Comparison of the changes of corneal astigmatism after long-term spherical and toric orthokeratology wearing_West China Medical Journal

Authors：

YANG Bi ^1,2,3 , PENG Yihong ¹ , HE Yuanhao ¹ , MA Wei ^1,2,3 ,  LIU Longqian ^1,2,3

1. Department of Optometry and Vision Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIU Longqian, Email: b.q15651@hotmail.com

Keywords：

Spherical; toric; orthokeratology; corneal astigmatism

DOI：

10.7507/1002-0179.202202068

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Objective To compare the changes of corneal astigmatism after long-term spherical and toric orthokeratology wearing, and to investigate the effects of different orthokeratology design on corneal astigmatism.Methods The medical records of myopic adolescent patients who have been prescribed spherical and toric orthokeratology in the contact lens clinic of West China Hospital, Sichuan University between January 2019 and December 2021 were analyzed retrospectively.The differences of corneal astigmatism changes after wearing spherical and toric orthokeratology for a long time and one month discontinuation were compared. The influencing factors of corneal astigmatism changes were analyzed. Results A total of 156 patients were included. There were 76 cases (76 eyes) in spherical orthokeratology group and 80 cases (80 eyes) in toric orthokeratology group. There was no significant difference between the two groups in age, gender, baseline myopia diopter and total lens wearing time (P>0.05). There were statistically significant differences between the spherical orthokeratology group and the toric orthokeratology group in the baseline corneal flat K value [42.1 (41.3, 43.3) vs. 43.1 (42.0, 44.1) D], baseline corneal steep K value [(43.4±1.3) vs. (44.6±1.5) D], baseline corneal astigmatism [(1.1±0.5) vs. (1.6±0.6) D], and baseline total eye astigmatism [−0.6 (−1.2, 0.0) vs. −1.4 (−1.8, −1.0) D] before wearing the orthokeratology (P<0.05). Compared with the baseline value, 1 month after the two groups stopped wearing the orthokeratology, the corneal flat K values became flatter [spherical orthokeratology group: 42.09 (41.28, 43.34) vs. 41.73 (40.98, 43.16) D, toric orthokeratology group: 43.09 (41.95, 44.10) vs. 42.61 (41.52, 43.56) D; P<0.05], the changes of corneal steep K values were not statistically significant (P>0.05), but the corneal astigmatism values increased [spherical orthokeratology group: (1.05±0.49) vs. (1.37±0.56) D, toric orthokeratology group: (1.62±0.57) vs. (1.99±0.63) D; P<0.05]. There was no significant difference in the changes of corneal flat K value, corneal steep K value and corneal astigmatism between the two groups (P>0.05). Multivariate analysis showed that age (P=0.011) and the total duration of orthokeratology wearing (P=0.004) were the main factors affecting the changes of corneal astigmatism. Conclusion After 1 month of non-wearing, the flat K value of the cornea becomes flat, the steep K value remains unchanged, and the corneal astigmatism increases. There is no difference in the effect of the spherical and toric orthokeratology on corneal astigmatism. The change of corneal astigmatism is related to the patient’s age and the total duration of wearing the orthokeratology. The younger the age, the longer the duration of orthokeratology wearing, the more significant the increase of corneal astigmatism after stopping wearing the orthokeratology.

Citation： YANG Bi, PENG Yihong, HE Yuanhao, MA Wei, LIU Longqian. Comparison of the changes of corneal astigmatism after long-term spherical and toric orthokeratology wearing. West China Medical Journal, 2022, 37(11): 1666-1671. doi: 10.7507/1002-0179.202202068 Copy

1.	Cho P, Cheung SW. Retardation of myopia in orthokeratology (ROMIO) study: a 2-year randomized clinical trial. Invest Ophthalmol Vis Sci, 2012, 53(11): 7077-7085.
2.	Chen C, Cheung SW, Cho P. Myopia control using toric orthokeratology (TO-SEE study). Invest Ophthalmol Vis Sci, 2013, 54(10): 6510-6517.
3.	Charm J, Cho P. High myopia-partial reduction ortho-k: a 2-year randomized study. Optom Vis Sci, 2013, 90(6): 530-539.
4.	Huang J, Wen D, Wang Q, et al. Efficacy comparison of 16 interventions for myopia control in children: a network meta-analysis. Ophthalmology, 2016, 123(4): 697-708.
5.	Xie P, Guo X. Chinese experiences on orthokeratology. Eye Contact Lens, 2016, 42(1): 43-47.
6.	He M, Du Y, Liu Q, et al. Effects of orthokeratology on the progression of low to moderate myopia in Chinese children. BMC Ophthalmol, 2016, 16: 126.
7.	Soni PS, Nguyen TT, Bonanno JA. Overnight orthokeratology: refractive and corneal recovery after discontinuation of reverse-geometry lenses. Eye Contact Lens, 2004, 30(4): 254-262.
8.	Barr JT, Rah MJ, Meyers W, et al. Recovery of refractive error after corneal refractive therapy. Eye Contact Lens, 2004, 30(4): 247-251.
9.	Kobayashi Y, Yanai R, Chikamoto N, et al. Reversibility of effects of orthokeratology on visual acuity, refractive error, corneal topography, and contrast sensitivity. Eye Contact Lens, 2008, 34(4): 224-228.
10.	Santodomingo-Rubido J, Villa-Collar C, Gilmartin B, et al. Short-term changes in ocular biometry and refraction after discontinuation of long-term orthokeratology. Eye Contact Lens, 2014, 40(2): 84-90.
11.	Chen Z, Zhou J, Xue F, et al. Increased corneal toricity after long-term orthokeratology lens wear. J Ophthalmol, 2018, 2018: 7106028.
12.	Wu R, Stapleton F, Swarbrick HA. Residual corneal flattening after discontinuation of long-term orthokeratology lens wear in asian children. Eye Contact Lens, 2009, 35(6): 333-337.
13.	吕帆. 接触镜学. 3 版. 北京:人民卫生出版社, 2017: 106-111.
14.	Kerns RL. Research in orthokeratology. Part V:results and observations-recovery aspects. J Am Optom Assoc, 1977, 48(3): 345-359.
15.	Bullimore MA, Johnson LA. Overnight orthokeratology. Cont Lens Anterior Eye, 2020, 43(4): 322-332.
16.	董光静, 刘陇黔. 长期配戴角膜塑形镜对散光和角膜形态的影响. 华西医学, 2020, 35(7): 839-844.
17.	Cheung SW, Cho P, Chan B. Astigmatic changes in orthokeratology. Optom Vis Sci, 2009, 86(12): 1352-1358.
18.	Nagra M, Dashrathi R, Senthan E, et al. Characterisation of internal, refractive, and corneal astigmatism in a UK university student population. Cont Lens Anterior Eye, 2020, 43(4): 333-337.
19.	Zhou J, Xue F, Zhou X, et al. Thickness profiles of the corneal epithelium along the steep and flat meridians of astigmatic corneas after orthokeratology. BMC Ophthalmol, 2020, 20(1): 240.
20.	Ren Q, Yang B, Liu L, et al. Orthokeratology in adults and factors affecting success: study design and preliminary results. Cont Lens Anterior Eye, 2020, 43(6): 595-601.
21.	Kang P, Swarbrick H. Discontinuation of long term orthokeratology lens wear and subsequent refractive surgery outcome. Cont Lens Anterior Eye, 2017, 40(6): 436-439.

1. Cho P, Cheung SW. Retardation of myopia in orthokeratology (ROMIO) study: a 2-year randomized clinical trial. Invest Ophthalmol Vis Sci, 2012, 53(11): 7077-7085.
2. Chen C, Cheung SW, Cho P. Myopia control using toric orthokeratology (TO-SEE study). Invest Ophthalmol Vis Sci, 2013, 54(10): 6510-6517.
3. Charm J, Cho P. High myopia-partial reduction ortho-k: a 2-year randomized study. Optom Vis Sci, 2013, 90(6): 530-539.
4. Huang J, Wen D, Wang Q, et al. Efficacy comparison of 16 interventions for myopia control in children: a network meta-analysis. Ophthalmology, 2016, 123(4): 697-708.
5. Xie P, Guo X. Chinese experiences on orthokeratology. Eye Contact Lens, 2016, 42(1): 43-47.
6. He M, Du Y, Liu Q, et al. Effects of orthokeratology on the progression of low to moderate myopia in Chinese children. BMC Ophthalmol, 2016, 16: 126.
7. Soni PS, Nguyen TT, Bonanno JA. Overnight orthokeratology: refractive and corneal recovery after discontinuation of reverse-geometry lenses. Eye Contact Lens, 2004, 30(4): 254-262.
8. Barr JT, Rah MJ, Meyers W, et al. Recovery of refractive error after corneal refractive therapy. Eye Contact Lens, 2004, 30(4): 247-251.
9. Kobayashi Y, Yanai R, Chikamoto N, et al. Reversibility of effects of orthokeratology on visual acuity, refractive error, corneal topography, and contrast sensitivity. Eye Contact Lens, 2008, 34(4): 224-228.
10. Santodomingo-Rubido J, Villa-Collar C, Gilmartin B, et al. Short-term changes in ocular biometry and refraction after discontinuation of long-term orthokeratology. Eye Contact Lens, 2014, 40(2): 84-90.
11. Chen Z, Zhou J, Xue F, et al. Increased corneal toricity after long-term orthokeratology lens wear. J Ophthalmol, 2018, 2018: 7106028.
12. Wu R, Stapleton F, Swarbrick HA. Residual corneal flattening after discontinuation of long-term orthokeratology lens wear in asian children. Eye Contact Lens, 2009, 35(6): 333-337.
13. 吕帆. 接触镜学. 3 版. 北京:人民卫生出版社, 2017: 106-111.
14. Kerns RL. Research in orthokeratology. Part V:results and observations-recovery aspects. J Am Optom Assoc, 1977, 48(3): 345-359.
15. Bullimore MA, Johnson LA. Overnight orthokeratology. Cont Lens Anterior Eye, 2020, 43(4): 322-332.
16. 董光静, 刘陇黔. 长期配戴角膜塑形镜对散光和角膜形态的影响. 华西医学, 2020, 35(7): 839-844.
17. Cheung SW, Cho P, Chan B. Astigmatic changes in orthokeratology. Optom Vis Sci, 2009, 86(12): 1352-1358.
18. Nagra M, Dashrathi R, Senthan E, et al. Characterisation of internal, refractive, and corneal astigmatism in a UK university student population. Cont Lens Anterior Eye, 2020, 43(4): 333-337.
19. Zhou J, Xue F, Zhou X, et al. Thickness profiles of the corneal epithelium along the steep and flat meridians of astigmatic corneas after orthokeratology. BMC Ophthalmol, 2020, 20(1): 240.
20. Ren Q, Yang B, Liu L, et al. Orthokeratology in adults and factors affecting success: study design and preliminary results. Cont Lens Anterior Eye, 2020, 43(6): 595-601.
21. Kang P, Swarbrick H. Discontinuation of long term orthokeratology lens wear and subsequent refractive surgery outcome. Cont Lens Anterior Eye, 2017, 40(6): 436-439.

West China Medical Journal

Comparison of the changes of corneal astigmatism after long-term spherical and toric orthokeratology wearing

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