The associations of accommodation and aberrations in myopia control with orthokeratology

PURPOSE: This study aimed to investigate the effect of orthokeratology (OK) on accommodative function and aberrations, to explore the correlations between them and determine what role they play in myopia control. METHODS: In this prospective case‐controlled study, 61 children were divided into an OK (n = 30) and a single‐vision spectacles (SVS) (n = 31) group. Accommodation and ocular wavefront aberrations in the OK group were measured at baseline and after 1, 3, 6, 9 and 12 months of OK wear, and again at 1 month after stopping OK (13(th) month). The same procedure was performed in the SVS group at baseline and at 3, 6 and 12 months. Axial length (AL), accommodative lag area and aberrations including spherical aberration (SA), coma and total higher‐order aberrations (HOAs) were analysed. RESULTS: During OK wear, the accommodative lag area at each visit was lower than the baseline level (all p < 0.01); all aberrations at each visit were higher than pre‐treatment (all p < 0.001). After 1 month of OK treatment, changes in accommodative lag area and SA did not show significant correlation (p = 0.16), but after OK cessation these changes were correlated (p = 0.01). In the OK group, multivariate regression analysis showed changes in accommodative lag area were associated with AL progression in the first 6 months but not in the 1‐year analysis. For the SVS group, there were no significant changes in the accommodative lag area or any aberrations during the study period. CONCLUSIONS: Increased HOAs and improved accommodative accuracy were observed during OK treatment, but began to regress after the cessation of OK. A significant positive correlation between improved accommodative accuracy and slowed axial elongation was only observed during the first 6 months of treatment.