Advertisement

Myopia Control in Children through Refractive Therapy Gas Permeable Contact Lenses: Is it for Real?

      Purpose

      To compare the safety and efficacy of orthokeratology as a nonsurgical treatment for myopia in children with alternate methods, such as soft contact lenses, rigid gas permeable lenses, and spectacles, throughout multiple studies.

      Design

      Perspective with literature review.

      Methods

      Analysis of recent studies to determine the safety and effectiveness of orthokeratology versus soft contact lenses, rigid gas permeable lenses, and spectacles in children.

      Results

      In all of the studies reviewed, the use of orthokeratology lenses proved to reduce myopia, to improve visual acuity, and, with the exception of the SMART study, to reduce the rate of axial elongation. Orthokeratology has been shown to be as effective as other methods in treating myopia and to be more effective at treating axial elongation. There were no major adverse events in any of the studies comparing orthokeratology with other methods of myopia treatment.

      Conclusions

      Studies show that the use of orthokeratology is a safe and efficacious nonsurgical treatment for myopia and that it is capable of slowing axial elongation, making it an effective myopic treatment for children.
      To read this article in full you will need to make a payment

      References

      1. World Health Organization. Visual Impairment and blindness fact sheet. Available at: http://www.who.int/mediacentre/factsheets/fs282/en/index.html. Accessed December 13, 2012.

        • National Eye Institute Eye Diseases Prevalence Research Group
        The prevalence of refractive errors among adults in the United States, Western Europe, and Australia.
        Arch Ophthalmol. 2004; 122: 495-505
        • Jung S.
        • Lee J.
        • Kakizaki H.
        • Jee D.
        Prevalence of myopia and its association with body stature and educational level in 19-year-old male conscripts in Seoul, South Korea.
        Invest Ophthalmol Vis Sci. 2012; 53: 5579-5583
        • Walline J.J.
        • Lindsley K.
        • Vedula S.S.
        • Cotter S.A.
        • Mutti D.O.
        • Twelker J.D.
        Interventions to slow progression of myopia in children.
        Cochrane Database Syst Rev. 2011; 7: CD004916
        • Wesley N.
        • Jessen G.
        Advanced techniques in contact lens fitting.
        Second edition. Contact Lens Publishing Company, Chicago, IL1960 (1–67)
        • Jessen G.
        Orthofocus techniques.
        Conctacta. 1962; 6: 200-204
        • Binder P.
        • May C.
        • Grant S.
        An evaluation of orthokeratology.
        Ophthalmology. 1980; 87: 729-744
        • Mountford J.
        • Ruston D.
        • Dave T.
        Orthokeratology: principles and practices.
        Butterwoth-Heinemann, Ann Arbor, MI2004 (1–320)
      2. Food and Drug Administration. Summary of Safety and Effectiveness Data of Paragon CRT. Available at: http://www.accessdata.fda.gov/cdrh_docs/pdf/P870024S043b.pdf. Accessed December 13, 2012.

        • Morgan P.
        • Woods C.
        • Tranoudis I.
        • Helland M.
        • Efron N.
        • Grupcheva C.
        • et al.
        International Contact Lens prescribing in 2011.
        Contact Lens Spectrum. 2012; 27: 26-31
        • Swarbrick H.A.
        • Wong G.
        • O'Leary D.J.
        Corneal response to orthokeratology.
        Optom Vis Sci. 1998; 75: 791-799
        • Soni P.
        • Nguyen T.
        • Bonanno J.
        Overnight orthokeratology: visual and corneal changes.
        Eye Contact Lens. 2003; 29: 137-145
        • Smith E.
        • Kee C.
        • Ramamirtham R.
        • Qiao-Grider Y.
        • Hung L.
        Peripheral vision can influence eye growth and refractive development in infant monkeys.
        Invest Ophthalmol Vis Sci. 2005; 46: 3965-3972
        • Liu Y.
        • Wildsoet C.
        The effect of two zone concentric bifocal spectacle lenses on refractive error development and eye growth in young chicks.
        Invest Ophthalmol Vis Sci. 2011; 52: 1078-1086
        • Cooper J.
        • Schulman E.
        • Jamal N.
        Current status on the development and treatment of myopia.
        Optometry. 2012; 83: 179-199
        • Lui W.-O.
        • Edwards M.H.
        Orthokeratology in low myopia, part I: efficacy and predictability.
        Contact Lens Anterior Eye. 2000; 23: 77-89
        • Walline J.
        • Jones L.
        • Mutti D.
        • Zadnik K.
        Contact lens and myopia progression (CLAMP).
        Optom Vis Sci. 2001; 78: 223-233
        • Edwards M.
        • Li R.
        • Lam C.
        • Lew J..KF.
        • Yu Y.
        The Hong Kong progressive lens myopia control study: Study design and main findings.
        Invest Ophthatmol Vis Sci. 2002; 43: 2852-2858
        • Cho P.
        • Cheung S.
        • Edwards M.
        The Longitudinal Orthokeratology Research in Children (LORIC) in Hong Kong: a pilot study on refractive changes and myopic control.
        Curr Eye Res. 2005; 30: 71-80
        • Walline J.
        • Rah M.
        • Jones L.
        The Children's Overnight Orthokeratology Investigation (COOKI) pilot study.
        Optom Vis Sci. 2004; 81: 407-413
        • Kerns R.L.
        Research in orthokeratology, part VI: statistical and clinical analyses.
        J Am Optom Assoc. 1977; 48: 1134-1147
        • Walline J.J.
        • Jones L.A.
        • Sinnott L.T.
        Corneal reshaping and myopia progression.
        Br J Ophthalmol. 2009; 93: 1181-1185
        • Kakita T.
        • Hiraoka T.
        • Oshika T.
        Influence of overnight orthokeratology on axial elongation in childhood myopia.
        Invest Ophthalmol Vis Sci. 2011; 52: 2170-2174
        • Hiraoka T.
        • Kakita T.
        • Okamoto F.
        • Takahashi H.
        • Oshika T.
        Long-term effect of overnight orthokeratology on axial length elongation in childhood myopia: a 5-year follow-up study.
        Invest Ophthalmol Vis Sci. 2012; 53: 3913-3919
        • Santodomingo-Rubido J.
        • Villa Collar C.
        • Gilmartin B.
        • Gutierrez-Ortega R.
        Myopia Control with Orthokeratology Contact Lenses in Spain (MCOS).
        Invest Ophthalmol Vis Sci. 2012; 2: 215-222
        • Cho P.
        • Cheung S.
        Retardation of Myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial.
        Invest Ophthalmol Vis Sci. 2012; 53: 7077-7085
        • Watt K.
        • Swarbrick H.
        Trends in microbial keratitis associated with orthokeratology.
        Eye Contact Lens. 2007; 33: 373-377
        • Swarbrick H.
        Overnight orthokeratology and the risk of microbial keratitis.
        Eye Contact Lens. 2005; 31: 201-208
        • Santodomingo-Rubido J.
        Orthokeratology vs. spectacle: adverse events and discontinuations.
        Optom Vis Sci. 2012; 89: 1133-1139
        • Schein O.
        • McNally J.
        • Katz J.
        • Chalmers R.
        • Tielsch J.
        • Alfonso E.
        • et al.
        The incidence of microbial keratitis among wearers of a 30-day silicone hydrogel extended-wear contact lens.
        Ophthalmology. 2005; 112: 2172-2179
        • Wollensak G.
        • Spoerl E.
        • Seiler T.
        Riboflavin/ultraviolet-A-induced collagen crosslinking for the treatment of keratoconus.
        Am J Ophthalmol. 2003; 135: 620-627
        • El Hage S.
        • Seiler
        Corneal Cross-linking and Orthokeratology.
        Contact Lens Spectrum. 2011; : 26-30
        • Koffler B.
        • Smith V.
        • Clements L.
        Achieving additional myopic correction in undercorrected radial keratotomy eyes using the Lexington RK splint design.
        CLAO J. 1999; 25: 21-27
        • Choo J.
        • Caroline P.
        • Harlin D.
        • Papas E.
        • Holden B.
        Morphologic changes in cat epithelium following continuous wear of orthokeratology lenses: a pilot study.
        Contact Lens Anterior Eye. 2008; 31: 29-37

      Biography

      Dr Bruce H. Koffler graduated from Ophthalmology Residency and Fellowship in cornea and external disease from Georgetown University Center for Sight. He began his academic career at the University of Kentucky School of Medicine in 1979. Dr Koffler moved to private practice in 1983. He is a Past President of CLAO and now serves on the Board as International Chair. He is Executive Secretary of the International Medical Contact Lens Counsel, and was recently honored with the Senior Award from the AAO.