Effects on Ocular Surface and Compliance of Orthokeratology Wear in Adults with Contact Lens Discomfort

Min Ku Kang; Kyung Sun Na; Hyun Seung Kim

doi:10.3341/jkos.2016.57.10.1549

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Kang, Na, and Kim: Effects on Ocular Surface and Compliance of Orthokeratology Wear in Adults with Contact Lens Discomfort

Original Article

J Korean Ophthalmol Soc 2016;57(10):1549-1554.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.10.1549

Effects on Ocular Surface and Compliance of Orthokeratology Wear in Adults with Contact Lens Discomfort

Min Ku Kang, MD, Kyung Sun Na, MD, PhD, Hyun Seung Kim, MD, PhD

Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Kyung Sun Na, MD, PhD Department of Ophthalmology, The Catholic University of Korea Yeouido St. Mary's Hospital, #10, 63-ro, Yeongdeungpo-gu, Seoul 07345, Korea Tel: 82-2-3779-1520, Fax: 82-2-761-6869 E-mail: githen@hanmail.net

Received 7 July 2016 Accepted 20 September 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the effects on the ocular surface and the compliance of overnight orthokeratology lenses wear in normal myopic adults experiencing contact lens discomfort.

Methods

In this study, 28 eyes of 14 subjects were analyzed using overnight orthokeratology (OOK). This prospective study investigated the compliance of OOK wear using questionnaires, spherical equivalents, keratometry, and central corneal thickness. Ocular surface disease index, tear osmolarity, Schirmer's test I, tear film break-up time, and ocular surface staining score were evaluated as ocular surface parameters. Meibomian gland function was evaluated by assessing lid margin abnormality and meiboscore using noncontact meibography. The tests were performed before and 1 and 6 weeks after OOK wear.

Results

The mean age of the subjects was 26.67 ± 3.26 years, and the average duration of previous contact lens use was 2.64 ± 2.41 years. The questionnaire results showed that OOK lenses were more comfortable to wear than conventional lenses. Significant changes in spherical equivalents, keratometry, and central corneal thickness were observed at 6 weeks compared with baseline values (all p < 0.001). No significant changes were detected in ocular surface or meibomian gland status at 1 and 6 weeks compared with baseline values (all p > 0.05).

Conclusions

Based on the findings, OOK is a relatively safe modality with good compliance for normal myopic adults experiencing contact lens discomfort.

Keywords: Contact lens discomfort, Meibomian glands, Ocular surface, Overnight orthokeratology

References

1. Efron N, Jones L, Bron AJ, et al. The TFOS International Workshop on Contact Lens Discomfort: report of the contact lens interactions with the ocular surface and adnexa subcommittee. Invest Ophthalmol Vis Sci. 2013; 54:TFOS98–122.

2. Begley CG, Chalmers RL, Mitchell GL, et al. Characterization of ocular surface symptoms from optometric practices in North America. Cornea. 2001; 20:610–8.

3. Dumbleton K, Caffery B, Dogru M, et al. The TFOS International Workshop on Contact Lens Discomfort: report of the subcommittee on epidemiology. Invest Ophthalmol Vis Sci. 2013; 54:TFOS20–36.

4. Young G, Veys J, Pritchard N, Coleman S. A abdominal study of lapsed contact lens wearers. Ophthalmic Physiol Opt. 2002; 22:516–27.

5. Nichols KK, Redfern RL, Jacob JT, et al. The TFOS International Workshop on Contact Lens Discomfort: report of the definition and classification subcommittee. Invest Ophthalmol Vis Sci. 2013; 54:TFOS14–9.

6. Swarbrick HA, Wong G, O'Leary DJ. Corneal response to orthokeratology. Optom Vis Sci. 1998; 75:791–9.

7. Soni PS, Nguyen TT, Bonanno JA. Overnight orthokeratology: visual and corneal changes. Eye Contact Lens. 2003; 29:137–45.

8. Cheung SW, Cho P, Chui WS, Woo GC. Refractive error and visual acuity changes in orthokeratology patients. Optom Vis Sci. 2007; 84:410–6.

9. Cho P, Cheung SW. Retardation of myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial. Invest Ophthalmol Vis Sci. 2012; 53:7077–85.

10. Carracedo G, González-Méijome JM, Pintor J. Changes in dia-denosine polyphosphates during alignment-fit and orthokeratology rigid gas permeable lens wear. Invest Ophthalmol Vis Sci. 2012; 53:4426–32.

11. Lipson MJ, Sugar A, Musch DC. Overnight corneal reshaping abdominal soft disposable contact lenses: vision-related quality-of-life differences from a randomized clinical trial. Optom Vis Sci. 2005; 82:886–91.

12. Arita R, Itoh K, Inoue K, Amano S. Noncontact infrared abdominal to document age-related changes of the meibomian glands in a normal population. Ophthalmology. 2008; 115:911–5.

13. Arita R, Itoh K, Inoue K, et al. Contact lens wear is associated with decrease of meibomian glands. Ophthalmology. 2009; 116:379–84.

Table 1.

Demographic information of the population enrolled in the study

Parameter	Values
Number of patients	14
Mean age (years)	26.67 ± 3.26
Age range (years)	22∼35
Sex (male/female)	2∼12
Prior contact lens history (years)	2.64 ± 2.41
Mean corneal astigmatism (D)	–0.73 ± 0.35
Range of corneal astigmatism (D)	–0.12∼−1.17
Mean flat keratometry (D)	43.53 ± 1.92
Mean steep keratometry (D)	44.39 ± 1.36
Mean refractive sphere (D)	–1.92 ± 1.23
Range of refractive sphere (D)	–0.25∼−5.25
Mean refractive cylinder (D)	–0.30 ± 0.33
Range of refractive cylinder (D)	0∼−0.75

Values are presented as mean ± SD unless otherwise indicated.

Table 2.

Ocular symptom parameters at baseline and 6 weeks after orthokeratology

	Baseline	6 weeks	p-value^*
Discomfort	3.28 ± 1.33	1.84 ± 1.11	<0.05
Dryness	3.63 ± 1.12	1.81 ± 0.93	<0.05
Blurry vision	3.01 ± 1.29	2.19 ± 1.28	0.079
Soreness/Irritation	2.85 ± 1.25	1.63 ± 0.94	<0.05
Grittiness/Scratchiness	2.65 ± 1.20	1.74 ± 0.86	<0.05
Foreign body sensation	2.62 ± 1.26	1.52 ± 0.81	<0.05
Burning/Stinging	2.53 ± 1.51	1.43 ± 0.77	<0.05
Photopsia	2.05 ± 1.25	1.89 ± 0.80	0.095
Itching	2.61 ± 1.31	1.78 ± 1.11	<0.05

Values are presented as mean ± SD unless otherwise indicated.

^* p-valued on Paired t-test.

Table 3.

Refractive and corneal parameters at baseline and 6 weeks after orthokeratology

	Baseline	6 weeks	p-value^*
Spherical equivalent (D)	–3.97 ± 1.56	–0.17 ± 0.78	<0.001
Sim K min (D)	43.53 ± 1.92	41.99 ± 1.52	<0.001
Central corneal thickness (μ m)	548.50 ± 27.2	536.05 ± 35.1	<0.001

Values are presented as mean ± SD unless otherwise indicated.

^* p-valued on Paired t-test.

Table 4.

Ocular surface parameters at baseline, 1 week and 6 weeks after orthokeratology

	Baseline	1 week	6 weeks	p-value^*
Ocualr surface parameters
OSDI score	10.94 ± 3.82	13.11 ± 3.44	12.92 ± 5.25	0.075
T osm (mm Hg)	296.28 ± 43.23	303.25 ± 32.62	301.87 ± 24.43	0.527
Schirmer I (mm)	20.25 ± 2.51	17.52 ± 2.86	18.47 ± 3.27	0.423
TBUT (sec)	13.21 ± 1.26	11.12 ± 0.32	12.0 ± 0.82	0.389
Oxford stain score	0	0.46 ± 0.28	0.44 ± 0.35	0.089
Evaluation of meibomian gland
Lid margin score (0–4)	0.10 ± 0.88	0.17 ± 0.35	0.15 ± 0.62	0.788
Meiboscore
Total	1.61 ± 0.54	0.82 ± 0.51	0.66 ± 0.22	0.950
Upper	0.50 ± 0.16	0.53 ± 0.46	0.51 ± 0.11	0.894
Lower	0.93 ± 0.50	0.95 ± 0.79	0.96 ± 0.50	0.975

Values are presented as mean ± SD unless otherwise indicated.

OSDI = ocular symptoms disease index; T osm = tear osmolarity; TBUT = tear film break-up time.

^* p-valued on Paired t-test.

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