Factors influencing treatment zone size in orthokeratology

The aim of this study was to analyze the influence of corneal topography, contact lens parameters and degree of myopia on the treatment zone (TZ) and peripheral plus ring (PPR) size in orthokeratology.

In this retrospective study the topographic zones of the right eyes of 106 patients (73 female, 22.16 ± 8.96 years) were analyzed in the tangential difference map of the Oculus Keratograph 5M (Oculus, Wetzlar, Germany). Using the MB-Ruler Pro 5.4 software (MB-Softwaresolutions, Iffezheim, Germany) the horizontal, vertical, longest, shortest diameters and area of the TZ; horizontal, vertical, total diameters and width of the PPR were measured. Correlations were determined between these zones and the subjects' baseline parameters (myopia; corneal diameter, radii, astigmatism, eccentricity, sagittal height; contact lens radii, toricity and total diameter) for three back optic zone diameter (BOZD) groups (5.5, 6.0 and 6.6 mm). A stepwise linear regression analysis was performed to test for TZ and PPR predictability.

In the group of BOZD 6.0 correlations were found between the amount of myopia and the short TZ diameter (r = -0.25, p = 0.025); the steep corneal radius and the vertical diameter (r = -0.244, p = 0.029), the longest diameter (r = -0.254, p = 0.023) and the area (r = -0.228, p = 0.042) of the TZ; the amount of astigmatism and PPR width (r = 0.266, p = 0.017); eccentricity of the steep corneal meridian and PPR width (r = -0.222, p = 0.047). BOZD correlated significantly positively with all zones (p < 0.05). The best prediction model (R² = 0.389) resulted with the TZ area as the outcome variable.

The amount of myopia, topography and contact lens parameters influence TZ and PPR in orthokeratology. Describing the TZ by its area may provide the most accurate representation of its size.