sensitivity, stereopsis and visual field testing to assess the risks for falls and low fragility fractures.
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Affiliation(s)
- Fiona L M Chew
- Department of Ophthalmology, University Malaya, Jalan Universiti, Kuala Lumpur, Wilayah Persekutuan 50603, Malaysia
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Residual corneal flattening after discontinuation of long-term orthokeratology lens wear in asian children. Eye Contact Lens 2010; 35:333-7. [PMID: 19816186 DOI: 10.1097/icl.0b013e3181bdc41f] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Most patients treated with orthokeratology (OK) in Asia are children. The effects of long-term OK on corneal curvature among children after lens wear discontinuation have not previously been reported. METHODS This study investigated 28 subjects, aged 10.4 +/- 2.5 years at commencement of OK lens wear, who had been treated with OK for 50.2 +/- 27.4 months. Corneal curvature was measured with a Canon RK3 autokeratometer before commencement of OK and again approximately 2 weeks (17.3 +/- 8.6 days) after discontinuation of OK lens wear. Data were analyzed using paired Student t tests, with a critical P value of 0.05. RESULTS Compared with baseline, residual flattening of the cornea was found after cessation of OK lens wear, averaging 0.07 +/- 0.04 mm in the flat meridian (P<0.001) and 0.02 +/- 0.07 mm in the steep meridian (P=0.07). This was confirmed by power vector analysis of curvature data, with a significant reduction in M (-0.27 +/- 0.23 diopter (D); P<0.001), and a slight increase in J0 (0.17D +/- 0.36D; P=0.02). A trend toward greater residual corneal flattening was found among subjects with more pretreatment myopic refractive error (P=0.04). CONCLUSIONS Corneal curvature may not necessarily return completely to baseline after discontinuation of long-term OK lens wear in children. Intermittent temporary discontinuation of OK lens wear and close monitoring of corneal recovery are recommended during long-term OK treatment.
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