Abstract: Objective To observe the changes of corneal higher-order aberrations (HOAs) by Toric orthokeratology (ortho-k) in correcting myopic teenagers with high astigmatism. Design Retrospective case series. Participants 35 patients (67 eyes) with myopia of -1.00~4.00 D and astigmatism of -1.50~-3.00 D. Method The patients were examined for uncorrected visual acuity (UCVA), refractive error, corneal topography, root mean square(RMS) values of total the HOAs before and at 1, 3, 6, 12 months after wearing ortho-k. All indexes were analyzed with repeated measurement analysis of variance. Main Outcome Measures UCVA, refractive error, corneal topography, decentration distance, RMS values of total the HOAs. Results All 67 eyes were in good and stable condition after wearing Toric orthokeratology. All the decentrations were less than 0.5 mm. There were no statistically significant differences in the decentration measurements at different time points after wearing Toric orthokeratology (all P>0.05)． UCVA were changed significantly (P=0.002) compared with the baseline, the myopia and astigmatism, FK and SK were changed significantly (P<0.001) compared with the baseline. 12 months after wearing Toric orthokeratology, RMS values of total the HOAs 6 mm pupil diameter of Coma (0.958±0.611) Eq.D, spherical aberration (0.486±0.24) Eq.D, residual aberration (0.797±0.663) Eq.D and total HOAs (1.191±0.794) Eq.D were increased than before wearing Toric orthokeratology, the difference was statistically significant (F=11.02, 10.31, 6.76, 10.74, P=0.002, 0.002, 0.015, 0.004). Conclusion Toric orthokeratology is an effective correction option for myopia with high astigmatism. However, Toric orthokeratology can increase the corneal HOAs and affected visual quality. (Ophthalmol CHN,  2021, 30: 125-129)

Key words: toric orthokeratology, myopia, high astigmatism, corneal higher order aberrations