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Seven-year retrospective analysis of the myopic control effect of orthokeratology in children: a pilot study

This Hong Kong Study reviewed the clinical records of over 200 short-sighted children attending a local opticians over a prior period of seven years and for a sub-group of 70 children divided into those who had undergone Overnight Vision Correction (OVC) treatment with an average commencement age of 9 and those who had worn spectacles with an average commencement age of 10. After seven years, the children wearing overnight ortho-k corrective contact lenses were shown to have only a modest increase in their short-sight of just over one-third of a diopter whilst those wearing spectacles showed an increase in their short-sight of more than two diopters. This significant difference - albeit based on a retrospective study rather than a controlled clinical trial - still confirms the superior performance of OVC in slowing down or halting the further development of short-sight in children. 

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.

Alan Kwok-hei Mok, Cindy Sin-Ting Chung Eye'ni,;Department of Anatomy,LiKaShing Faculty of Medicine, TheUniversity of Hong Kong, Hong Kong,People's republic of China 

Read full article at Clinical Optometry

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