OK lenses for myopia induce significant structural and optical changes particularly in the central epithelium after 15 days or 1 month of wear. The central corneal epithelium responds to OK wear by undergoing significant epithelial cell shape and size alterations with no effects, however, on the cells of the corneal endothelium or the corneal stroma. Peripheral corneal thickness increased with respect to baseline values. These findings suggest that the corneal epithelium is the principal structure affected by the mechanical forces exerted by the OK lenses.
Q-values varied according to the refractive properties examined. However, the relationship between refractive state and corneal asphericity was found to be determined more by the geometric properties of the eye (corneal power and axial length) than by manifest refraction.
Swimming in contaminated water might represent a risk for orthokeratology patients. CXL was effective for treating Acanthamoeba keratitis in an orthokeratology patient to eliminate active and cystic forms of the microorganism. Confocal microscopy was useful to confirm the diagnosis in the presence of confounding clinical signs observed during a conventional slit-lamp examination. Both CXL and confocal microscopy are essential to the outcome of PK.
Objective: To assess the effects of a short period of orthokeratology (OK) on corneal subbasal nerve plexus (SBNP) morphology and corneal sensitivity. Methods: Measurements were made in 56 right eyes of 56 subjects with low-to-moderate myopia who wore 2 OK lens designs (Group CRT: HDS 100 Paragon CRT, n¼35; Group SF: Seefree; n¼21) for a period of 1 month and in 15 right eyes of noncontact lens wearers as controls. The variables determined in each participant were corneal sensitivity using a Cochet-Bonnet esthesiometer and 12 SBNP variables determined on laser scanning confocal microscopy images using 3 different software packages. Correlation between SBNP architecture and corneal sensitivity was also examined. Results: Few changes were observed over the 1-month period in the variables examined in the OK treatment and control groups. However, significant reductions were detected over time in the number of nerves in the central cornea in the groups CRT (P¼0.029) and SF (P¼0.043) and in central corneal sensitivity in CRT (P¼0.047) along with significant increases in central and midperipheral corneal Langerhans cell counts in SF (P¼0.001 and 0.048, respectively). Conclusions: This study provides useful data to better understand the anatomical changes induced by OK in corneal SBNP. The different response observed to the 2 OK lens designs requires further investigation.
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