Histomorphometric Profile of the Corneal Response to Short-term Reverse-geometry Orthokeratology Lens Wear in Primate Corneas

Cheah, Pike See; Mohidin, Norhani; Mohd‐Ali, Bariah; Maung, Myint; Lye, Munn Sann; Azian, Abdul Latiff

doi:10.1097/ico.0b013e318165642c

Cited by 31 publications

(23 citation statements)

References 21 publications

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“…It has been postulated that rather than a simple molding or bending effect, there is a central thinning and peripheral thickening accounting for the corresponding topographic change in curvature. 18,19 24 Although there have been sporadic reports of infective keratitis following OK a systematic review of this procedure did not reveal any increased risk directly attributable to overnight OK. 25 No infectious keratitis was seen in this study as well. OK lenses are worn overnight over a short period of 8-9 h unlike the 24 h wearing pattern of extended wear lenses, where the risk is highest.…”

Section: Discussionmentioning

confidence: 99%

A prospective interventional study of effect of accelerated orthokeratology on the corneal curvature and refraction among young adults with myopia

Khan

Gupta

Ahluwalia

et al. 2016

Medical Journal Armed Forces India

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m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 2 ( 2 0 1 6 ) 1 2 5 -1 3Background: Orthokeratology with reverse geometry contact lens is a non-surgical alternative to conventional contact lenses for correction of myopia. However, the strength of evidence for its efficacy and safety is limited to retrospective studies and only a few prospective studies. This prospective study, the first on Indian subjects, evaluated the outcome of orthokeratology among young myopes.Methods: Fifty eyes of 25 young myopes (age 19-29 years) with myopia of À1 to 5.0 diopter underwent accelerated orthokeratology using the reverse geometry ortho K -LK lenses for correction of myopia. They were followed up prospectively with weekly vision, refraction, corneal topography, and pachymetry to assess the correction of myopia.Results: The mean Log MAR vision corrected from 0.748 AE 0.225 at base line to 0.025 AE 0.0630 at 12 weeks with 86% achieving 6/6 unaided day time vision. This was associated with significant central corneal flattening and thinning. The lenses were well tolerated with no significant complications. Conclusion:Overnight accelerated orthokeratology effectively corrects moderate degree of myopia and provide excellent spectacle free day time vision without any significant adverse effects in the short term. #

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Section: Discussionmentioning

confidence: 99%

A prospective interventional study of effect of accelerated orthokeratology on the corneal curvature and refraction among young adults with myopia

Khan

Gupta

Ahluwalia

et al. 2016

Medical Journal Armed Forces India

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“…[13][14][15] Some studies have also determined OK effects on tear film components, 16 such as inflammatory mediators. 17 These studies conducted both in animals [18][19][20] and humans 6,7,12 have identified corneal changes produced in stromal and epithelial cell density, SBNP thickness and distribution, 7,12 and epithelial layer thickness ans also changes in the levels and distribution of proinflammatory mediators in the tear film samples of OK wearers. 17,21 To date, however, the effects of OK treatment on tear film osmolarity (TFO ) have not yet been examined.…”

mentioning

confidence: 99%

Tear Film Osmolarity in Response to Long-Term Orthokeratology Treatment

Nieto-Bona

Nombela-Palomo

Felipe-Marquez

et al. 2018

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

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Purpose: To compare tear film osmolarity (TFO) measurements in noncontact lens (CL) wearers and wearers of hydrogel or overnight orthokeratology (OK) CLs, and to assess possible effects of long-term OK on TFO. Methods: Overall, 108 subjects with moderate myopia participated in 2 experiments, and TFO was measured using the TearLab osmolarity system. In experiment 1, TFO measurements were made in 77 right eyes of 23 non-CL wearers, 26 hydrogel wearers, and 28 OK wearers. Subjects in the last 2 groups had worn their CL for at least 3 years. In experiment 2, 31 individuals (habitual soft CL wearers) were enrolled for prospective longterm follow-up of OK treatment. These subjects were fitted with Paragon-CRT (n¼16) or Seefree (n¼15) lenses, and TFO readings were taken at baseline and after 1 month and 1 year of lens wear and after 1 month of OK treatment interruption. Results: Values of TFO were within the normal limits in all 3 subject groups, although significantly lower osmolarities (P,0.01) were observed in non-CL wearers (281.765.9 mOsm/L) compared with hydrogel (291616.5 mOsm/L) or OK lens wearers (301.7610.8 mOsm/L). In experiment 2, TFO differed significantly at baseline between the Paragon-CRT and Seefree groups (P,0.05), and a significant decrease in TFO compared with baseline (P,0.01) was observed in the Paragon-CRT group after 1 month of cessation of lens wear. Conclusion:Higher TFO values were observed in lens wearers (hydrogel or OK) than non-CL wearers. After interruption of OK treatment, TFO returned to similar values to those found in non-CL wearers. O rthokeratology (OK), also known as overnight corneal refractive therapy or corneal reshaping, is a clinical technique designed to transiently reduce or eliminate myopia. Over the years, developments in the field have made OK a feasible correction option for subjects who prefer not to wear spectacles or contact lenses (CLs) during the day. Today's fitting techniques enable predictable and safe outcomes for improving uncorrected visual acuity and contrast sensitivity, 1-4 including satisfactory subjective vision according to the National Eye Institute Refractive Error Quality of Life Instrument-42 questionnaire. 5 The success of OK has been accompanied by a need to address the corneal response to treatment. Recent research efforts have examined changes in corneal morphology and physiology by assessing the effects of treatment on cell density, 6-8 thicknesses of the corneal layers, 9-11 subbasal nerve plexus (SBNP) distribution, 7,12 and corneal biomechanics. [13][14][15] Some studies have also determined OK effects on tear film components, 16 such as inflammatory mediators. 17 These studies conducted both in animals 18-20 and humans 6,7,12 have identified corneal changes produced in stromal and epithelial cell density, SBNP thickness and distribution, 7,12 and epithelial layer thickness ans also changes in the levels and distribution of proinflammatory mediators in the tear film samples of OK wearers. 17,21 To date, however, the effects of OK treatment o...

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“…В передней строме роговицы в ЦОЗ имело место уве-личение количества активированных кератоцитов до 7,7 ± 2,5 кл./мм² (t = 26,5; p < 0,001) с достоверной раз-ностью между группами пациентов с миопией слабой и средней степени (t = 2,6; p < 0,01). При превышении количества активированных кератоцитов более 2-й сте-пени по классификации (>10 кл./мм²) назначали корне-опротекторную терапию для профилактики осложнений (патент RU на изобретение 2571714 «Способ подбора ортокератологических линз у детей и подростков с мио-пией», 25.11.15) [19].…”

Section: ;15(2s):183-188unclassified

“…В настоящее время у детей и подростков для коррек-ции и контроля миопии применяются различные виды оптических средств коррекции зрения [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15], в том чис-ле ортокератологические линзы (ОКЛ) [16][17][18][19][20][21][22][23]. Извест-но, что для создания рефракционного эффекта в дизай-не ОКЛ используется принцип «обратной» геометрии.…”

unclassified

“…Исследования в данном направлении в настоящее вре-мя возможны благодаря прижизненной (in vivo) конфо-кальной микроскопии (КМ) [1,3,4,17], позволяющей в онлайн-режиме наблюдать за состоянием физиологи-ческой жизнедеятельности роговицы при применении контактных линз [4,6,8,16]. В настоящее время в лите-ратуре имеется ряд немногочисленных российских [16,17] и зарубежных работ [19,20,22,23], посвященных изучению гистоморфологической картины роговицы на фоне использования ОКЛ. Соответственно, представля-ется клинически значимым исследование влияния ОКЛ на ультраструктуру роговицы в период адаптации к ним, а также определение границ переносимости данного вида лечения.…”

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Value of Confocal Microscopy of the Cornea in Assessment of the Adaptation Period at Patients with Myopia when Using Orthokeratological Lenses

Ежова¹,

Мелихова²,

Balalin³

2018

Ophthalmology in Russia

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Гистоморфологическое исследование роговицы у пациентов с миопией при использовании ортокератологических линз ФГАУ «МНТК "Микрохирургия глаза" имени академика С.Н. Федорова» Министерства здравоохранения Российской Федерации, Волгоградский филиал ул. Землячки, 80, Волгоград, 400138, Российская Федерация РЕЗЮМЕЦель -изучить гистоморфологическое состояние роговицы с помощью конфокальной микроскопии у пациентов с миопией в период адаптации к ортокератологическим контактным линзам (ОКЛ). Пациенты и методы. Проведено исследование гисто-морфологического состояния роговицы в центральной оптической (ЦОЗ), средне-периферической (СПЗ) и перилимбальной зоне с помощью прижизненной конфокальной микроскопии (ConfoScan-4) у 72 пациентов (144 глаза) с миопией слабой степени (38 человек, 76 глаз) и средней степени (34 человека, 68 глаз) в течение 12 месяцев после использования ОКЛ. Результаты. Через 7 дней применения ОКЛ в центральной оптической зоне (ЦОЗ) роговицы фиксировалось достоверное увеличение степе-ни изменения эпителия, а через 1 месяц -степени активации нервных волокон и количества активированных кератоцитов. В средне-периферической зоне (СПЗ) роговицы отмечалось через 1 месяц достоверное увеличение степени изменения эпите-лия, количества активированных кератоцитов, а через 3 месяца -степени активации нервных волокон. Через 12 месяцев применения ОКЛ в ЦОЗ и СПЗ роговицы наблюдалась стабилизация показателя степени изменения эпителия, нервных волокон, а также количества активированных кератоцитов. Заключение. Полученные результаты гистоморфологических показателей позволили выделить «стрессовый» период адаптации продолжительностью 1 месяц, переходный период -от 1 до 3 месяцев и устойчивый период адаптации, формирование которого отмечалось к 12 месяцу применения ОКЛ. Стабильные данные плот-ности кератоцитов в различных слоях стромы роговицы, ПЭК в течение всего периода наблюдения свидетельствовали о до-статочно хорошей переносимости ОКЛ. Ключевые слова: роговица, ортокератологические контактные линзы, конфокальная микроскопия, периоды адаптации Для цитирования: Ежова Е.А., Мелихова И.А., Балалин С.В. Гистоморфологическое исследование роговицы у пациентов с мио-пией при использовании ортокератологических линз. Офтальмология. 2018;15(2S):183-188. https://doi

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Histomorphometric Profile of the Corneal Response to Short-term Reverse-geometry Orthokeratology Lens Wear in Primate Corneas

Cited by 31 publications

References 21 publications

A prospective interventional study of effect of accelerated orthokeratology on the corneal curvature and refraction among young adults with myopia

A prospective interventional study of effect of accelerated orthokeratology on the corneal curvature and refraction among young adults with myopia

Tear Film Osmolarity in Response to Long-Term Orthokeratology Treatment

Value of Confocal Microscopy of the Cornea in Assessment of the Adaptation Period at Patients with Myopia when Using Orthokeratological Lenses

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