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Objective:To evaluate the clinical effect of Toric design orthokeratology in myopic teenagers with mild-to-moderate astigmatism.Methods:A non-randomized controlled clinical study was conducted.Eighty juvenile myopia patients (160 eyes) diagnosed with mild to moderate astigmatism with myopia after mydriatic computer optometry and received the treatment of orthokeratology at Zhejiang Rongjun Hospital from January 2016 to June 2017 were enrolled.The patients were divided into regular spherical design orthokeratology group and Toric design orthokeratology group, with 80 eyes (40 cases) in each group.The patients wore orthokeratology for 8 to 10 hours every night and were re-examined at 1 day, 1 week and 1, 3, 6, 12 and 18 months after wearing, respectively.The visual acuity, refraction, corneal health status and central deviation of the treatment area in the corneal topography map were measured and recorded during the 18-month treatment.The complications during treatment were recorded.After 12-month wearing, the uncorrected visual acuity and the center deviation of the treatment area were compared between the two groups.After 18-month wearing, patients in the two groups stopped wearing the orthokeratology lens for 1 month, and then the refraction examination, IOLMaster and corneal topography were performed to compare the spherical equivalent, axial length and degree of astigmatism.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Zhejiang Rongjun Hospital (No.2020-10). Written informed consent was obtained from guardians prior to any medical examination.Results:After 12-month wearing, the center deviation of the shaping treatment area was (0.86±0.23)mm in the Toric design orthokeratology group, which was significantly lower than (1.16±0.44)mm in the regular spherical design orthokeratology group ( t=5.404, P<0.001). After 12-month wearing, the uncorrected visual acuity was (0.03±0.08) LogMAR in the Toric design orthokeratology group, which was significantly higher than (0.09±0.10) LogMAR in the regular spherical design orthokeratology group ( t=2.963, P=0.004). The spherical equivalent and the axial length of Toric design orthokeratology group were significantly smaller than those of the regular spherical design orthokeratology group ( t=2.542, 2.107; both at P<0.05), and there was no statistically significant difference in the degree of astigmatism between the two groups ( t=0.821, P=0.413). During the 18-month follow-up, the adverse reaction, punctate corneal epithelial opacity, occurred in 18 eyes.The incidence of adverse effect was 6.26%(5/80) in the Toric design orthokeratology group, which was significantly lower than the 16.25% (13/80) in the regular spherical design orthokeratology group ( χ2=3.897, P=0.048). Conclusions:The Toric design orthokeratology shows better efficacy in myopia control as well as reducing the adverse reaction rate in juvenile myopia, and it can better solve the deviation in corneal shaping in the use of regular spherical design orthokeratology.
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Objective To evaluate the 1-year clinical outcome of orthokeratology contact lens wear and glasses wear for myopia in children,mainly focusing on the effects on the biological parameters of the eyeballs.Methods A randomized-controlled clinical study analyzed 200 eyes of 200 adolescent,with low and moderate myopia from January 2018 to August 2018 at Chengdu Aier Eye Hospital.The subjects were divided into an orthokeratology group and a spectacles group,100 eyes in each group.The axial lengths (AL),central corneal thickness (CCT),anterior chamber depth (ACD),and crystalline lens thickness were measured and compared between the two groups before and 6 months,12 months after wearing the lenses,and 1 month after stopping lens wear.This study conformed to the tenets of the Declaration of Helsinki.Written informed consent was obtained from each subject prior to entering the study cohort.The study protocol was approved by the Ethics Committee of Chengdu Aier Eye Hospital (No.[2018]01-1).Results The overall difference in AL was statistically significant in the two groups at various time points (Fgroup =4.617,P =0.043;Ftime =10.939,P =0.023).Compared with before wearing lenses,the AL was significantly lengthened in both of the groups at 6 and 12 months after wearing lenses and 1 month after stopping lens wear (all at P＜ 0.05).There was no significant difference in AL between 1 month after stopping lens wear and 12 months after wearing lenses in the orthokeratology group (P＞0.05).Twelve months after wearing lenses,the AL increases values of the orthokeratology group were significantly lower than those of the spectacles group ([0.13±0.06]mm vs.[0.29±0.08] mm) (t=16.000,P=0.002).The differences in CCT at time points in the two groups were statistically significant (Fgroup =2.297,P =0.013;Ftime =11.219,P＜ 0.01).At 6 and 12 months after wearing the lenses,the CCT in the orthokeratology group was significantly thinner than that before lens wear (all at P＜ 0.05).CCT showed no significant difference between 1 month after stopping lens wear and before wearing lenses in the orthokeratology group (P＞0.05).There was no statistically significanant difference in the ACD between the two groups at time points (Fgroup =4.226,P =0.051;Ftime =3.208,P=0.057).The overall differences in crystalline lens thickness at time points before and after wearing lenses in the two groups were statistically significant (Fgroup =13.13,P＜0.01;Ftime =0.804,P =0.047).At 6 and 12 months after wearing the lenses and 1 month after stopping lens wear,the crystalline lens thickness in the orthokeratology group was significantly greater than that before lens wear and that in the spectacles group at the same time points (all at P＜0.05).There was no significant difference in the crystalline lens thickness between 1 month after stopping lens wear and 12 months after wearing the lenses in the orthokeratology group (P＞0.05).Conclusions Compared with wearing spectacles,orthokeratology lenses wear can effectively slow down the prolongation of the AL,decrease CCT reversibly and increase crystalline lens thickness in adolescent myopic subjects,but it has no significant effect on the ACD.
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Objective@#To evaluate the 1-year clinical outcome of orthokeratology contact lens wear and glasses wear for myopia in children, mainly focusing on the effects on the biological parameters of the eyeballs.@*Methods@#A randomized-controlled clinical study analyzed 200 eyes of 200 adolescent, with low and moderate myopia from January 2018 to August 2018 at Chengdu Aier Eye Hospital.The subjects were divided into an orthokeratology group and a spectacles group, 100 eyes in each group.The axial lengths (AL), central corneal thickness (CCT), anterior chamber depth (ACD), and crystalline lens thickness were measured and compared between the two groups before and 6 months, 12 months after wearing the lenses, and 1 month after stopping lens wear.This study conformed to the tenets of the Declaration of Helsinki.Written informed consent was obtained from each subject prior to entering the study cohort.The study protocol was approved by the Ethics Committee of Chengdu Aier Eye Hospital (No.[2018]01-1).@*Results@#The overall difference in AL was statistically significant in the two groups at various time points(Fgroup= 4.617, P=0.043; Ftime=10.939, P=0.023). Compared with before wearing lenses, the AL was significantly lengthened in both of the groups at 6 and 12 months after wearing lenses and 1 month after stopping lens wear (all at P<0.05). There was no significant difference in AL between 1 month after stopping lens wear and 12 months after wearing lenses in the orthokeratology group (P>0.05). Twelve months after wearing lenses, the AL increases values of the orthokeratology group were significantly lower than those of the spectacles group ([0.13±0.06]mm vs. [0.29±0.08]mm) (t=16.000, P=0.002). The differences in CCT at time points in the two groups were statistically significant (Fgroup=2.297, P=0.013; Ftime=11.219, P<0.01). At 6 and 12 months after wearing the lenses, the CCT in the orthokeratology group was significantly thinner than that before lens wear (all at P<0.05). CCT showed no significant difference between 1 month after stopping lens wear and before wearing lenses in the orthokeratology group (P>0.05). There was no statistically significanant difference in the ACD between the two groups at time points (Fgroup=4.226, P=0.051; Ftime=3.208, P=0.057). The overall differences in crystalline lens thickness at time points before and after wearing lenses in the two groups were statistically significant (Fgroup=13.13, P<0.01; Ftime=0.804, P=0.047). At 6 and 12 months after wearing the lenses and 1 month after stopping lens wear, the crystalline lens thickness in the orthokeratology group was significantly greater than that before lens wear and that in the spectacles group at the same time points (all at P<0.05). There was no significant difference in the crystalline lens thickness between 1 month after stopping lens wear and 12 months after wearing the lenses in the orthokeratology group (P>0.05).@*Conclusions@#Compared with wearing spectacles, orthokeratology lenses wear can effectively slow down the prolongation of the AL, decrease CCT reversibly and increase crystalline lens thickness in adolescent myopic subjects, but it has no significant effect on the ACD.