Long-Term Orthokeratology Patient Satisfaction

Yet another study supporting the use of orthokeratology (also known as corneal reshaping) appeared in the November 2013 issue of the scientific journal Contact Lens.  The new study found that long-term satisfaction rates with orthokeratology treatment were high.  We have provided orthokeratology at our Vancouver eye clinic since we opened.

Orthokeratology is a safe and effective vision correction method where patient wears a lens retainer at night that reshapes the cornea of the eye.  The result is clear vision the next day without the need to wear corrective lenses during waking hours.  A number of studies have also shown that orthokeratology is effective in slowing or stopping myopia progression and that is save and effective in children.

The researchers who conducted the new study used a questionnaire where patients rated their visual experience and satisfaction levels with orthokeratology on a scale of 0-10.

The results of the study showed that light distortion in low light conditions decreases over time and decreases more quickly in younger patients and in patients with lower amounts of myopia. Predictably, visual performance declined after a patient skipped a night of lens retainer wear but this was usually tolerated.  In addition, the majority of patients report that they skipped overnight wear at least 1 night per week, but tolerate the resulting transient decrease in vision. Overall satisfaction was high, even after skipping a night of lens wear.

Here are the results in the study's own words:

More than 50% of patients skipped lens wear at least 1 night per week. The most common wearing pattern was 6-8 hours a day for 72.7% with 54.5% of patients wearing lenses every 2-3 nights only. Subjective vision scores after lens removal was 9.1 ± 1.1 after having worn the lenses and 8.1 ± 1.4 after skipping lens wear for 1 night. Subjective vision scores before lens insertion at the end of the day was 6.9 ± 2.0 and 5.8 ± 2.4, respectively. The number of hours until noticeable blur reduced with increased level of baseline myopia (r = 0.396; P < 0.001). 

Source:

Eye & Contact Lens
Subjective Satisfaction in Long-Term Orthokeratology Patients Eye Contact Lens 2013 Nov 01;39(6)388-393, E Santolaria, A Cerviño, A Queirós, R Brautaset, JM González-Méijome

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Laser eye sugery makes you queasy?

I came across this news article from Houston, Texas on corneal reshaping, which doctors call orthokeratology (the article curiously used the term "corneal molding", which makes it sound like your cornea is past its expiry date...).

Orthokeratology reshapes your cornea while you sleep so that you have perfect vision during the day. No glasses, no contacts, no surgery. It is very popular with people who are active in sports, especially swimming, people who don't like the discomfort of contact lenses and people who are tired of wearing glasses. It is also a good option for people who are not good candidates for laser eye surgery or who just don't like the idea of having elective surgery on their eyes.

The patient will wear custom designed hard contact lenses while they sleep (they are very comfortable) and remove them in the morning. Sometimes there is a trial and error process to get the fit perfect and to ensure maximum effectiveness and comfort. During sleep, the lens reshapes the cornea of the eye resulting in 20/20 vision upon waking.

Orthokeratology should be done under doctor supervision to ensure that the lenses are doing their job properly, that the eyes are adapting well to the lenses and that there is no risk of damage is being done. The risks of orthokeratology are generally the same as those associated with regular contact lens use, namely that improper care and cleaning can cause infections.

New research even suggests that orthokeratology can stop the progression of myopia (near-sightedness). Many young people have the unnerving experience of seeing their glasses prescription get worse and worse every time they go to the eye doctor. Orthokeratology appears to be one way to slow or stop that process. Incidentally, I have also had success in my clinic with using vision therapy to stop the progression of myopia.

Many of my patients have opted for orthokeratology and I'm happy to say that the vast majority of them really love it. If you are interested in orthokeratology, go see your optometrist who will assess your eyes and determine if you are a good candidate for it.

To read the Houston, Texas article, click here.