Impact of orthokeratology lenses on axial length, refractive power, and complications in myopic children under corneal curvature stratification.

OBJECTIVE

To investigate the long-term effects of orthokeratology lenses (OK lenses) on myopic children with different baseline corneal curvatures (CCs).

METHODS

178 myopic children were categorized into three groups based on their CC: Axial Group (AG, CC ≤41.5D), Curvature Group (CG, CC ≥44D), and Mixed Group (MG, 41.5D ≤ CC ≤44D). The age range was from 6 to 15 years. The refractive error (RE), axial length (AL), CC, RE changes, axial elongation rate, changes in CC, corneal endothelial cell (CEC) parameters, and complications were compared among the three groups.

RESULTS

After wearing glasses, the patients' RE, CC, AL, and axial growth rate in all three groups were significantly improved compared to before wearing glasses (P<0.05). The differences in AL increase at different time points after wearing glasses were not statistically significant (F = 10.20, P > 0.05). The changes in CC in the AG were significantly different from those in the CG (P < 0.05), and the AG showed a greater increase in AL after treatment compared to the CG and MG (P < 0.05). For instance, the mean CC in the AG before wearing glasses was 41.82 ± 0.79D, which decreased to 38.17 ± 0.59D after two years of wearing glasses. In the CG, the mean CC before wearing glasses was 43.69 ± 1.57D, decreasing to 42.87 ± 1.08D after two years of wearing glasses. The differences in CEC density, mean cell area, coefficient of variation (COA), and hexagonal cell ratio (HCR) at various time points before and after wearing glasses and between the different groups were minimal (P > 0.05). The complication rate was 58.62% in the AG, 41.82% in the CG, and 53.85% in the MG, with the CG showing the lowest complication rate after two years, which was significantly different from the other two groups (P < 0.05).

CONCLUSION

OK lenses demonstrate marked efficacy in controlling myopia, particularly in patients with higher CC, where the control of AL growth is notably effective. Additionally, CC is associated with the incidence of complications.