Slowing Myopia Progression in Adolescents Using Orthokeratology: A Retrospective Chart Review

This study evaluated the effectiveness of orthokeratology (ortho-k) in reducing myopia progression rates in adolescents from a rural Appalachian community by comparing pre- and post-treatment clinical measures of refractive error and corneal curvature.

A retrospective chart review was conducted on 45 adolescents (90 eyes, aged 8-16) who had been treated with ortho-k for at least six months at a rural optometry practice. Post-treatment clinical data were obtained between 21 and 90 days of treatment discontinuation. Refractive error, corneal curvature (k values), and adverse events were collected and statistically analyzed, with myopia progression rates compared to the published untreated rate of -0.50 diopters per year (D/y).

The mean myopia progression rate was -0.227 ± 0.351 D/y, significantly slower than the untreated rate (p < 0.001). A subgroup with corneal flattening (n = 11 eyes) showed a progression rate of -0.028 ± 0.134 D/y. Post-treatment corneal curvature steepened on average (Δkm = 0.327 ± 0.445 D), but flattening was linked to slower progression. No significant effects of sex, age, or treatment duration were found in the full sample, although male patients in the flattened subgroup had slower progression than female patients (p = 0.014). No adverse events were reported.

Ortho-k significantly reduces myopia progression in adolescents, particularly in those with corneal flattening, as demonstrated by a slower progression rate compared to untreated individuals. Its safety and effectiveness make it a valuable treatment option for managing myopia in rural communities.