Abstract:At present, the effectiveness of orthokeratology lenses in controlling the progression of myopia has been preliminarily recognized, and it is one of the common clinical methods in the treatment of myopia. Orthokeratology is mainly used in children and adolescents, so there should be persistent concern about safety. This article reviews the information about orthokeratology's safety from related literature. Microbial keratitis is the most serious adverse reaction. Other common adverse reactions include corneal stromal infiltration, corneal epithelium damage, conjunctivitis, corneal pigment ring, in addition, changes in lacrimal film, endothelial cells, corneal thickness and corneal biomechanical properties may also bring potential safety concerns. There are few concordant conclusions on etiology, mechanism, incidence and long-term effects, which are needed to be confirmed by further studies. Currently, in view of the occurrence of myopia at a young age and the tendency of myopia to develop into high myopia, orthokeratology is an effective means of clinical myopia control, and has beneficial application values. But it is still important to pay attention to its application safety and evaluate its long-term effects.
赵文辰,何鲜桂,许迅.. 角膜塑形镜临床应用的安全性研究进展[J]. 中华眼视光学与视觉科学杂志, 2022, 24(3): 235-240.
Wenchen Zhao, Xiangui He, Xun Xu. Research Progress on the Safety of the Clinical Application of Orthokeratology. Chinese Journal of Optometry Ophthalmology and Visual science, 2022, 24(3): 235-240. DOI: 10.3760/cma.j.cn115909-20200908-00360
Lipson MJ, Brooks MM, Koffler BH. The role oforthokeratology in myopia control: a review. Eye Contact Lens, 2018, 44(4): 224-230. DOI: 10.1097/icl.0000000000000520.
[2]
Cho P, Tan Q. Myopia and orthokeratology for myopia control. Clin Exp Optom, 2019, 102(4): 364-377. DOI: 10.1111/ cxo.12839.
[3]
VanderVeen DK, Kraker RT, Pineles SL, et al. Use of orthokeratology for the prevention of myopic progression in children: a report by the American Academy of Ophthalmology. Ophthalmology, 2019, 126(4): 623-636. DOI: 10.1016/ j.ophtha.2018.11.026.
[4]
Huang J, Wen D, Wang Q, et al. Efficacy comparison of 16 interventions for myopia control in children: a network metaanalysis. Ophthalmology, 2016, 123(4): 697-708. DOI: 10.1016/ j.ophtha.2015.11.010.
[5]
Walline JJ, Lindsley KB, Vedula SS, et al. Interventions to slow progression of myopia in children. Cochrane Database Syst Rev, 2020, 1(1): CD004916. DOI: 10.1002/14651858.CD004916. pub4.
[6]
Guan M, Zhao W, Geng Y, et al. Changes in axial length after orthokeratology lens treatment for myopia: a meta-analysis. Int Ophthalmol, 2020, 40(1): 255-265. DOI: 10.1007/s10792-019- 01167-9.
[7]
Sun Y, Xu F, Zhang T, et al. Orthokeratology to control myopia progression: a meta-analysis. PLoS One, 2015, 10(4): e0124535. DOI: 10.1371/journal.pone.0124535.
[8]
Cho P, Cheung SW. Protective role of orthokeratology in reducing risk of rapid axial elongation: a Reanalysis of Data From the ROMIO and TO-SEE Studies. Invest Ophthalmol Vis Sci, 2017, 58(3): 1411-1416. DOI: 10.1167/iovs.16-20594.
[9]
Cho P, Cheung SW. Retardation of myopia in orthokeratology (ROMIO) study: a 2-year randomized clinical trial. Invest Ophthalmol Vis Sci, 2012, 53(11): 7077-7085. DOI: 10.1167/ iovs.12-10565.
[10]
Li X, Friedman IB, Medow NB, et al. Update on orthokeratology in managing progressive myopia in children: efficacy, mechanisms, and concerns. J Pediatr Ophthalmol Strabismus, 2017, 54(3): 142-148. DOI: 10.3928/01913913-20170106-01.
Bullimore MA, Sinnott LT, Jones-Jordan LA. The risk of microbial keratitis with overnight corneal reshaping lenses. Optom Vis Sci, 2013, 90(9): 937-944. DOI: 10.1097/ OPX.0b013e31829cac92.
[14]
Kam KW, Yung W, Li G, et al. Infectious keratitis and orthokeratology lens use: a systematic review. Infection, 2017, 45(6): 727-735. DOI: 10.1007/s15010-017-1023-2.
[15]
Li W, Wang Z, Qu J, et al. Acanthamoeba keratitis related to contact lens use in a tertiary hospital in China. BMC Ophthalmol, 2019, 19(1): 202. DOI: 10.1186/s12886-019-1210-2.
[16]
Van Meter WS, Musch DC, Jacobs DS, et al. Safety of overnight orthokeratology for myopia: a report by the American Academy of Ophthalmology. Ophthalmology, 2008, 115(12): 2301-2313. e1. DOI: 10.1016/j.ophtha.2008.06.034.
[17]
Wilhelmus KR. Acanthamoeba keratitis during orthokeratology. Cornea, 2005, 24(7): 864-866. DOI: 10.1097/01. ico.0000175410. 28859.bd.
Cope JR, Collier SA, Schein OD, et al. Acanthamoeba keratitis among rigid gas permeable contact lens wearers in the United States, 2005 through 2011. Ophthalmology, 2016, 123(7): 1435- 41. DOI: 10.1016/j.ophtha.2016.03.039.
Zada M, Cabrera-Aguas M, Branley M, et al. Microbial keratitis associated with long-term orthokeratology. Clin Exp Ophthalmol, 2019, 47(2): 292-294. DOI: 10.1111/ceo.13386.
[22]
Koffler BH, Sears JJ. Myopia control in children through refractive therapy gas permeable contact lenses: is it for real? Am J Ophthalmol, 2013, 156(6): 1076-1081.e1. DOI: 10.1016/ j.ajo.2013.04.039.
[23]
Hsu CC. Dendrite-like anterior stromal keratitis coinfected with acanthamoeba and pseudomonas in an orthokeratology contact lens wearer. Taiwan J Ophthalmol, 2019, 9(2): 131-133. DOI: 10.4103/tjo.tjo_114_17.
[24]
Yuan S, Zhang S, Jiang Y, et al. Effect of short-term orthokeratology lens or ordinary frame glasses wear on corneal thickness, corneal endothelial cells and vision correction in adolescents with low to moderate myopia. BMC Ophthalmol, 2019, 19(1): 242. DOI: 10.1186/s12886-019-1222-y.
Li J, Dong P, Liu H. Effect of overnight wear orthokeratology lenses on corneal shape and tears. Eye Contact Lens, 2018, 44(5): 304-307. DOI: 10.1097/ICL.0000000000000357.
[30]
Liu YM, Xie P. The safety of orthokeratology--a systematic review. Eye Contact Lens, 2016, 42(1): 35-42. DOI: 10.1097/ ICL.0000000000000219.
[31]
Ng LH. Corneal foreign body injury during overnight orthokeratology lens wear: a case report. Cont Lens Anterior Eye, 2008, 31(3): 158-160. DOI: 10.1016/j.clae.2008.01.006.
Wang X, Li J, Zhang R, et al. The Influence of overnight orthokeratology on ocular surface and meibomian gland dysfunction in teenagers with myopia. J Ophthalmol, 2019, 2019: 5142628. DOI: 10.1155/2019/5142628.
[35]
Cho P, Chui WS, Mountford J, et al. Corneal iron ring associated with orthokeratology lens wear. Optom Vis Sci, 2002, 79(9): 565-568. DOI: 10.1097/00006324-200209000-00007.
[36]
Charm J, Cho P. High myopia-partial reduction orthokeratology (HM-PRO): study design. Cont Lens Anterior Eye, 2013, 36(4): 164-170. DOI: 10.1016/j.clae.2013.02.012.
[37]
Liu CF, Lee JS, Sun CC, et al. Correlation between pigmented arc and epithelial thickness (COPE) study in orthokeratologytreated patients using OCT measurements. Eye (Lond), 2020, 34(2): 352-359. DOI: 10.1038/s41433-019-0542-8.
[38]
Huang PW, Yeung L, Sun CC, et al. Correlation of corneal pigmented arc with wide epithelial thickness map in orthokeratology-treated children using optical coherence tomography measurements. Cont Lens Anterior Eye, 2020, 43(3): 238-243. DOI: 10.1016/j.clae.2020.02.004.
[39]
Cheung SW, Cho P, Bron AJ, et al. Case report: the occurrence of fibrillary lines in overnight orthokeratology. Ophthalmic Physiol Opt, 2006, 26(5): 525-531. DOI: 10.1111/j.1475- 1313.2006.00395.x.
[40]
Cheung SW, Cho P, Cheung A. White lesion in the corneal pigmented ring associated with orthokeratology. Ophthalmic Physiol Opt, 2005, 25(3): 264-268. DOI: 10.1111/j.1475- 1313.2005.00283.x.
Na KS, Yoo YS, Hwang HS, et al. The influence of overnight orthokeratology on ocular surface and meibomian glands in children and adolescents. Eye Contact Lens, 2016, 42(1): 68-73. DOI: 10.1097/ICL.0000000000000196.
[43]
Panaser A, Tighe BJ. Evidence of lipid degradation during overnight contact lens wear: gas chromatography mass spectrometry as the diagnostic tool. Invest Ophthalmol Vis Sci, 2014, 55(3): 1797-1804. DOI: 10.1167/iovs.13-12881.
[44]
Carracedo G, Villa-Collar C, Martin-Gil A, et al. Comparison between viscous teardrops and saline solution to fill orthokeratology contact lenses before overnight wear. Eye Contact Lens, 2018, 44 Suppl 1: S307-S311. DOI: 10.1097/ ICL.0000000000000416.
[45]
Singh K, Bhattacharyya M, Goel A, et al. Orthokeratology in moderate myopia: a study of predictability and safety. J Ophthalmic Vis Res, 2020, 15(2): 210-217. DOI: 10.18502/jovr. v15i2.6739.
[46]
Cheung SW, Cho P. Does a two-year period of orthokeratology lead to changes in the endothelial morphology of children?. Cont Lens Anterior Eye, 2018, 41(2): 214-218. DOI: 10.1016/ j.clae.2017.10.006.
[47]
Li F, Jiang ZX, Hao P, et al. A meta-analysis of central corneal thickness changes with overnight orthokeratology. Eye Contact Lens, 2016, 42(2): 141-146. DOI: 10.1097/ ICL.0000000000000132.
[48]
Lian Y, Shen M, Jiang J, et al. Vertical and horizontal thickness profiles of the corneal epithelium and Bowman's layer after orthokeratology. Invest Ophthalmol Vis Sci, 2013, 54(1): 691- 696. DOI: 10.1167/iovs.12-10263.
[49]
Zhou J, Xue F, Zhou X, et al. Thickness profiles of the corneal epithelium along the steep and flat meridians of astigmatic corneas after orthokeratology. BMC Ophthalmol, 2020, 20(1): 240. DOI: 10.1186/s12886-020-01477-y.
[50]
Nieto-Bona A, González-Mesa A, Nieto-Bona MP, et al. Longterm changes in corneal morphology induced by overnight orthokeratology. Curr Eye Res, 2011, 36(10): 895-904. DOI: 10.3109/02713683.2011.593723.
[51]
Kim WK, Kim BJ, Ryu IH, et al. Corneal epithelial and stromal thickness changes in myopic orthokeratology and their relationship with refractive change. PLoS One, 2018, 13(9): e0203652. DOI: 10.1371/journal.pone.0203652.
[52]
Kong Q, Guo J, Zhou J, et al. Factors determining effective orthokeratology treatment for controlling juvenile myopia progression. Iran J Public Health, 2017, 46(9): 1217-1222.
[53]
Chen R, Mao X, Jiang J, et al. The relationship between corneal biomechanics and anterior segment parameters in the early stage of orthokeratology: a pilot study. Medicine (Baltimore), 2017, 96(19): e6907. DOI: 10.1097/MD.0000000000006907.
[54]
Lam AKC, Hon Y, Leung SYY, et al. Association between longterm orthokeratology responses and corneal biomechanics. Sci Rep, 2019, 9(1): 12566. DOI: 10.1038/s41598-019-49041-z.