Analysis of corneal complications in children wearing orthokeratology lenses at night

Abstract

Objective: To explore the characteristics, prognoses and corneal complications of children wearing orthokeratology lenses (Ortho-K) at night. Methods: Retrospective case analysis. A total of 113 cases (219 eyes) wore Ortho-K for myopia at night, including 7 cases with unilateral glass wear. The average age was (11.5±2.0) years old. The myopia ranged from -1.00 D to -9.00 D in all eyes and from -2.00 D to -4.00 D in 157 of them. Examinations were performed before lens wearing, at 1 hour, the next morning, 2 days, 3 days, 1 week and 2 weeks after lens wearing, and thereafter once a month. The follow-up was 6 months. Slit lamp examination was used to observe whether there was edema, mechanical damage, pigment deposition, turbidity or infiltration. The morphology, location, number, range and depth of fluorescein staining were tracked for more than 6 months. Results: There were punctate corneal epithelial exfoliation in 18 cases (29 eyes, 13.24%), corneal stromal infiltration and opacity in 5 cases (6 eyes, 2.74%), and corneal iron deposition in 9 cases (17 eyes, 7.76%), with no obvious symptoms. After stopping wearing lenses and related treatment, the punctate epithelial exfoliation was completely cured, and the other complications gradually disappeared within 6 months. These complications occurred within 3 months after lens wearing in six eyes and after at least 6 months of lens wearing in 46 eyes. Conclusions: Children who have complications after wearing Ortho-K at night should immediately stop wearing the lenses. Timely treatment and follow-up help to avoid deterioration and serious complications. Orthokeratology should be performed in medical institutions, with the follow-up by qualified ophthalmic doctors. (Chin J Ophthalmol, 2017, 53:198-202).