Abstract:

Objective To observe the efficacy and safety of Orthokeratology for controlling myopic progression in children. Design Prospective case series. Participants 105 children with myopia in the Department of Ophthalmology of Mianyang Central Hospital from 2010 to 2015, who were 8~12 years old, with the spherical equivalent (SE) degree -0.50~-5.00 D. Method 35 cases (70 eyes) were in experimental group using Orthokeratology, 70 cases were in control group wearing myopic single vision lenses. The participants were followed for 1 year, measuring the visual acuity (LogMAR) and SE, the axial length (AL) (measured with IOL Master); corneal topographic map (Humphery Atlas 8.0 corneal topography analysis system); central corneal thickness (CCT)(AL2000). Main Outcome Measures Uncorrected visual acuity, SE, AL, CCT. Results In the experimental group, before therapy the SE was -4.15±1.08 D, after Orthokeratology therapy it was -3.21±1.02 D, the difference has statistical significance (t=4.3, P<0.001). In the control group it was -4.71±1.36 D at the end of the follow up, which was significant different from experimental group (t=5.59, P<0.001). The difference of before and after Orthokeratology therapy was 0.9±1.6 D and 0.06±1.9 D in the experimental and control group respectively (t=2.35, P=0.02). In the experimental group, before therapy the visual acuity (LogMAR) before and after Orthokeratology was 0.69±0.14 and 0.42±0.11 respectively (t=10.8, P<0.001), and in the control group after treatment it was 0.58±0.15 (t=-5.43, P<0.001). The difference of before and after therapy was -0.26±0.19 and -0.03±0.19 in the experimental and control group respectively (t=-5.7, P<0.001). In the experimental group, the AL was 27.42± 0.91 mm, and 27.0±1.2 mm before and after therapy respectively (t=1.8, P=0.07), and in the control group was 28.2±1.1 mm (t=-16.97, P<0.001). The difference of AL before and after therapy was -0.35±0.6 mm and 1.3±1.1 mm in the experimental and control group respectively (t=8.02, P<0.001). In the experimental group, the CCT was 550.2±30.5 μm, and 548.1±26.8 μm before and after therapy respectively (t=0.31, P=0.71), and in the control group was 554.2±23.6 μm(t=1.55, P=0.24). The difference of CCT before and after Orthokeratology therapy was 2.3±1.36 μm and 1.8±1.31 μm in the study and control group respectively (t=1.78, P=0.08). In the experimental group, the cornea curvature was 43.52±1.07 D and  38.02±2.20 D before and after therapy respectively (t=17.2, P<0.001), and in the control group was 44.37±2.12 D (t=-13.87, P<0.001). The difference before and after Orthokeratology therapy was 3.81±2.17 D and 0.91±1.4 D in the study and control group respectively(t=8.03, P<0.001). The cornea was in good health condition, and the discomfort symptoms disappeared after treatment with appropriate medication. Conclusion Orthokeratology for children with moderate myopia was an effective and safe control method. (Ophthalmol CHN, 2016, 25: 98-101)

Key words: orthokeratology, myopia, children