The Clinical Effects Of Toric Design Orthokeratology For Adolescent Myopia With Moderate To High Astigmatism

Objective: To evaluate the clinical effects of toric design orthokeratology and regular spherical orthokeratology contact lenses in the treatment of adolescent myopia with moderate to high astigmatism.Methods: A retrospective analysis of 49 adolescent patients(95 eyes) aged 8-18(11.52±2.476) who presented with mild and moderate myopia, Shenyang Aier Optometry Eye Hospital February, 2014 and August, 2014 were recruited. Group A(45 eyes) who presented with moderate to high astigmatism(?1.50 D)were fitted toric design orthokeratology contact lenses. Group B(50 eyes) who presented with mild astigmatism(<1.50 D)were fitted general spherical orthokeratolog contact lenses. Before treatment, uncorrected visual acuity, myopia diopter, corneal thickness of the pupil center, corneal astigmatism, axial length and best corrected visual acuity were measured between the two groups. After wearing orthokeratology one week,one month,three months the visual acuity, corneal thickness of the pupil center, corneal astigmatism were observed, and after wearing orthokeratology one year the axial length was observed, The data were analyzed with a paired t test, an independent samples t test.Results: Compared to the initial values(0.6895± 0.17774) the uncorrected visual acuity were increased after wearing orthokeratology one week, one month, three months(0.1232± 0.16075?0.0011±0.07219?-0.0147±0.05829). The differences in these variables were statistically significant(t=30.047?39.465?33.533,P<0.05). Compared to the initial values(1.436±0.6235) D the corneal regular astigmatism in 3mm were decreased after wearing orthokeratology one week, one month, three months(0.5719± 0.34736 ?0.4387±0.33623?0.4975±0.28774) D(t=11.975?13.902?13.725,P<0.05), and the changes were more obvious in group A(1.3864±0.58101?1.5373±0.49810?1.4382±0.59866) D than in group B(0.3936±0.41096?0.5108± 0.45312?0.4884±0.30644) D(t=9.689?10.519?9.877,P<0.05). The differences in these variables were statistically significant. Compared to the initial values(542.88±29.450) ?m the corneal thickness of the pupil center were decreased after wearing orthokeratology one week,one month, three months(535.09±28.263?535.0.2±28.705?534.91±28.773) ?m. The differences in these variables were statistically significant(t=15.891?18.364?13.308,P<0.05). Compared to the initial values(24.9180±0.73387) mm the axial length had no changes after wearing orthokeratology one year(24.9414±0.77990) mm. And the corneal thickness of the pupil center had no changes after wearing orthokeratology one year(542.4316±29.13237) ?m. The differences in these variables were not statistically significan(t=-0.513,1.039,P>0.05). After treatment the uncorrected visual acuity, corneal thickness of the pupil center, corneal astigmatism, and the changes of axial length had no significant difference between different lens designs(P>0.05). During following up time, two eyes had corneal fluorescein staining and all occurred within one week after wearing orthokeratology and were less than?level, and improved after using artificial tear eyedrops in 2-3days.No complications occurred in any of the cases in the two groups.Conclusions: Toric design can slow down the development speed of adolescent myopia as well as general spherical orthokeratolog contact lenses who with moderate to high astigmatism.Toric design orthokeratology contact lenses have been developed to improve lens centration as well as for astigmatism correction, can be highly effective for improving the uncorrected visual acuity, and can slow down the development speed of adolescent myopia, safely and effectively.