Corneal Changes and Wavefront Analysis after Orthokeratology Fitting Test

Purpose To evaluate corneal changes and ocular aberrations during an orthokeratology test. Design A prospective, nonrandomized cohort study. Methods Fourteen myopic patients (26 eyes) underwent an orthokeratology fitting test with the BE contact lens (Ultravision Pty, Ltd, Brisbane, Australia). Best...

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Bibliographic Details
Published in:American journal of ophthalmology 2007-09, Vol.144 (3), p.378-386
Main Authors: Stillitano, Iane Gonçalves, Chalita, Maria Regina, Schor, Paulo, Maidana, Eduardo, Lui, Marcelo Mastromonico, Lipener, Cesar, Hofling-Lima, Ana Luisa
Format: Article
Language:English
Subjects:
Adolescent
Adult
Astigmatism
Biological and medical sciences
Biomechanical Phenomena
Coma
Contact Lenses
Cornea - diagnostic imaging
Cornea - physiopathology
Corneal Topography
Design
Female
Geometry
Humans
Male
Medical sciences
Middle Aged
Miscellaneous
Myopia
Myopia - physiopathology
Myopia - therapy
Ophthalmology
Patients
Prospective Studies
Prosthesis Fitting
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Refraction, Ocular - physiology
Tomography
Ultrasonography
Visual Acuity - physiology
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Summary:Purpose To evaluate corneal changes and ocular aberrations during an orthokeratology test. Design A prospective, nonrandomized cohort study. Methods Fourteen myopic patients (26 eyes) underwent an orthokeratology fitting test with the BE contact lens (Ultravision Pty, Ltd, Brisbane, Australia). Best spectacle-corrected visual acuity (BSCVA), uncorrected (Ultravision Pty, Ltd, Brisbane, Australia) visual acuity (UCVA), subjective cycloplegic refraction, biomicroscopy, corneal topography, optical pachymetry, and aberrometry were performed at baseline and one and eight nights orthokeratology. The short-term effect of orthokeratology using corneal topography, tomography, and ocular aberrations was evaluated. Results The mean spherical equivalent changed from −2.24 ± 0.98 diopters (D) at baseline to 0.15 ± 0.76 D after the eight nights of lens wear ( P = .001). All patients had an UCVA of 20/30, 69.2% with 20/20. Changes in central corneal pachymetry were not observed. There was a statistically significant increase in the temporal corneal thickness from night one, without any difference between nights one and eight ( P > .001). A significant increase of higher-order root mean square values was observed from baseline (0.42 ± 0.16 μm), night one (0.81 ± 0.24 μm), and night eight (1.04 ± 0.24 μm). Increases in coma (Z7+Z8) and spherical aberration (Z12) were observed. Positive horizontal (Z8) coma increased in right eyes, and negative horizontal (Z8) coma increased in left eyes ( P < .001). Conclusions Myopia reduction resulting from rapid central corneal flattening and improvement of UCVA occurred after orthokeratology. Higher-order aberrations (HOAs), particularly spherical aberration and coma, increased significantly during the orthokeratology test. An increase of temporal pachymetry and differences in coma direction induced between the eyes may be related to the subclinical lens decentration temporally.
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2007.05.030