Efficacy, predictability and safety of long-term orthokeratology: An 18-year follow-up study

Gispets, Joan; Yébana, Pilar; Lupón, Núria; Cardona, Genı́s; Pérez-Corral, Joan; Pauné, Jaume; Cortilla, Bernat

doi:10.1016/j.clae.2021.101530

Cited by 18 publications

(11 citation statements)

References 28 publications

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“…The incidence of microbial keratitis in children wearing orthokeratology lenses is low and with similar rates to daily-wear soft contact lenses 51 . Nevertheless, it is advisable to monitor corneal staining and mild corneal epithelial disorders, which are common findings, and it is important to prevent more serious corneal surface diseases that may lead to visual impairment 29,52–54 . Orthokeratology lenses are widely used and studied, but the dropout rates are usually high, and the number of subjects included is low.…”

Section: Resultsmentioning

confidence: 99%

“…51 Nevertheless, it is advisable to monitor corneal staining and mild corneal epithelial disorders, which are common findings, and it is important to prevent more serious corneal surface diseases that may lead to visual impairment. 29,[52][53][54] Orthokeratology lenses are widely used and studied, but the dropout rates are usually high, and the number of subjects included is low. Also, the complications and causes of dropout are usually not well explained.…”

Section: Orthokeratologymentioning

confidence: 99%

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Topical Review: Studies on Management of Myopia Progression from 2019 to 2021

2022

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SIGNIFICANCEMyopia is a common eye condition that increases the risk of sight-threatening complications. Each additional diopter increases the chance of complications. The purpose of this review was to make an overview of myopia control treatment options for children with myopia progression.In this nonsystematic review, we searched PubMed and Cochrane databases for English-language studies published from 2019 to September 2021. Emphasis was given to selection of randomized controlled trials. Nineteen randomized controlled trials and two retrospective studies were included. Topical atropine and orthokeratology remain the most used treatments, whereas lenses with novel designs are emerging treatments. Overall myopia progression in the treatment groups for low-dose atropine and orthokeratology was lower than in the control groups, and their efficacy was reported in several randomized controlled trials and confirmed by various systematic reviews and meta-analysis. The findings of myopia progression and axial elongation for the MiSight, defocus incorporated multiple segment spectacle lens, highly aspherical lenslets, and diffusion optics technology spectacle lens were comparable. Public health interventions to optimize environmental influences may also be important strategies to control myopia. Optimal choice of management of myopia depends on treatment availability, acceptability to child and parents, and specific patient features such as age, baseline myopia, and lifestyle. Eye care providers need to understand the advantages and disadvantages of each therapy to best counsel parents of children with myopia.

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Section: Resultsmentioning

confidence: 99%

Section: Orthokeratologymentioning

confidence: 99%

Topical Review: Studies on Management of Myopia Progression from 2019 to 2021

2022

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“…Orthokeratology, as previously reported in the scientific literature, 1,10,11 has been shown to be an effective and safe procedure for the correction of myopia. In this short-term prospective experimental study, changes in refraction, corneal topography, ocular aberrations, and epithelial thickness were analyzed and characterized for the first hour post-treatment, first night, and first week.…”

Section: Discussionmentioning

confidence: 61%

Modeling and Prediction of the Immediate and Short-Term Effect of Myopic Orthokeratology

Sánchez‐García

Molina‐Martín²,

Ariza-Gracia³

et al. 2022

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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To characterize the clinical changes occurring in the initial phase of the orthokeratology (OK) treatment for myopia correction, developing a model of prediction of the refractive changes in such phase. Methods: Prospective study enrolling 64 eyes of 32 patients (range, 20-40 years) undergoing myopic OK treatment with the reverse geometry contact lens CRT (Paragon Vision Science). Changes in uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), refraction, corneal topography, ocular aberrations, and corneal epithelial thickness were evaluated during the first hour of OK lens wear and after 1 week of OK treatment. Multiple linear regression analysis was used to obtain a model to predict the short-term refractive effect of OK. Results:The UCVA improved at each visit, reaching normal visual acuity values after a week (P,0.001) of OK treatment, which was consistent with the significant spherical equivalent (SE) reduction and central flattening (P,0.001). Multiple linear regression analysis revealed that one night change in refraction (DR•1N) could be predicted according to the following expression (P,0.001, R 2 ¼0.686): DR•1N¼1.042+0.028•Age+1.014•BCET (baseline central epithelium thickness)20.752•BKm (baseline mean keratometry)21.405•BSE (baseline SE)+1.032•DR•1 h (change in SE after 1 hr of OK lens use). Similarly, a statistically relevant linear relationship was obtained for predicting the refractive change after 1 week (DR•1W) of OK use (P,0.001, R 2 ¼0.928): DR•1W¼3.47021.046•BSE21.552•BBCVA (baseline BCVA)20.391•BKm+0.450•DR•1 h. Conclusions:The immediate and short-term refractive effects of myopic OK with the reverse geometry contact lens CRT can be predicted with enough accuracy from baseline and first trial visits data.

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“…On the other hand, Maseedupally et al [ 29 ] reported that increased corneal toricity increased amounts of treatment zone decentration; however, we found that initial astigmatism or use of toric lenses was not a risk factor for lens decentration. Regarding punctate keratitis, Gispets et al described that the incidence of corneal staining increased with the duration of Ortho-K treatment [ 30 ]. Nevertheless, the daily wearing time, weekly wearing days, and duration of treatment were not related to punctate keratitis in the study; adequate wearing time (7–8 h) and regular lens replacement (1.5–2 years) might be the possible reasons.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Satisfaction, Compliance and Side Effects among Long-Term Orthokeratology Wearers

Wang

Chiu

2022

JCM

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Purpose: This study aims to assess the satisfaction, compliance, and side effects among the long-term orthokeratology (Ortho-K) users in a tertiary hospital in Taiwan and analyze the side effects and related risk factors. Methods: Children and their guardians were assessed using a structured and validated questionnaire inquiring about background information, wear and care behaviors, daily activities, satisfaction, and related concerns. Clinical information, including refractive data and side effects, was obtained through patient medical files. Results: Three hundred and five school-aged patients were enrolled, and the average age was 13.13 ± 3.39 years, with an average wearing period of 17.1 ± 8.1 months. Over 83% of the subjects had clear daytime vision all day, around 88% felt satisfied or very satisfied with the results, and 98% exhibited a willingness to continue wearing the Ortho-K lenses. Most guardians (83%) were pleased with the controlling effect of myopic progression. Initial spherical equivalent and regular cleaning of the lens protein significantly correlated with clear day vision. Wearing >6 days/week correlated with less risk of lens binding. Based on the questionnaire, the main reasons for using Ortho-K were effectiveness, safety, and practicality, while the major concerns were discomfort, harmful to the eyes, and no effect. Conclusion: With a comprehensive care program from practitioners and good compliance of users, Ortho-K could be the most effective and satisfactory option for myopic children in Taiwan.

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Efficacy, predictability and safety of long-term orthokeratology: An 18-year follow-up study

Cited by 18 publications

References 28 publications

Topical Review: Studies on Management of Myopia Progression from 2019 to 2021

Topical Review: Studies on Management of Myopia Progression from 2019 to 2021

Modeling and Prediction of the Immediate and Short-Term Effect of Myopic Orthokeratology

Assessment of Satisfaction, Compliance and Side Effects among Long-Term Orthokeratology Wearers

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