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Kim, Kim, Kwag, Choi, Pak, Lee, Park, Chung, and Hyun: Comparative Effect of Spectacles and Orthokeratology Lenses on Axial Elongation in Children with Mild-to-Moderate Myopia
Original Article

J Korean Ophthalmol Soc 2018;59(11):1009-1016.

Published online: 25 September 2018

DOI: https://doi.org/10.3341/jkos.2018.59.11.1009

Comparative Effect of Spectacles and Orthokeratology Lenses on Axial Elongation in Children with Mild-to-Moderate Myopia

Tae Hee Kim, MD1, Myung Hun Kim, MD2, Joo Young Kwag, MD1, Jin Seok Choi, MD, PhD1, Kyu Hong Pak, MD1, Kyeongwook Lee, MD1, Taeseong Park, MD1, Sung Kun Chung, MD, PhD1, Joo Hyun, MD1,

1Saevit Eye Hospital, Goyang, Korea

2Jalboneun Seoul Eye Clinic, Hwaseoung, Korea

Address reprint requests to Joo Hyun, MD Saevit Eye Hospital, #1065 Jungang-ro, Ilsandong-gu, Goyang 10447, Korea Tel: 82-31-900-7700, Fax: 82-31-900-7777 E-mail: jjulujjulu@hanmail.net

Received 3 May 2018       Revised 7 July 2018       Accepted 30 October 2018

Copyright © 2018 Korean Ophthalmological Society

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 assess the effect on axial elongation and associated factors between spectacles and of orthokeratology lens (OK) wearing in children with mild to moderate myopia.

Methods

A total of one hundred subjects, ranging in age from 6 to 13 years, and with mild to moderate myopia no more than −4.50 diopters in spherical equivalent, visited our clinic from 2013 to 2015. The OK group (75 eyes) and the spectacles group (64 eyes) were compared and analyzed on the axial elongation and associated factors.

Results

In the OK group, axial length was elongated in 1 year period with a mean increase of 0.24 ± 0.29 mm. In spectacles group, axial length was elongated in 1 year period with a mean increase of 0.42 ± 0.20 mm. The statistically significant suppression of axial elongation was observed in OK group compared to the spectacles group (Mann-Whitney U test, p < 0.05). For OK group, the age of starting OK (Pearson's correlation, r = −0.481, p < 0.05) was the only influencing factor on axial elongation, which had negative correlation with axial elongation. In spectacles group, the age of starting spectacles had negative correlation with axial elongation (Pearson's correlation, r = −0.462, p < 0.05) and baseline spherical equivalent, spherical diopter, cylindrical diopter from manifest refraction had positive correlation with axial elongation. Comparison of axial elongation in orthokeratology lens group and spectacles group by age groups (6 to 9 years [28 eyes], 9 to 13 years [47 eyes]), 9 to 13 years of orthokeratology lens group had the stronger suppression of axial elongation (Mann-Whitney U test, p < 0.05).

Conclusions

The OK effectively suppresses axial elongation compared to the spectacles. Although the patients are in age from 9 to 13 years, the axial elongation was effectively suppressed.

Keywords: Axial elongation, Myopia, Orthokeratology lens

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Figure 1.
Means of axial length in the orthokeratology lens group and control groups over 1 year in 6 months period. Values in the table are presented as mean ± standard deviation unless otherwise indicated. * Mann-Whitney U test.
jkos-59-1009f1.tif
Figure 2.
Comparison of axial elongation between young and old age groups in orthokeratology lens group and spectacles group. Significantly different axial elongation groups between A and B (p-value = 0.000*), C and D (p-value = 0.001*), and B and D (p-value = 0.000*). * Mann-Whitney U test.
jkos-59-1009f2.tif
Figure 3.
Graph of Pearson's correlation between changes in axial length and age, baseline spherical equivalent, baseline spherical diopter and baseline cylindrical diopter in orthokeratology lens group and spectacles group. (A) Negative correlation between change in axial length and age in both orthokeratology lens group (p = 0.000) and spectacles group (p = 0.000). (B-D) No correlations between change in axial length and baseline spherical equivalent, spherical diopter and cylindrical diopter in orthokeratology lens group (p = 0.224, p = 0.206, p = 0.461), but positive correlation in spectacles group (p = 0.000, p = 0.005, p = 0.002). * Statistically significant in Pearson's correlation coefficient test (p < 0.05).
jkos-59-1009f3.tif
Table 1.
Inclusion criteria for data collection
Inclusion criteria
Age: between 6–13 years
No prior history of contact lens or OK wear
Best corrected visual acuity of logMAR 0 or better
Spherical equivalent: between 0.50 D and 4.50 D myopia
Ocular health status for suitability for OK wear was screened using pre-wear corneal topography
Subjects maintained regular follow-up appointments for at least one year
Astigmatism less than 3.00 D

OK = orthokeratology lens; logMAR = log minimal angle of resolution; D = diopters.

Table 2.
Demographics of patients
  Orthokeratology lens Spectacles p-value
Eyes (n) 75 64  
Patients (n) 60 40  
Male/Female (n) 25/35 16/24 0.919*
Age (years, range) 9.1 ± 1.9 (6∼13) 8.7 ± 1.8 (6∼13) 0.207†
Follow up period (months, range) 12.94 ± 2.11 13.30 ± 2.17 0.329†
  (8.67∼19.55) (10.81∼22.34)  
Uncorrected visual acuity 0.48 ± 0.21 0.40 ± 0.28 0.069†
(logMAR, range) (0.1∼1.1) (0.1∼1.1)  
Axial length (mm, range) 24.00 ± 0.68 23.93 ± 0.75 0.452†
  (22.50∼25.68) (22.20∼25.65)  
Spherical equivalent (D, range) −1.41 ± 0.63 −1.23 ± 0.80 0.151†
  (−4.50∼0.50) (−3.75∼0.50)  
Mean K (D, range) 43.26 ± 1.45 43.29 ± 1.30 0.910†
  (39.25∼46.50) (40.25∼46.75)  

Values are presented as mean ± SD (range) unless otherwise indicated. logMAR = log minimal angle of resolution; D = diopters.

* χ2 test

† Independent t-test.

Table 3.
Correlation coefficients (γ) and probabilities (p) between changes in axial length and multivariate in orthokeratology lens group and spectacles group
  Orthokeratology lens (n = 75)
 Spectacles (n = 64)
γ p-value* γ p-value*
Age at first use −0.481 0.000 −0.462 0.000
Baseline spherical equivalent −0.142 0.224 0.525 0.000
Baseline spherical diopters −0.148 0.206 0.349 0.005
Baseline cylindrical diopters 0.086 0.461 0.377 0.002
Baseline mean keratometry −0.253 0.031 −0.116 0.366

* Pearson's correlation coefficient test.

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