Observation on the long - term effectiveness and safety of juvenile myopia patients wearing orthokeratology / 国际眼科杂志(Guoji Yanke Zazhi)

coefficient of variation, corneal endothelium hexagonal cell ratio, anterior corneal surface curvature ratio of horizontal(HK) and vertical curvature(VK) were not statistically significant before and after wearing for 6mo, 1, and 2a (P > 0. 05). The uncorrected visual acuity increased significantly, and the diopter decreased significantly after their wearing (P<0.05). There was no significant difference in axial length after wearing OK lens for 6mo,1,and 2a (P>0.05). CONCLUSION: The orthokeratology lenses can significantly increase uncorrected visual acuity and improve refractive power for juvenile myopia without severe corneal or conjunctival complications occurred, which has little influence on corneal endothelial cells and corneal thickness with a certain degree of safety.

Effect of Toric Orthokeratology Lenses in Patients with Limbus to Limbus Corneal Astigmatism

PURPOSE: To report the efficacy of toric orthokeratology lenses in patients with astigmatism within 1.5 D having difficulty in wearing spherical orthokeratology lenses due to the limbus-to-limbus corneal astigmatism. METHODS: Twenty-three eyes of 16 patients with limbus-to-limbus corneal astigmatism who had been wearing toric orthokeratology lenses for more than 6 months were recruited. The uncorrected visual acuity (UCVA), refractive error, and keratometric changes including eccentricity before and after wearing lenses were compared, and the correlations between corneal astigmatism as well as refractive astigmatism and lens toricity were assessed. RESULTS: After wearing the lens, UCVA (log MAR) significantly improved from 0.61 +/- 0.22 to 0.05 +/- 0.08 (p < 0.001). Myopia and spherical equivalent were also reduced significantly (p < 0.001 and p < 0.001, respectively). While Simulated K (Sim K) tended to be more flattened (p < 0.001) and the eccentricity showed significant decrease (p < 0.001), corneal and refractive astigmatism were not changed significantly (p = 0.330 and p = 0.124, respectively). Correlations between corneal and refractive astigmatism and lens toricity were not statistically significant (r = 0.244, p = 0.300; r = -0.051, p = 0.832). No patients showed lens decentration or visual discomfort. CONCLUSIONS: Corneal topography was essential in patients who had difficulty in wearing spherical orthokeratology lenses due to the limbus-to-limbus corneal astigmatism. Toric orthokeratology lenses may be an effective treatment option in patients with limbus-to-limbus corneal astigmatism.

Effect of Toric Orthokeratology Lenses in Patients with Limbus to Limbus Corneal Astigmatism

PURPOSE: To report the efficacy of toric orthokeratology lenses in patients with astigmatism within 1.5 D having difficulty in wearing spherical orthokeratology lenses due to the limbus-to-limbus corneal astigmatism. METHODS: Twenty-three eyes of 16 patients with limbus-to-limbus corneal astigmatism who had been wearing toric orthokeratology lenses for more than 6 months were recruited. The uncorrected visual acuity (UCVA), refractive error, and keratometric changes including eccentricity before and after wearing lenses were compared, and the correlations between corneal astigmatism as well as refractive astigmatism and lens toricity were assessed. RESULTS: After wearing the lens, UCVA (log MAR) significantly improved from 0.61 +/- 0.22 to 0.05 +/- 0.08 (p < 0.001). Myopia and spherical equivalent were also reduced significantly (p < 0.001 and p < 0.001, respectively). While Simulated K (Sim K) tended to be more flattened (p < 0.001) and the eccentricity showed significant decrease (p < 0.001), corneal and refractive astigmatism were not changed significantly (p = 0.330 and p = 0.124, respectively). Correlations between corneal and refractive astigmatism and lens toricity were not statistically significant (r = 0.244, p = 0.300; r = -0.051, p = 0.832). No patients showed lens decentration or visual discomfort. CONCLUSIONS: Corneal topography was essential in patients who had difficulty in wearing spherical orthokeratology lenses due to the limbus-to-limbus corneal astigmatism. Toric orthokeratology lenses may be an effective treatment option in patients with limbus-to-limbus corneal astigmatism.

Correction of Limbus-to-Limbus Corneal Astigmatism with Toric Orthokeratology Lenses

PURPOSE: To report the efficacy of toric orthokeratology lenses in a patient with corneal astigmatism within 1.5 D having difficulty wearing spherical orthokeratology lenses because of limbus-to-limbus corneal astigmatism. CASE SUMMARY: An 11-year-old boy who wanted to wear orthokeratology lenses had a refractive error of -4.75 D sph = -1.00 D cyl 180 in the right eye and -4.50 D sph = -1.25 D cyl 180 in the left eye. The corneal astigmatism was 1.19 D and 1.19 D, respectively, and limbus-to-limbus corneal astigmatism was observed in topography. After wearing spherical orthokeratology lenses, the patient complained of monocular diplopia and both lenses were found to be displaced nasally. Toric orthokeratology lenses were prescribed for centration of lenses and resulted in significant improvement of uncorrected visual acuity of 20/20, refractive error of +0.75 D sph = -0.50 D cyl 170 in the right eye and +0.50 D sph = -0.50 D cyl 160 in the left eye, and centration of lenses for the 12-month follow-up period. CONCLUSIONS: Toric orthokeratology lenses should be considered if spherical orthokeratology lenses are not effective even in patients having less than 1.5 D of corneal astigmatism because of limbus-to-limbus corneal astigmatism.

Attempts to Reduce the Progression of Myopia and Spectacle Prescriptions during Childhood: A Survey of Eye Specialists

PURPOSE: To determine methods tried in clinical trials to reduce the progression of myopia in children, and spectacle prescribing patterns of hospital ophthalmologists. METHODS: A multi-sectioned survey composed of Likert items relating to the methods of reducing myopia progression (orthokeratology lenses [O-K lenses], undercorrected glasses, and topical atropine) and the patterns of prescribing spectacles for children (including two cases involving a 5-year-old girl and an 8-year-old boy) were distributed to members of the Korean Ophthalmological Society, and the collected data was statistically analyzed. RESULTS: A total of 78 out of 130 ophthalmologists returned the survey. On a scale of 1 to 5, the mean rates of whether the ophthalmologists think O-K lenses arrest myopia progression, and whether they recommend their patients to wear O-K lenses if indicative, were 3.06 and 2.75, respectively. Moreover, the mean rates of whether they consider that wearing glasses which are undercorrected would slow down the progression of the myopia, or if they think topical atropine helps in arresting myopia progression in children, were 2.34 and 1.27, respectively. In response to the case studies, the majority of practitioners preferred to prescribe the full amount found in cycloplegic refraction to pediatric patients with myopia. CONCLUSIONS: Ophthalmologists in clinical practice encouraged children to wear O-K lenses more than undercorrected glasses as a way to retard myopia progression. However, the application of atropine is rarely tried in clinical trials. In managing pediatric patients with myopia (case specific), the majority of the practitioners chose to prescribe glasses with full cycloplegic correction.