Abstract
Purpose
Orthokeratology (OK) is known to alter relative peripheral refraction (RPR) with this
presumed to be its key myopia control mechanism. A prospective, longitudinal study
was performed to examine stability of OK-induced RPR changes in myopic children and
young adults.
Methods
RPR of twelve children (C)(8–16 years) and eight adults (A)(18–29 years) with spherical
equivalent refraction of -0.75 to -5.00D were measured unaided and while wearing single
vision soft contact lenses (SCL). Measurements were repeated after 1, 6 and 12 months
of OK wear. RPR was measured using an open-field Shin Nippon SRW-5000 autorefractor
at 10, 20 and 30 degrees nasally (N) and temporally (T), converted into power vectors
M, J0 and J45. On-axis refractions and axial lengths (IOL Master) were also measured.
Results
Compared to the unaided state, 1-month of OK wear shifted the RPR in the myopic direction
at 30 T (C: p = 0.023; A:, p = 0.002) and 30 N (C&A, p = 0.003) and was stable thereafter,
with similar changes compared to SCL wear. J0 showed a myopic shift in comparison
to both unaided and SCL correction in children but not adults, and J45 did not change
in either group. The on-axis OK correction was predictive of the RPR shift in both
children and adults at 30 T (C: r=−0.58, p = 0.029; A: r=−0.92, p < 0.001) and 30 N
(C: r=−0.60, p = 0.024; A: r=−0.74, p = 0.013) with symmetry of RPR shifts (C: r = 0.67,
p = 0.008; A: r = 0.85, p = 0.004). No relationships between changes in RPR and axial
length were found after twelve months of OK wear; level of myopia was stable in both
groups.
Conclusion
Relative to both unaided and single vision SCL correction, OK shifted the RPR in the
myopic direction; the RPR was stable from 1 to 12 months. The RPR shift in OK wear
varied with the degree of myopia but was not correlated with myopia progression.
Keywords
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Article info
Publication history
Published online: November 30, 2019
Accepted:
November 18,
2019
Received in revised form:
November 18,
2019
Received:
September 12,
2019
Identification
Copyright
© 2019 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
