Does Orthokeratology really control myopia?
Over three years, myopia progressed significantly less in children wearing Orthokeratology compared to conventional soft contact lenses.
One eye was fit with an Orthokeratology lens and the other with conventional rigid gas-permeable (RGP) lens. After six months the lens-eye combinations were reversed. The RGP eye showed an increase in axial length during both intervals and the orthok eye showed no axial length increase. Axial length increase is a sign of myopia progression.
These two published papers both ended up with similar outcomes, concluding that Orthokeratology is effective in slowing myopic progression in school aged children.
This study showed that Orthokeratology was both safe and effective for myopia control in children over a 12 year period.
This study has controls for environmental and genetic factors and suggests that Orthokeratology provides excellent myopia control over 12-24 months.
Is Orthokeratology safe?
One of the first studies showing that orthokeratology is a safe method of contact lens wear. The risk of an eye infection is similar to the risk of a reusable soft contact lens, such as a monthly replacement lens. It remains relatively low at 13 per 10,000 patient wearing years.
This study shows that long term success of Orthokeratology depends on proper fitting of the lenses, compliance to lens care and cleaning, routine follow ups and appropriate treatments of complications.
This study shows that children (aged 8-12) and teens (aged 13-17) are no more risky contact lens wearers than adults. Evidence indicates that there is an even lower rate of eye infection in children than teens and adults, which is likely because of better compliance and closer parental supervision.
This study compared the safety of Orthokeratology to soft contact lenses in children over a period of 10 years. No significant differences in complications were found between both groups and they concluded that Orthokeratology is safe for long term use.
This paper summarises the known risks with various methods of myopia control (including Orthokeratology). It also models the risk of visual imparement and potential diseases (myopic maculopathy, cataract, retinal detachment, glaucoma) if myopia is not controlled. They concluded that the potential benefits of myopia control outweigh the risks.
New data shows that the risk of an eye infection with Orthokeratology is even safer than as previously noted. The risk is 5 cases per 10,000 patient wearing years, compared to a 2013 study that estimated it to be 13 cases per 10,000 patient wearing years. This means that the risk of an eye infection remains similar to rates associated with use of daily wear soft contact lenses. The improved safety profile in this study likely reflects the effect of gathering data from a single group of practices with standardised training, whereas the previous study obtained data from numerous different practices. It could also reflect a greater effort to improve Orthokeratolog safety and compliance in the past decade.