Adjunctive Eyelid Hygiene Improves Early Adaptation to Pediatric Orthokeratology: A Randomized Clinical Study.

PURPOSE: To evaluate the effect of daily eyelid wipes on ocular-surface health and comfort during the early adaptation period of orthokeratology (Ortho-K) wear in children.

METHODS

This single-masked, randomized clinical study was conducted at a tertiary eye hospital from July to October 2025. Fifty-eight myopic children (aged 8-12 years) initiating Ortho-K were randomly assigned to an eyelid-wipe group or a control group. The examiner was masked to group allocation. Baseline and 1-month measurements included noninvasive tear breakup time, lipid-layer thickness, tear meniscus height, meibomian gland expressibility, corneal fluorescein staining, matrix metalloproteinase-9 levels, and Ocular Surface Disease Index.

RESULTS

After 1 month, noninvasive tear breakup time and lipid-layer thickness showed no significant between-group differences in change ( P =0.12 and P =0.07, respectively). Meibomian gland expressibility improved more in the eyelid-wipe group (2.5±0.9-1.9±0.8) than in controls (2.4±0.8-2.3±0.9), with a significant between-group difference in change ( P =0.002). Corneal fluorescein staining at the 1-month visit was lower in the eyelid-wipe group than in controls (0.9±0.8 vs. 1.3±0.9, P =0.03). Ocular Surface Disease Index scores showed a greater reduction in the eyelid-wipe group than in controls ( P =0.02). Tear meniscus height and matrix metalloproteinase-9 levels did not differ significantly between groups. All participants continued wipe use, and no adverse events were reported.

CONCLUSIONS

Daily sterile eyelid wipes safely improved meibomian gland function and comfort without inducing inflammation, suggesting a simple adjunctive approach to enhance early ocular-surface adaptation in pediatric Ortho-K wearers.