The Berkeley Orthokeratology Study, part III: safety

Area of Science:

• Ophthalmology
• Optometry
• Corneal Physiology

Background:

• Orthokeratology (OK) involves reshaping the cornea with specialized contact lenses to correct refractive errors.
• Assessing the long-term safety and ocular impact of OK lens wear is crucial for patient management.
• Understanding complications and follow-up needs informs clinical practice guidelines for OK procedures.

Purpose of the Study:

• To evaluate the safety of orthokeratological (OK) procedures by monitoring key ocular characteristics.
• To assess the incidence and causes of extra clinical visits due to ocular complications.
• To determine if safety factors correlate with patient loss to follow-up in OK treatment.

Main Methods:

• Monitored corneal thickness, refractive and corneal astigmatism, spectacle acuity, corneal edema, staining, and endothelial cell density.
• Analyzed extra clinical visits and reasons for patient discontinuation or loss to follow-up over a 1.2-year period.
• Compared a treatment group (T) undergoing OK procedures with a control group (C).

Main Results:

• Minimal changes observed in corneal thickness (0.2 vs. 3.2 microns), refractive astigmatism (0.07 vs 0.01 D), and corrected spectacle acuity (0.02 vs 0.018 logMAR) between groups.
• Changes in corneal thickness and astigmatism were small and not clinically significant during treatment.
• The OK group had slightly more extra visits (1.25x) due to complications, but none warranted discontinuing lens wear; reasons for follow-up loss were similar in both groups.

Conclusions:

• Orthokeratology (OK) treatment appears safe for the studied patient population, with no clinically significant adverse ocular changes.
• OK lens wear may require more intensive patient monitoring than conventional hard contact lenses.
• Patient compliance and motivation, influenced by minor contact lens symptoms, are key factors in follow-up adherence.