Purpose To investigate the effect of OK lens treatment zone decentration on myopia control. Methods We retrospectively selected 30 OK lens wearers who met the following conditions in our hospital from more than 1300 cases: wearing lens in both eyes and only one eye was off-center while the other one was centric for more than 12 months. During the period of follow-up, the UCVA of each eye was better than 0.1 of logMAR and there were no obvious tropia, Kappa angle, and complications such as glare and diplopia. Result Among 30 cases, 15 are males and 15 are females, with an average age of 9.3 ± 1.51Y. There were no significant differences in equivalent spherical lens, astigmatism, e value, flat K, steep K, astigmatism, lens diameter, and toric between the two groups (p > 0.05). The average distance of decentration was 0.73 ± 0.25 mm. Axis growth per year in was 0.20 ± 0.24 mm the OK-lens-decentered group and 0.29 ± 0.20 mm in the OK-lens-centric group, which shows significant difference between them (p < 0.05). According to the direction of decentration, 30 decentered eyes were divided into temporal group (20 eyes) and other direction group (10 eyes). The efficiency of myopia control (the growth of AL per year in OK-lens-decentered eye/the growth of AL per year in the contralateral OK-lens-centric eye) was 0.69 ± 0.50 in the temporal decentration group and 0.75 ± 0.52 in the other direction group, showing no significant difference between them (p > 0.05). There was no significant correlation between the efficiency of myopia control and the degree of decentration among temporal decentration group (p > 0.05). Conclusion This self-control study without much interference factors shows that the decentration of OK lens can delay the development of myopia more effectively than being centric when uncorrected visual acuity was acceptable without obvious corneal complications, glare, or ghosting.

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Purpose To determine the pattern of axial variation in subjects with initial shortened axial length during the entire period of orthokeratology and to discuss the possibility of shortened AL after one month of orthokeratology becoming a predictor of myopia control. Method This study retrospectively included 106 children with myopia aged 8 to 14 wearing OK lenses. Fifty-four eyes with shortened axial length (AL) at the first-month visit were enrolled in the axial length shortening (ALS) group, and fifty-two eyes without shortened AL were enrolled in the no axial length shortening (NALS) group. Axial length and refractive error at baseline and within the entire period of orthokeratology (20 months), including fitting, washout period and re-wear, were measured. Eighty-five children who started wearing single vision spectacle were also included as a control group. Results In the ALS group, AL became longer after shortening and slowly exceeded baseline; afterward, AL experienced a rebound during the washout period and shortened again if OK lenses were re-worn. After washout period, significant difference in AL (ALS:0.28 ± 0.19 mm, NALS: 0.52 ± 0.17 mm) and spherical equivalent (ALS:-0.43 ± 0.44D, NALS:-0.91 ± 0.40D) between the two groups were found(P<0.05). The changes in AL and SE were both significantly correlated with the changes in AL at the first-month visit (P<0.05). Conclusion After AL is shortened in the initial stage of orthokeratology, it will experience a rapid rebound during the washout period, and the shortening can reappear when re-wearing OK lenses. Hence, the evaluation of orthokeratology will be more objective and accurate after the wash-out period. In addition, the existence and degree of axial shortening can be used as a predictor of long-term myopia development.

Purpose. To investigate the microbial profile of congenital nasolacrimal duct obstruction (CNLDO) in Chinese children. Methods. We retrospectively reviewed the medical records of 330 consecutive children (330 eyes) who were diagnosed with tear duct infections secondary to CNLDO and were admitted to the Children’s Hospital of Fudan University from January 2013 to January 2020. Bacterial cultures were grown from tear duct samples of each patient. Samples from conjunctival secretions were cultivated on blood or chocolate agar. Clinically significant bacterial growth was reported. Results. Of the 330 eyes considered, 62.7% (207/330) were associated with positive bacterial cultures. A total of 223 isolates were detected from 207 culture-positive eyes. Among the 223 isolates, 52.0% (116/223) were Gram-positive bacteria and 47.1% (105/223) were Gram-negative bacteria. The most prevalent Gram-positive bacteria were Streptococcus viridans (67 isolates, 30%), followed by Staphylococcus aureus (36 isolates, 16.1%) and Streptococcus pneumoniae (5 isolates, 2.2%). The most prevalent Gram-negative bacteria were Neisseria (nonpathogenic) (25 isolates, 11.2%), followed by Escherichia coli (16 isolates, 7.2%) and Haemophilus influenzae (16 eyes, 7.2%). Antibiotic susceptibility test results suggested that both Gram-positive and Gram-negative bacteria were highly sensitive to most of the tested antibiotics. Conclusions. S. viridans and S. aureus are the most prevalent bacteria in tear duct infections secondary to CNLDO. Broad-spectrum antibacterial eye drops are suggested as empirical antibiotic treatments.