Factors Preventing Myopia Progression with Orthokeratology Correction

Abstract

Orthokeratology is a successful treatment option in controlling axial elongation compared to SV in children of older age, had earlier onset of myopia, were female, had lower rate of myopia progression before baseline, had lower myopia at baseline, had longer anterior chamber depth, had greater corneal power, had more prolate corneal shape, had larger iris and pupil diameters, and had lower levels of parental myopia.

Higher spherical equivalent refractive errors is associated with slower axial elongation wearing orthokeratology

“…Recently, there were some contradicting study results about the relationship between pre-treatment SER and AL elongation [11][12][13][14][15]. Hiraoka et al [11] and Cho et al [12] found that more myopic children wearing OK showed a slowly increase in Kakita et al [15] observed the higher SER was associated with slower AL growth only in higher myopic patients wearing OK. Santodomingo-Rubido et al [13] discovered that lower myopic patients wearing OK showed more slowly increase in AL increase. However, Cho and Cheung [14] and Kakita et al [15] reported that there was no relationship between them.…”

“…At present, orthokeratology (OK) is the most effective non-pharmacological method in slowing down myopia progression compared to the use of single-vision spectacle lenses (SV) [3][4][5], bifocal spectacles [6], progressive addition lenses [7,8], soft lenses [9], and rigid gas-permeable contact lenses (RGP) [10]. However, the biggest challenge is to identify those children who may benefit from the use of OK. Investigators have tried to identify the factors affecting the efficacy of OK in myopic control such as initial age [11][12][13][14], spherical equivalent refractive errors (SER) [11][12][13][14][15], pupil diameter [13,16], age of myopia onset [13], myopia progression 2 years before baseline [13], anterior chamber depth [13], and parental refraction [13]. Myopia progression was estimated from changes in axial length (AL), which was evaluated using a noncontact optic biometric device (IOL Master).…”

Control de la miopía con ortoqueratología

“…Otra investigación trabajó con un grupo de control corregido solo con anteojos: se encontró que la progresión de la miopía en niños adaptados con ortoqueratología durante un mes fue de 0,13 D, en comparación con los niños adaptados con anteojos, que fue de 1,00 D (21). Se comparó la calidad de vida de los niños adaptados con lentes de ortoqueratología y anteojos, al analizar la agudeza visual, el rendimiento académico, los síntomas, la satisfacción y la apariencia; así, se presentó una mejora en la actitud de los niños en tratamiento con ortoqueratología y una mayor adaptación a diversas actividades (22 Zhong y colaboradores (25) investigaron la relación entre la progresión miópica y tres ejes -nasal, superior e inferior-, después de un tratamiento de ortoqueratología durante dos años; se hallaron cambios refractivos por el desenfoque miópico generado en la retina periférica de los pacientes, así como un aumento en las curvas corneales en los tres ejes.…”

Clinical management of progressive myopia

“…28 Practitioners might then expect less effective control with orthokeratology with lower initial myopia and greater control with higher levels. This is by no means proven or well understood, as one study recently showed the inverse effect; 24 however, it may be useful to guide clinical choices. It should be noted as well that the primary goal of an orthokeratology patient is to achieve good daytime vision and this tends to be more challenging at myopia levels higher than À 6.00 diopters.…”

“…Data are re-plotted from Holden. 22 It is becoming well established in multiple clinical trials, [24][25][26] including a recent 2-year-randomized clinical trial, 27 that orthokeratology slows myopia progression by 50% on average in children. These studies further showed that the slowing of myopia was not limited to the first year.…”