Toric orthokeratology: a case report

Correlation between ocular residual astigmatism and anterior corneal astigmatism in children with low and moderate myopia

Background

To assess the correlation between ocular residual astigmatism and anterior corneal astigmatism in children with low and moderate myopia.

Methods

Refractive astigmatism was determined by subjective manifest refraction. Anterior corneal astigmatism was determined by IOL Master. Thibos vector analysis was used to calculate ocular residual astigmatism. Correlation analysis was used to assess the relationship between the amounts of ocular residual astigmatism and anterior corneal astigmatism. The relationship between the vectors of ocular residual astigmatism and anterior corneal astigmatism was evaluated by a physical method.

Results

The study analysed 241 right eyes of 241 children aged 8 to 18 years old. In this study, the median magnitude of ocular residual astigmatism was 1.02 D, with an interquartile range was of 0.58 D. Against-the-rule ocular residual astigmatism was seen in 232 eyes (96.3%). There was a significant and moderate correlation between ocular residual astigmatism and anterior corneal astigmatism (r = 0.50, P < 0.001). Ocular residual astigmatism compensated for anterior corneal astigmatism in 240 eyes (99.6%). The mean compensation value was 1.00 ± 0.41 D (range 0.02 D to 2.34 D). Based on this effect, 37 eyes had a different axial classification of anterior corneal astigmatism and refractive astigmatism. In contrast, one eye (0.4%) had oblique ocular residual astigmatism and the ocular residual astigmatism superimposed with-the-rule anterior corneal astigmatism.

Conclusions

The magnitude of ocular residual astigmatism was relatively large in myopic children and predominantly compensated for anterior corneal astigmatism. Ocular residual astigmatism should be assessed in patients before fitting them with orthokeratology lenses.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12886-022-02560-2.

Comparison of myopia control between toric and spherical periphery design orthokeratology in myopic children with moderate-to-high corneal astigmatism

AIM

To compare clinical results between toric and spherical periphery design orthokeratology (ortho-k) in myopic children with moderate-to-high corneal astigmatism.

METHODS

This retrospective study enrolled 62 eyes of 62 subjects using toric ortho-k lenses. These subjects were assigned to the toric group. Based on the one-to-one match principle (same age, proximate spherical equivalence and corneal astigmatism), 62 eyes of 62 subjects were enrolled and included in the spherical group. At one-year follow-up visit, visual acuity, corneal astigmatism, treatment zone decentration, axial elongation and adverse reaction were compared between these two groups.

RESULTS

At the one-year visit, corneal astigmatism was significantly lower in the toric group (1.22±0.76 D) than in the spherical group (2.05±0.85 D) (P=0.012). The mean magnitude of the treatment zone decentration was 0.62±0.42 mm in the toric group and 1.07±0.40 mm in the spherical group (P=0.004). Axial elongation was significantly slower in the toric group (0.04±0.13 mm) than in the spherical group (0.09±0.13 mm) (P=0.001). The one-year axial elongation was significantly correlated with initial age (r=-0.487, P<0.001) and periphery design of ortho-k lens (r=0.315, P<0.001). The incidence of corneal staining was lower in the toric group (8.1%) than in the spherical group (19.4%) (P<0.001).

CONCLUSION

Toric periphery design ortho-k lenses may provide lower corneal astigmatism, better centration, slower axial elongation and lower incidence of corneal staining in myopic children with moderate-to-high corneal astigmatism.

Contact lens intolerance: refitting with dual axis lens for corneal refractive therapy

Corneal refractive therapy is a non-surgical procedure whose main purpose is to improve uncorrected visual acuity during the day, without spectacles or contact lenses. We report an adult woman who shows contact lens intolerance and does not want to wear eyeglasses. We used dual axis contact lens to improve lens centration. We demonstrate a maintained unaided visual acuity during one year of treatment. In conclusion, we can consider refitting with dual axis lens for corneal refractive therapy as a non-surgical option for patients who show contact lens intolerance.