Journal of Ophthalmology

Overnight Orthokeratology: Technology, Efficiency, Safety, and Myopia Control


Publishing date
01 Feb 2019
Status
Published
Submission deadline
05 Oct 2018

1Universidad Europea, Madrid, Spain

2Universidad Complutense de Madrid, Madrid, Spain

3Fudan University, Shanghai, China

4Universidade do Minho, Braga, Portugal


Overnight Orthokeratology: Technology, Efficiency, Safety, and Myopia Control

Description

The moulding of the anterior corneal surface, also known as Orthokeratology, was first noticed as a side effect of using PMMA corneal contact lenses that flattened the radius of the cornea. For a long time, this technique lacked validity from a clinical and healthcare point of view, and almost no scientific evidence was available until it was analysed and approved by healthcare organisations, the US Food and Drugs Administration (FDA) among them. The Corneal Refractive Therapy (CRT®) developed by Paragon Vision Science was approved by the FDA in 2002, so that it could be adapted for the treatment of myopia (up to 6 diopters) and astigmatism (up to 1.75 diopters), and the Vision Shaping Treatment developed by Bausch & Lomb was also approved in 2004. Since then, especially in the last decade, the progress has been colossal. The underlying reasons for such an evolution can be found in the improvement of technology, the increase in the efficiency, the predictability and safety of the technique, and its effects on the progression of myopia.

Presently, the new technologies implemented by the industry, allowing the manufacture of more sophisticated designs, and the development of instruments for the measuring and analysis of the cornea allow carrying out adaptations outside the range approved by the FDA. Thus, cases of astigmatism exceeding 1.75 diopters, as well as farsightedness, presbyopia, and severe myopia (more than 6 diopters) are being currently treated using this technique. However, in these cases, it has not been demonstrated whether their degree of efficiency and/or safety is similar to the cases of low myopia and astigmatism.

Notwithstanding the foregoing, this technique is most currently used in short-sighted babies and teenagers, in an effort to slow down the evolution of their condition. It has been generally accepted that Orthokeratology using contact lenses during sleeping hours (overnight orthokeratology) has a dampening effect on the evolution of myopia, at least in the short term. Long term effects, from both the efficiency and the safety points of view, are being currently studied, as well as the eventual occurrence of a rebound effect when contact lenses are no longer used and the consequences of this technique on the corneal mechanics in the medium-long term. There is controversy among certain eye care professionals, who maintain that Orthokeratology may induce a weakening of the cornea and increases the chances of occurrence of corneal ectasias if the patient undergoes corneal refractive surgery in the future.

Thus, there are currently sufficient lines of research open in this field that justify the printing of a special issue dedicated to overnight Orthokeratology. Among the eventual topics to be covered, the following could be mentioned, without limitation.

Potential topics include but are not limited to the following:

  • Known effects on the lachrymal and corneal physiology in the short, medium, and long term
  • Swelling: tear markers and changes detected in confocal microscopy
  • Corneal rheology: stability and regression of results
  • Effects on corneal biomechanics and refractive surgery following the use of overnight orthokeratology
  • Lens design: range of application of the technique, depending on the specific refractive error
  • Efficiency and predictability and corneal topography
  • Astigmatism
  • Farsightedness and presbyopia
  • Safety, permeability of the corneal epithelium, absolute and relative contraindications, microbial keratitis, and visual and nonvisual complications other than microbial keratitis
  • Changes in corneal and ocular higher-order aberrations and quality of vision
  • Orthokeratology in the control of myopia: clinical trials and meta-analysis

Articles

  • Special Issue
  • - Volume 2019
  • - Article ID 2607429
  • - Editorial

Overnight Orthokeratology: Technology, Efficiency, Safety, and Myopia Control

César Villa-Collar | Gonzalo Carracedo | ... | José M. Gonzalez-Méijome
  • Special Issue
  • - Volume 2019
  • - Article ID 6964043
  • - Research Article

Current State and Future Trends: A Citation Network Analysis of the Orthokeratology Field

Miguel Angel Sanchez-Tena | Cristina Alvarez-Peregrina | ... | Cesar Villa-Collar
  • Special Issue
  • - Volume 2019
  • - Article ID 4275269
  • - Research Article

Comparison of Toric and Spherical Orthokeratology Lenses in Patients with Astigmatism

Jun Jiang | Lili Lian | ... | E. Song
  • Special Issue
  • - Volume 2019
  • - Article ID 5142628
  • - Clinical Study

The Influence of Overnight Orthokeratology on Ocular Surface and Meibomian Gland Dysfunction in Teenagers with Myopia

Xiu Wang | Jing Li | ... | Ruihua Wei
  • Special Issue
  • - Volume 2019
  • - Article ID 1082472
  • - Research Article

The Topographical Effect of Optical Zone Diameter in Orthokeratology Contact Lenses in High Myopes

G. Carracedo | T. M. Espinosa-Vidal | ... | L. Batres
  • Special Issue
  • - Volume 2018
  • - Article ID 7106028
  • - Clinical Study

Increased Corneal Toricity after Long-Term Orthokeratology Lens Wear

Zhi Chen | Jiaqi Zhou | ... | Xiaomei Qu
  • Special Issue
  • - Volume 2018
  • - Article ID 3174826
  • - Clinical Study

Changes and Diurnal Variation of Visual Quality after Orthokeratology in Myopic Children

Hao-Chen Guo | Wan-Qing Jin | ... | A-Yong Yu
Journal of Ophthalmology
 Journal metrics
Acceptance rate36%
Submission to final decision73 days
Acceptance to publication31 days
CiteScore2.800
Impact Factor1.447
 Submit

We are committed to sharing findings related to COVID-19 as quickly as possible. We will be providing unlimited waivers of publication charges for accepted research articles as well as case reports and case series related to COVID-19. Review articles are excluded from this waiver policy. Sign up here as a reviewer to help fast-track new submissions.