Is fluorescein pattern analysis a valid Method of assessing the accuracy of reverse geometry lenses for orthokeratology?

Background: The aims of this study were to investigate the relative frequencies of correct identifications of variations in the fit of conventional rigid gas permeable (RGP) lenses and reverse geometry lenses (RGL) from fluorescein pattern analysis by orthokeratology (ortho-k) practitioners and non-ortho-k practitioners and to determine whether fluorescein pattern analysis is sensitive for assessing ortho-k lens fittings. Methods: Slides of fluorescein patterns of different lens fittings were shown to the practitioners, who were asked to identify the ideal, flatter, flattest, steeper and steepest lens fittings. Results: Observed frequencies of correct identifications of most of the conventional RGP lens fittingss were not significantly different from the expected frequencies for both groups of practitioners. The observed frequencies of correct identifications of all of the RGL fittings were either not significantly different or were lower than the expected frequencies. Conclusion: The relative frequencies of correct identifications of fluorescein patterns of both conventional RGP lens and RGL fittings by experienced ortho-k practitioners were not different from those by non-experienced ortho-k practitioners. Practitioners from the two groups were not always able to diagnose conventional RGP lens and RGL fittings adequately from fluorescein pattern analysis alone. Fluorescein pattern analysis alone may not be sufficiently sensitive for assessing ortho-k lens fitting.