Peripheral Refraction With Toric Orthokeratology and Soft Toric Multifocal Contact Lenses in Myopic Astigmatic Eyes

PURPOSE: There has been little research on myopia management options for patients with astigmatism. This study quantified changes in peripheral refraction induced by toric orthokeratology (TOK) and soft toric multifocal (STM) contact lenses. METHODS: Thirty adults with refractive error of plano to −5.00 D (sphere) and −1.25 to −3.50 D (cylinder) were enrolled. Cycloplegic autorefraction was measured centrally, ±20 degrees, and ±30 degrees from the line of sight nasally (N) and temporally (T) on the retina. Measurements were made at baseline, after 10 ± 2 days of TOK wear (without lenses on eye), and after 10 ± 2 days of STM wear (with lenses on the eyes) and compared with repeated-measures analysis of variance. RESULTS: Compared to baseline, TOK induced a myopic shift in defocus (M) at all locations (all P < 0.01), but STM only induced a myopic shift at 20 T in both eyes and 30 N/T in the left eye (all P < 0.01). TOK resulted in more myopic defocus than STM at all locations (all P < 0.05) except 20 T in the left eye. TOK induced more J(0) astigmatism at all locations (all P < 0.02), except 20 N in the right eye; J(0) with STM was different than baseline at 20 N in both eyes and 30 N in the right eye (all P < 0.02). TOK induced more J(0) astigmatism than STM at all locations (all P < 0.01), except 20 T in the left eye. Differences in J(45) astigmatism, when significant, were clinically small. CONCLUSIONS: Greater amounts of peripheral myopic defocus and J(0) astigmatism were induced by TOK compared to STM, which may influence efficacy for myopia management.