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Multivariable Model to Predict Toric Ortho-K Lens Prescription.

Hsiuwan Wendy Yang1, Chihkai Leon Liang, Hsinhui Wang

  • 1Department of Biomedical Engineering (H.W.Y., H.K.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan; and Ophthalmology Clinics (C.L.L., H.W.), Eyeplus Group, Taiwan.

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A new 4-variable model accurately predicts toric Ortho-K lens fitting. Key predictors include corneal astigmatism and Sagittal Height Difference, improving myopia control for astigmatic patients.

Keywords:
Corneal astigmatismCorneal eccentricityMultivariable regressionOrthokeratologyROC curveSagittal height difference at 8 mmToric ortho-k lenses

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Area of Science:

  • Ophthalmology
  • Optometry
  • Corneal Physiology

Background:

  • Orthokeratology (Ortho-K) is effective for myopia control.
  • Toric Ortho-K lenses address moderate-to-high astigmatism.
  • Predictive models for toric Ortho-K fitting are limited.

Purpose of the Study:

  • Identify key predictors for successful toric Ortho-K lens prescription.
  • Develop a predictive model for toric Ortho-K fitting.
  • Enhance myopia management strategies for astigmatic individuals.

Main Methods:

  • Retrospective analysis of 506 Ortho-K patients.
  • Inclusion of 15 corneal and refractive parameters.
  • Logistic regression and stepwise regression for predictor identification.
  • Receiver operating characteristic (ROC) curve analysis for model validation.

Main Results:

  • A 4-variable model (corneal astigmatism, steep eccentricity, Sagittal Height Difference at 8 mm [SD8], Corneal Cylindrical to Spherical ratio) achieved an AUC of 0.92.
  • Corneal astigmatism (∆K > 1.50 D) and SD8 (> 34 μm) were strong predictors.
  • Eccentricity parameters provided additional predictive and clinical insights.

Conclusions:

  • Developed a validated 4-variable model for toric Ortho-K lens fitting.
  • Corneal astigmatism and SD8 are crucial for predicting limbus-to-limbus astigmatism.
  • The model enhances precision in toric Ortho-K prescriptions for myopia control.