The Montreal Experience: Impact of Different Orthokeratology Lens Designs on Corneal Treatment Zone Characteristics

Abstract

OBJECTIVE: To evaluate the effect of the orthokeratology (OK) lens design, used in the Montreal Experience cohort, on corneal treatment zone characteristics and their relationship to the pupil. METHODS: This retrospective study follows previously published work and refers to the analysis of 4 different OK lenses. Tangential topography maps were obtained at baseline and after 1 month of OK lens wear. The extracted parameters are: distance treatment zone diameter (DTZD (mm)); relative peripheral power (RPP (D)); mid-peripheral width (MPW (mm)); a new concept, the plus power ratio (PPR (%)), corresponding to the coverage of the pupil area by the positive power zones. RESULTS: DTZD and MPW were significantly different between the lens designs (Welch’s ANOVA). (DTZD (OK 1: 3.68 ± 0.46 mm; OK 2: 3.06 ± 0.67; OK 3: 2.83 ± 0.54; OK 4: 3.20 ± 0.53) MPW (OK 1: 1.65 ± 0.21 mm; OK 2: 1.31 ± 0.40 mm; OK 3: 1.46 ± 0.17 mm; OK 4: 1.57 ± 0.17 mm)). PPR was significantly lower in OK 1 (40.1 ± 22.1%) than the other designs (OK 2: 53.8 ± 18.4%; OK 3: 60.3 ± 13.6; OK 4: 54.7 ± 15.3). CONCLUSION: This study shows that the corneal response to OK lens wear varies with lens design. When analyzed, topographic analysis shows that OK 1 is associated with a larger DTZD, which produces a lower PPR. This may explain why previously published results showed significantly faster axial length (AL) progression with this lens.

Keywords

• orthokeratology
• myopia management
• axial length
• pupil diameter