Predicting Success with Orthokeratology Lens Wear: A Retrospective Analysis of Ocular Characteristics

PURPOSE: Orthokeratology procedures suffer from lack of predictability in the response of individuals. To identify factors contributing to this, we have retrospectively studied a range of ocular parameters in patients with varying outcomes from orthokeratology lens wear. EXPERIMENTAL DESIGN: Three groups were studied: an experimental group (9 subjects wearing Contex OK-3 design orthokeratology contact lenses), and 2 control groups [10 rigid gas permeable (RGP) contact lens wearers and 10 non-contact lens wearers]. Three categories were identified among the orthokeratology group: those responding well, moderately, or poorly to orthokeratology lens wear. Measurements included subjective refraction, intraocular distances, corneal thickness, ocular rigidity, and epithelial fragility. RESULTS: When comparing the three orthokeratology categories, there was no significant difference for central and peripheral epithelial fragility and ocular rigidity. There was also no significant difference for any of the biometric characteristics measured. The prefitting spherical equivalent power was found to be significantly different between categories of responders (p = 0.0228), with the poor responders having the highest initial level of myopia. None of the measured characteristics differed significantly among the orthokeratology group and the two control groups. CONCLUSIONS: In this pilot study, the success of orthokeratology lens wear was not related to ocular biomechanical or biometric attributes, but it was related to prefitting refractive error