CLEAR - Orthokeratology

Stephen J. Vincent, Pauline Cho, Ka Yin Chan, Daddi Fadel, Neema Ghorbani-Mojarrad, José M. González-Méijome, Leah Johnson, Pauline Kang, Langis Michaud, Patrick Simard, Lyndon Jones

Research output: Journal article publicationJournal articleAcademic researchpeer-review

9 Citations (Scopus)

Abstract

Orthokeratology (ortho-k) is the process of deliberately reshaping the anterior cornea by utilising specialty contact lenses to temporarily and reversibly reduce refractive error after lens removal. Modern ortho-k utilises reverse geometry lens designs, made with highly oxygen permeable rigid materials, worn overnight to reshape the anterior cornea and provide temporary correction of refractive error. More recently, ortho-k has been extensively used to slow the progression of myopia in children. This report reviews the practice of ortho-k, including its history, mechanisms of refractive and ocular changes, current use in the correction of myopia, astigmatism, hyperopia, and presbyopia, and standard of care. Suitable candidates for ortho-k are described, along with the fitting process, factors impacting success, and the potential options for using newer lens designs. Ocular changes associated with ortho-k, such as alterations in corneal thickness, development of microcysts, pigmented arcs, and fibrillary lines are reviewed. The safety of ortho-k is extensively reviewed, along with an overview of non-compliant behaviours and appropriate disinfection regimens. Finally, the role of ortho-k in myopia management for children is discussed in terms of efficacy, safety, and potential mechanisms of myopia control, including the impact of factors such as initial fitting age, baseline refractive error, the role of peripheral defocus, higher order aberrations, pupil size, and treatment zone size.

Original languageEnglish
Pages (from-to)240-269
Number of pages30
JournalContact Lens and Anterior Eye
Volume44
Issue number2
Early online date25 Mar 2021
DOIs
Publication statusPublished - Apr 2021

Keywords

  • Contact lens evidence-based academic reports (CLEAR)
  • Corneal reshaping
  • Myopia control
  • Orthokeratology
  • Refractive error correction

ASJC Scopus subject areas

  • Ophthalmology
  • Optometry

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