Comparison of the control effect of corneal refractive therapy with vision shaping treatment designed orthokeratology on corneal morphology myopia at low E-values / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe and analyze the effectiveness and safety of wearing corneal refractive therapy(CRT)and vision shaping treatment(VST)designed orthokeratology in controlling myopic progression in adolescents with low E-value corneal morphology.METHODS: This prospective study involved 100 cases(100 eyes)of adolescent myopia patients fitted with orthokeratology at our optometry clinic from January 2020 to December 2021. The data of right eye were collected for research, and they were divided into low myopia group(-1.00 to -3.00 D)and moderate myopia group(-3.25 to -5.00 D)according to spherical equivalent, with 50 cases in each group. Each group of patients was further randomly divided into the CRT group and the VST group, with 25 cases in each group. Uncorrected visual acuity, refractive error, axial length(AL), tear film break-up time(BUT), corneal endothelial cell density, corneal staining grading, lens decentration, and refractive power at 15°-30° were measured before and after wearing orthokeratology, with a follow-up duration of 1.5 a.RESULTS: The uncorrected visual acuity of CRT and VST subgroups in the low myopia group showed no statistical significance at any time point after wearing orthokeratology. However, in the moderate myopia group, CRT subgroup showed better uncorrected visual acuity than the VST subgroup, with significant differences at 1 d and 1 wk(t=-9.474, -12.067, both P<0.01); no significant differences were noted at other time points. After wearing lens for 6 mo and 1.5 a, the AL growth for the CRT subgroup in low and moderate myopia was less than the VST subgroup, with no statistically significant differences. There were no statistically significant differences in binocular BUT and corneal endothelial cell density after wearing lens for 6 mo and 1.5 a. Corneal injury was lower in the CRT subgroup than that in the VST subgroup, but the difference was not statistically significant(Z=-1.803, P=0.071). Lens decentration was significantly better in the CRT subgroup than in the VST subgroup(Z=-4.629, P<0.001). In the periphery of the retina at 15°-30°, there were no significant differences in the amount of myopic defocus between the two groups, while it was statistically significant at 1, 3, and 6 mo in the moderate myopia subgroup(t=-3.949, P=0.008; t=-5.833, P<0.001; t=-6.231, P<0.001), indicating that CRT subgroup could produce a greater amount of myopic defocus.CONCLUSION: For patients with low E-value corneal morphology, CRT, using the vector height at 8 mm on the cornea for fitting, is not limited to the corneal E-value. It shapes faster and improves uncorrected visual acuity after shaping, especially for moderate myopia, achieving better daytime vision. In terms of controlling myopia, CRT fitting elevates return zone depth(RZD), creating a small central optical zone to produce more peripheral myopic defocus. However, there was no significant difference between the two groups in controlling AL growth. Both groups showed minimal corneal damage, indicating consistent safety in myopia control.

Comparison of the effect between night-wearing orthokeratology lens and frame glasses on the treatment of juvenile myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the effects of night-wearing orthokeratology lenses and frame glasses on the treatment of juvenile myopia, and provide reference for the selection of myopia treatment methods in adolescents.METHODS: A prospective study was conducted on 106 adolescent myopia patients who received treatment in our hospital from June to November 2020. According to the wishes of patients, they were divided into two groups with 53 cases in each group. The control group was given regular frame glasses after optometry, while the observation group was given night-wearing orthokeratology lenses. The uncorrected visual acuity(LogMAR), refractive index(spherical equivalent and cylindrical lens power), and ocular biological parameters(axial length, central corneal thickness, anterior chamber depth and lens thickness)were compared between the two groups.RESULTS: The uncorrected visual acuity(LogMAR)of the observation group was lower than that of the control group at 1a after treatment(0.51±0.12 vs. 0.73±0.15), and the spherical equivalent(-0.23±0.05 vs. -5.32±1.35D)and cylindrical lens power(-1.53±0.22 vs. -1.97±0.35DC)were smaller than those of the control group(P<0.001). The axial length of the eyes in the two groups increased at 1a after treatment and the axial length in the control group was longer(25.53±0.84 vs. 25.95±0.83 mm); the lens thickness of the observation group was increased compared with that before treatment(3.39±0.19 vs. 3.31±0.15 mm; P<0.05). After 1a treatment, the accommodative amplitude(14.29±1.37 vs. 12.90±1.07D), accommodative facility(11.05±2.09 vs. 7.59±1.82cpm), and total staining rate of corneal epithelium in the observation group were higher than those in the control group(15.1% vs. 1.9%), and the accommodative lag was lower than that in the control group(0.55±0.11 vs. 0.97±0.30D; P<0.05). There were no significant differences in corneal cell density(3197.23±249.66 vs. 3207.41±258.14 cells/mm2), corneal endothelial cell area(309.27±28.04 vs. 312.62±24.95mm2)and the incidence of complications between the two groups before and after treatment(5.7% vs. 9.4%; P>0.05).CONCLUSION: Night-wearing orthokeratology lenses can improve uncorrected visual acuity in adolescent patients with myopia, reduce the spherical equivalent and cylindrical lens power, and improve the accommodation-related parameters, but has no significant effect on the corneal function.

Effect of base curve aspheric orthokeratology lens on ocular surface of adolescents with myopia and moderate to high astigmatism / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To explore the effect of base curve aspheric orthokeratology lens in the treatment of adolescents with myopia and moderate to high astigmatism, and its influence on ocular surface morphology and tears.METHODS:A total of 232 adolescents(464 eyes)with myopia and moderate to high astigmatism treated in the hospital from December 2018 to March 2020 were selected as the research subjects. They were randomly divided into control group(116 patients, 232 eyes)and observation group(116 patients, 232 eyes). The control group was treated with base curve spheric orthokeratology lens, while the observation group was treated with base curve aspheric orthokeratology lens. Comparison was made between the two groups in terms of the correction effect, objective visual quality, ocular surface morphology, tears related indicators before and after wearing the lenses, and the incidence of complications after wearing the lenses for 12mo.RESULTS:After wearing the lenses, the uncorrected visual acuity(UCVA)and diopter of the two groups were significantly improved. The UCVA and diopter of the observation group were significantly better than those of the control group(all P<0.05). After wearing the lenses, the whole-eye and corneal coma, spherical aberrations and high-order aberrations were significantly increased, while Strehl ratio and modulation transfer function were decreased in the two groups. Trefoil aberrations was significantly increased(all P<0.05). These indicators in the observation group were better than those in the control group(all P<0.05). After wearing the lenses, the epithelium fluorescence staining scores, ocular surface disease index(OSDI)scores were significantly decreased in the two groups(P<0.05), but there was no statistically significant difference between the two groups(P>0.05); The noninvasive tear breakup time(NI-BUT)of the two groups were significantly decreased after wearing the lenses(P<0.05), but there was no statistically significant difference between the two groups(P>0.05). The Schirmer Ⅰ test and tear meniscus height of the two groups showed no statistically significant difference before and after wearing the lenses(P>0.05). The incidence rates of complications in the observation group and the control group after wearing the lenses were close(6.9% vs 6.0%, P >0.05).CONCLUSION:Base curve aspheric orthokeratology lens is superior to base curve spheric orthokeratology lens in the treatment of adolescents with myopia and moderate to high astigmatism in terms of correction effect and objective visual quality. The two lenses have similar influence on ocular surface morphology and tears.

Orthokeratology lens and conventional frame glasses for ocular parameters of myopia adolescent / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the effects of overnight orthokeratology lens and conventional frame glasses on the myopic diopter, uncorrected visual acuity and ocular parameters of myopia adolescent. <p>METHODS: Totally 102 cases of(204 eyes)of adolescent myopia patients were randomly divided into observation group and control group with 51 cases(102 eyes)in each group during April 2014 to April 2017. Control group was only given conventional frame glasses, and observation group was given overnight orthokeratology lens. The myopic diopter and uncorrected visual acuity(UCVA)before wearing glasses and at 1wk, 1, 3, 6mo and 1a of wearing glasses, and the ocular parameters before wearing glasses and at 1a after wearing glasses were observed in the two groups, and the occurrence of complications was compared between the two groups. <p>RESULTS: After 1wk to 1a of wearing glasses, the myopic diopter in observation group was gradually decreased(<i>P</i><0.05), and there was no significant difference in control group(<i>P</i>>0.05), but there was statistically significant difference between-groups at different time points(<i>P</i><0.05). After 1wk to 1a of wearing glasses, the UCVA in observation group showed a increasing tendency(<i>P</i><0.05), and the UCVA in observation group after 6mo to 1a of wearing glasses was significantly higher than that in control group(<i>P</i><0.05). At 1a after wearing glasses, the axial length, corneal endothelial cell density, central anterior chamber depth, and intraocular pressure in observation group were not significantly different from those before wearing glasses(<i>P</i>>0.05), and the axial length in control group was significantly longer than that before wearing glasses and that in observation group(<i>P</i><0.05). The total incidence rates of complications in observation group and control group were 10.8% and 6.9% respectively(<i>P</i>>0.05).<p>CONCLUSION: Overnight orthokeratology lens for adolescent myopia can effectively correct the myopic diopter, and improve the uncorrected visual acuity. It is less harmful to the eyes and less complications, and it is safe and reliable in clinical application.