Effectiveness of customized ortho-k lenses in controlling myopia in children

Abstract

Background. The increasing prevalence of myopia in children highlights the need for effective treatments. Orthokeratology is a key approach to slow myopia progression, yet standard ortho-k lenses often fall short due to diverse corneal structures. Personalized ortho-lens designs are crucial for optimizing myopia control and maximizing the benefits of corneal refractive therapy.Aim: to evaluate the impact of custom ortho-k lens use on myopia control in children, specifically assessing changes in refraction and axial length during orthokeratology treatment.Materials and methods. In our study, 41 school-aged children underwent custom orthokeratology treatment with 81 ortho-k lenses. Utilizing a Medmont E300 for corneal topography and the OrthoTool for lens calculations, alongside Lenstar LS 900 for optical biometry, we assessed myopia progression and axial elongation. The subjects’ average age was 12.6 ± 2.4 years, with an average lens wear duration of 17.0 months (range 10.0 to 23.5 months). Initial mean myopia was –5.5 ± 2.0 D in both eyes.Results. During the study period, 87.8% of the participants (36 children) showed stabilization in refraction and axial length, indicating effective myopia control. However, 12.2% (5 children) experienced myopia progression at a rate of –0.5 diopters per year. Notably, all children undergoing orthokeratology treatment achieved high visual acuity (0.9–1.0). Complications were limited to 12.2% of the participants, who developed mild epitheliopathy (2 degrees) and/or Fleischner rings; no inflammatory complications were observed.Conclusions. Customized orthokeratology offers significant advantages over standard ortho-k lenses, tailoring treatment to individual corneal structures for more effective myopia control. The results advocate for further, long-term studies into customized orthokeratology and its role in managing myopia.