Orthokeratology Treatment in Adults Yields Quality of Life Improvements

Orthokeratology treatment in adults with mild to moderate myopia may result in efficacious myopia correction and quality of life (QOL) improvements, according to a study published in Contact Lens & Anterior Eye. 

Investigators included 44 participants (age range, 18-38 years; 79.5% women) with mild to moderate myopia (-0.75 to -5.00 diopters [D]; <1.50 D astigmatism) in a 1-year clinical study to examine vision and QOL improvements following orthokeratology treatment in adults. The team assigned study participants to treatment with conventional compression factor (0.75 D; n=23) or increased compression factor (1.75 D; n=21) 5-zone geometric design orthokeratology lenses and performed refraction, axial length, corneal topography, and biomechanical measurements at baseline and 6-month intervals during the 1-year study duration. Scheduled aftercare visits were conducted at 1 day, 1 week, 2 weeks, 1 month, 3 months, and 9 months following lens wear commencement. Participants also completed a questionnaire in which they reported satisfaction with treatment using a 10-point Likert scale (1, very unsatisfied; 10, very satisfied). 

Participants’ AL was shortened significantly at the 12-month visit compared with baseline (-0.03 mm; P <.05). While many participants presented with overall and central corneal staining, most cases were mild (grade 1). Central endothelial cell density was reduced by 40/mm2 (loss rate 1.4 %), according to the report. 

Patients reported high levels of satisfaction on the questionnaire during the 6-month and 1-year follow-up visits. An 11-point improvement in National Eye Institute/Refractive Error QoL Instrument-42 questionnaire (NEI-RQL-42) total score at 12 months (P <.001) revealed overall QOL satisfaction accompanied orthokeratology treatment in adults compared with baseline values.

“The results of the study showed that the effect of ortho-k on endothelial cells (central cornea) was minimal and the changes observed over the year were mainly caused by normal aging,” according to the researchers. “The satisfaction questionnaire results also did not differ significantly over the study period, indicating that levels of satisfaction were stable after 1 month.”

Study limitations include a small sample size, short study duration, and a convenience sample consisting of hospital staff and students.