Retrospective Analysis of Axial Length Changes in Overnight Orthokeratology in an Academic Myopia Control Clinic

SIGNIFICANCE: Although the myopia control efficacy of orthokeratology lenses has been established with clinical trials, reports of axial length change in non–study-based patient care are scarce. This study investigates the use of orthokeratology lenses for myopia control in a clinical population and compares axial elongation against those published in recent clinical investigations. PURPOSE: This study aimed to investigate factors affecting axial elongation during use of orthokeratology lenses for myopia control in an academic clinical setting. METHODS: This study was a retrospective consecutive case series from the Myopia Control Clinic at the Herbert Wertheim School of Optometry at the University of California, Berkeley (Berkeley, CA). Patients ranging from 5 to 18 years old using orthokeratology for at least 1 year were included in the study. Data from 102 patients' eyes were analyzed at baseline (before the initiation of treatment) and after 1 year of wear (12 ± 3 months). Multivariate analysis was undertaken to identify factors significantly associated with axial elongation over this period. RESULTS: Mean (±standard deviation) spherical equivalent refraction and axial length at baseline were −2.54 (±1.21) D and 24.53 (±0.82) mm, respectively. By the 1-year follow-up, eyes had shown significant axial elongation (0.18 ± 0.24 mm; P < .001), which was found to be inversely correlated with age (P < .001). Race, sex, baseline axial length, and baseline refraction were not significantly associated with axial elongation. CONCLUSIONS: Factors influencing axial length and the magnitude of axial elongation in our orthokeratology patient population are consistent with orthokeratology treatment groups from published randomized clinical trials and support the use of these lenses for myopia control in a clinical practice setting.