Objectives:To investigate retrospectively the difference in myopia progression, over about 7 years, between two groups of Hong Kong Chinese myopic children who wore overnight orthokeratology lenses or single-vision spectacles. Methods: A total of 238 records of children wearing overnight orthokeratology lenses or single-vision spectacles from Eye'ni optical shop (Hong Kong) between January 1999 and December 2009 were reviewed. Refractive and central corneal curvature data with 6-year or a longer follow-up period of 70 patients were retrieved: 34 children (15 boys and 19 girls, aged 9.2 ± 1.8 years) wore orthokeratology lenses and 36 (20 boys and 16 girls, aged 10.2 ± 2.0 years) wore spectacles. Myopic progression was determined as the change of myopia from the baseline to the final visit. Results: No statistically significant differences (P . 0.05) in age, central flat corneal curvatures, baseline refractive error, or follow-up period were observed between the two groups. Average myopic progression of the overnight orthokeratology contact lens cohort (−0.37 ± 0.49 D) was significantly less (P , 0.001) than of the single-vision spectacle group (−2.06 ± 0.81 D) over about 7 years. Conclusion: Our preliminary 7-year data support the claim that overnight orthokeratology contact lenses may be a feasible clinical method for myopic progression control. Prospective and randomized investigations are warranted to overcome the limitations of this retrospective study. Keywords: myopia, contact lens, orthokeratology, myopia progression
IntroductionOrthokeratology contact lenses began to be fitted in the late 1960s. At this time, the technique suffered because only a small amount of myopia was corrected, the time for the correction to occur was long, and the technique was unpredictable. Changes in technology and design have made orthokeratology a predictable means of correcting low to moderate myopia safely, such that the technique is now used as an overnight modality in children. New materials with higher oxygen permeability and reverse geometry contact lens design allow myopic children to wear the contact lenses during sleep to temporarily flatten the central cornea (overnight orthokeratology). An orthokeratology lens flattens the central cornea while it steepens the mid-peripheral cornea. This rearrangement of the shape of the cornea induces peripheral myopic defocus. Several investigations [1][2][3] propose that peripheral myopic defocus may play a vital role in myopic progression; thus overnight orthokeratology is hypothesized to control myopic progression.
2Mok and Chung myopia progression in children. The aim of this pilot report was to investigate the difference in myopia progression, over 7 years, between two groups of myopic children who wore either orthokeratology lenses or single-vision spectacles. A retrospective review may provide preliminary data to justify conducting a prospective and randomized long-term study on the effect of orthokeratology on myopia progression, since no report of the effect of orthokerat...