Related Experiment Video
Updated: Jul 13, 2026
Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter
Published on: September 16, 2025
Corneal changes and wavefront analysis after orthokeratology fitting test
Iane Gonçalves Stillitano1, Maria Regina Chalita, Paulo Schor
1Contact Lens & Refractive Surgery Sectors, Department of Ophthalmology, Federal University of São Paulo/Paulista School of Medicine UNIFESP/EPM, São Paulo, Brazil. ianestillitano@oftalmol.epm.br
Purpose:
To evaluate corneal changes and ocular aberrations during an orthokeratology test.
Design:
A prospective, nonrandomized cohort study.
Methods:
Fourteen myopic patients (26 eyes) underwent an orthokeratology fitting test with the BE contact lens (Ultravision Pty, Ltd, Brisbane, Australia). Best spectacle-corrected visual acuity (BSCVA), uncorrected (Ultravision Pty, Ltd, Brisbane, Australia) visual acuity (UCVA), subjective cycloplegic refraction, biomicroscopy, corneal topography, optical pachymetry, and aberrometry were performed at baseline and one and eight nights orthokeratology. The short-term effect of orthokeratology using corneal topography, tomography, and ocular aberrations was evaluated.
Results:
The mean spherical equivalent changed from -2.24 +/- 0.98 diopters (D) at baseline to 0.15 +/- 0.76 D after the eight nights of lens wear (P = .001). All patients had an UCVA of 20/30, 69.2% with 20/20. Changes in central corneal pachymetry were not observed. There was a statistically significant increase in the temporal corneal thickness from night one, without any difference between nights one and eight (P > .001). A significant increase of higher-order root mean square values was observed from baseline (0.42 +/- 0.16 mum), night one (0.81 +/- 0.24 mum), and night eight (1.04 +/- 0.24 mum). Increases in coma (Z7+Z8) and spherical aberration (Z12) were observed. Positive horizontal (Z8) coma increased in right eyes, and negative horizontal (Z8) coma increased in left eyes (P < .001).
Conclusions:
Myopia reduction resulting from rapid central corneal flattening and improvement of UCVA occurred after orthokeratology. Higher-order aberrations (HOAs), particularly spherical aberration and coma, increased significantly during the orthokeratology test. An increase of temporal pachymetry and differences in coma direction induced between the eyes may be related to the subclinical lens decentration temporally.