Central and Peripheral Corneal Power Change in Myopic Orthokeratology and Its Relationship With 2-Year Axial Length Change

Abstract

We assessed the relationship between axial length (AL) change and corneal refractive power change induced by orthokeratology (ortho-k) contact lens wear. A total of 88 myopic children aged 7 to 12 years were fitted with ortho-k lenses for overnight wear. Axial length was measured before enrollment and every 6 months after initiation of lens wear up to 24 months. Corneal apical refractive power and the mean power of each concentric ring from 0.5 to 7.2 mm in diameter at 0.1-mm intervals were measured using the Pentacam HR, and compared before and after 3 months of ortho-k lens wear. Summed corneal power change (SCPC) was defined as the sum of relative corneal power change within the central 7.2-mm diameter corneal region. Age, baseline spherical equivalent refractive error (SERE), and SCPC were tested against 2-year AL growth in a stepwise multiple linear regression model. Of the 88 myopic children who were successfully fitted with ortho-k lenses, 64 completed the 2-year follow-up period. These completed test subjects experienced a mean axial growth of 0.37 ± 0.27 mm. Spherical equivalent refractive error and corneal apical refractive power decreased from baseline values of -2.88 ± 0.96 diopters (D) and 43.47 ± 1.03 D to -0.20 ± 0.85 D and 40.61 ± 1.23 D, respectively, after 3 months of lens wear. The mean SCPC was 10.84 ± 5.28 D · mm after 3 months. Axial elongation was significantly correlated with SCPC (standardized β = -0.573, P < 0.001) and baseline age (standardized β = -0.403, P < 0.001), but not with baseline SERE (β = 0.081, P = 0.396). The regression model using SCPC and baseline age to predict axial elongation was acceptable (adjusted R2 = 0.56) and statistically significant (F2,61 = 41.09, P < 0.001). Axial elongation in children undergoing ortho-k therapy is negatively correlated with the age of the wearer and summed corneal power change from the central to the mid-peripheral cornea. We speculate that axial elongation is influenced by the extent to which the retinal defocus profile is altered with ortho-k lens wear. (http://www.chictr.org number, ChiCTR-TNRC-11001210.).