Impact of peripheral optical properties induced by orthokeratology lens use on myopia progression

The objective of the present retrospective comparative cohort study was to compare the impact of wearing glasses versus an orthokeratology (Ortho-K) lens on peripheral optical properties and myopia progression in a population of South Korean children. Participants included children with myopia, between 8 and 12 years of age (n = 22 eyes), and divided into two groups: those who used glasses (Group I, n = 9) and those who used an Ortho-K lens (Group II, n = 13). Myopia progression over one year was quantified by changes in the central axial length of the eye. Keratometry and corneal aberrations on both the anterior and posterior surfaces of the eye were obtained using a Scheimpflug camera. A custom-developed Shack-Hartmann aberrometer was also used to measure peripheral aberrations across the horizontal visual field, up to 30°, and along the nasal-temporal meridian in 10-degree steps. Central axial elongation was larger in Group I (0.59 ± 0.21 mm) than in Group II (0.34 ± 0.18 mm) (P = .01). Relative peripheral spherical refractions at 10 and 20° nasally and at 10° temporally (P = 0.04, 0.049, and 0.042, respectively) relative to the fovea were positively correlated with central axial elongation in Group II. Group II exhibited an increase in peripheral ocular high order aberrations, such as horizontal coma and asymmetric trefoil. The use of Ortho-K lenses was found to slow the rate of central axis elongation in children with myopia. This effect might be related to an increase in both peripheral spherical refraction and peripheral ocular higher order aberrations with Ortho-K lens use.