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Hahn IK, Lee D, Lee DH, Lee H, Tchah H, Kim JY. Serially Checked Spherical Aberration Can Evaluate the Anti-Myopia Effect of Orthokeratology Lens in Children. J Pers Med 2022; 12:jpm12101686. [PMID: 36294825 PMCID: PMC9604799 DOI: 10.3390/jpm12101686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/04/2022] Open
Abstract
We aimed to investigate the changes in higher-order aberrations (HOAs) after wearing orthokeratology (OK) lenses in myopic patients. The study included 15 eyes from ten myopic patients, whose refractive error was myopia less than -4.5 diopters (D) and astigmatism less than 1.5 D. Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were measured, and Zywave® aberrometry was performed at baseline and 1, 3, and 6 months following OK lens wear. The mean age was 11.5 years (range: 9-15 years). There was a significant improvement in UCVA (p ≤ 0.001) and a decrease in the spherical equivalent measured with auto-refraction at 6 months (p ≤ 0.001). Total HOAs significantly increased after OK lens wear (p ≤ 0.001), with spherical aberration increasing approximately 3.9-fold (p = 0.05). Spherical aberration demonstrated statistically significant positive correlations with the change in spherical equivalent at 3 and 6 months (p = 0.007 and 0.003, respectively). After wearing properly prescribed OK lens, all subjects had significantly improved UCVA and decreased myopic spherical equivalent, with increased total HOAs and positive spherical aberration at 1 month, and the changes were maintained at 6 months. Serially checked spherical aberration could evaluate the anti-myopia effect of the orthokeratology lens in children.
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Affiliation(s)
- In-Kyun Hahn
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul 05505, Korea
| | - Donghan Lee
- University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul 05505, Korea
| | - Dong-Ho Lee
- Bitsarang Eye Clinic, Prince Building, 492, Nohae-ro, Nowon-gu, Seoul 01751, Korea
| | - Hun Lee
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul 05505, Korea
| | - Hungwon Tchah
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul 05505, Korea
| | - Jae-Yong Kim
- Department of Ophthalmology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul 05505, Korea
- Correspondence: ; Tel.: +82-2-3010-3680; Fax: +82-2-470-6440
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Tomiyama ES, Logan AK, Richdale K. Corneal Elevation, Power, and Astigmatism to Assess Toric Orthokeratology Lenses in Moderate-to-High Astigmats. Eye Contact Lens 2021; 47:86-90. [PMID: 32568927 PMCID: PMC7749028 DOI: 10.1097/icl.0000000000000721] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Fitting philosophies for toric orthokeratology are based on elevation or corneal astigmatism, but it is unclear which is more effective. The purpose of this analysis was to further understand corneal shape and the relationship between peripheral elevation and central astigmatism in moderate-to-high astigmats. METHODS Corneal tomography was measured three times on the right eyes of 25 moderate-to-high refractive myopic astigmatic adults. Corneal astigmatism and elevation were calculated at 4-, 6-, and 8-mm chords. Subjects were fitted with toric orthokeratology lenses following the manufacturer's guidelines based on elevation. Twenty subjects completed 10 days of wear. A masked examiner assessed movement and centration via slitlamp videos and quantified treatment zone and decentration from tangential power difference tomography maps. Correlations between variables were assessed. RESULTS Average corneal astigmatism was 2.20±0.70 DC and peripheral elevation was 50.88±18.92 μm and they were strongly correlated (4 mm R2=0.96, 6 mm R2=0.92, 8 mm R2=0.86, all P<0.001). Each diopter of astigmatism equated to 25 μm of elevation at an 8-mm chord. Via slitlamp, average treatment zone area was 12.73±4.62 mm2 and 13 lenses decentered. From tomography, average treatment zone area was 7.16±2.56 mm2 and 17 were decentered. Tomography treatment zone area was negatively correlated with central corneal astigmatism (R2=0.60) and elevation at an 8-mm chord (R2=0.64, both P<0.001). CONCLUSIONS For tomography images, central corneal astigmatism was highly correlated with peripheral elevation and may be a more expedient measure for clinical use. Treatment area decreased as corneal astigmatism and elevation increased.
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Affiliation(s)
| | - Anna-Kaye Logan
- University of Houston College of Optometry, Houston, TX, USA
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Gao C, Wan S, Zhang Y, Han J. The Efficacy of Atropine Combined With Orthokeratology in Slowing Axial Elongation of Myopia Children: A Meta-Analysis. Eye Contact Lens 2021; 47:98-103. [PMID: 33060414 DOI: 10.1097/icl.0000000000000746] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Previous studies have found that atropine can slow axial elongation and control the progression of myopia. Some ongoing trials have applied atropine combined with orthokeratology for myopia control, but few studies explored the effect of the strategy on axial elongation. This meta-analysis made a preliminary evaluation of the effect of atropine combined with orthokeratology on axial elongation to provide a reference for further researches. METHODS We performed a specific search on PubMed, EMBASE, Cochrane library, Web of Science, Ovid and Chinese electronic databases of VIP and Wanfang for randomized controlled trials, cohort studies and case-control studies conducted up to December 2019. The weighted mean difference (WMD) of mean change in axial elongation between the combination group of atropine and orthokeratology and the orthokeratology group was used for evaluation. Publication bias was detected using the Funnel plots test. RESULTS A total of five studies involving 341 participants younger than 18 years old met our inclusion criteria. The axial elongation was lower in the combination group of atropine and orthokeratology than that of the orthokeratology group (0.25 vs. 0.35; WMD=-0.09 mm, [95% confidence intervals, -0.15 to -0.04], Z=3.39, P=0.0007). CONCLUSIONS This meta-analysis demonstrates atropine combined with orthokeratology is effective in slowing axial elongation in myopia children. This effect may be superior to that of the orthokeratology alone.
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Affiliation(s)
- Canran Gao
- School of Clinical Medicine (C.G., S.W., Y.Z.), Capital Medical University, Beijing, China ; and Department of Ophthalmology (J.H.), Tangdu Hospital, the Air Force Medical University, Xi'an, Shaanxi, China
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Lam AKC, Hon Y, Leung SYY, Shu-Ho L, Chong J, Lam DCC. Association between long-term orthokeratology responses and corneal biomechanics. Sci Rep 2019; 9:12566. [PMID: 31467346 PMCID: PMC6715748 DOI: 10.1038/s41598-019-49041-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 08/19/2019] [Indexed: 12/22/2022] Open
Abstract
Myopia is very prevalent worldwide, especially among Asian populations. Orthokeratology is a proven intervention to reduce myopia progression. The current study investigated association between baseline corneal biomechanics and orthokeratology responses, and changes of corneal biomechanics from long-term orthokeratology. We fitted 59 adult subjects having myopia between −4.00D to −5.00D with overnight orthokeratology. Corneal biomechanics was measured through dynamic bidirectional corneal applanation (in terms of corneal hysteresis, CH and corneal resistance factor, CRF) and corneal indentation (in terms of corneal stiffness, S and tangent modulus, E). Subjects with poor orthokeratology responses had lower E (mean 0.474 MPa) than subjects with good orthokeratology responses (mean 0.536 MPa). Successful orthokeratology for 6 months resulted in reducing CH (reduced by 5.8%) and CRF (reduced by 8.7%). Corneal stiffness was stable, but E showed an increasing trend. Among subjects with successful orthokeratology, a higher baseline S resulted in greater myopia reduction (Pearson correlation coefficient, r = 0.381, p = 0.02).
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Affiliation(s)
- Andrew K C Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Ying Hon
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Stanley Y Y Leung
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Lu Shu-Ho
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Jones Chong
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - David C C Lam
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
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Zhang Y, Chen YG. Comparison of myopia control between toric and spherical periphery design orthokeratology in myopic children with moderate-to-high corneal astigmatism. Int J Ophthalmol 2018; 11:650-655. [PMID: 29675386 DOI: 10.18240/ijo.2018.04.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/18/2018] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Yu Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
| | - Yue-Guo Chen
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
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Na M, Yoo A. The effect of orthokeratology on axial length elongation in children with myopia: Contralateral comparison study. Jpn J Ophthalmol 2018. [PMID: 29524061 DOI: 10.1007/s10384-018-0573-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE To evaluate the effectiveness of the orthokeratology (OK) lens slowing myopic progression compared with no intervention in pediatric eyes METHODS: A retrospective review of medical records was performed on 45 monocular myopic subjects 7 to 13 years of age who were treated with monocular ortho-k lens and followed-up for more than 12 months. The monocular myopia in the subjects' eyes was -0.75 to -4.25 D (diopter), and near emmetropia in the contralateral and with-the-rule astigmatism no greater than -1.50 D. Axial elongation OU, reflecting the progression of myopia was measured at baseline using the same AL-Scan Optical Biometer and compared between the two eyes of each individual every six months for one year in all subjects and for two years in 9 subjects. RESULTS After 12 months of lens wear, axial length had increased by 0.36 ± 0.23mm in the control eyes (P < 0.001) but showed far less change (+0.07 ± 0.21 mm) in the OK eyes (P = 0.038). The nine subjects followed-up for 2 years showed no axial length change (+0.16 ± 0.25 mm) in the OK eyes (P = 0.095) after 24 months and significant axial length growth (+0.38 ± 0.26 mm; P = 0.002) in the control eyes. Control eyes showed progressive axial length growth throughout the study compared with the one OK lens eye. CONCLUSIONS Using a contralateral eye study design, which prevented the influence of potential confounding factors, Effectiveness of the OK lens was proved. Myopic progression within a subject was excellent compared with no intervention.
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Affiliation(s)
- Miri Na
- Department of Ophthalmology, Saevit Eye Hospital, 1065, Jungang-ro, Ilsandong-gu, Goyang, Gyeonggi-do, 10447, Republic of Korea
| | - Aeri Yoo
- Department of Ophthalmology, Saevit Eye Hospital, 1065, Jungang-ro, Ilsandong-gu, Goyang, Gyeonggi-do, 10447, Republic of Korea.
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