Abstract：Objective: To investigate the changes of corneal sub-basal nerve and corneal transparency in adolescents aged 8 to 15 years with orthokeratology lenses. Methods: In this prospective clinical study, myopic adolescents aged 8-15 years old fitted with orthokeratology lens in the Affiliated Hospital of Qingdao University from November 2020 to August 2021 were randomly selected. Nerve fiber density (NFD),nerve fber length (NFL), nerve fber orientation (NFO), and nerve fber width (NFW) were assessed by confocal laser microscopy before and 1, 3 and 6 months after wearing lens. The optical density of cornea in different diameters was evaluated by Pentacam anterior segment analyzer. Pre- and post-wear comparisons of neuromorphological parameters and corneal optical density were performed using randomized zone group ANOVA. Results:Atotal of 16 patients (32 eyes) with myopia were included in the study, of which 4 were lost and 12 (28 eyes) eventually completed the follow-up. In the central cornea, the NFD was signifcantly increased at 1-month (P=0.003) after wearing and gradually decreased to the baseline level at 3-and 6-month (P>0.05). The difference in NFLshows no signifcant difference after lens wear (P>0.05). NFO was significantly higher at 1 and 6 months (P=0.015 and 0.047, respectively). NFW increased signifcantly at 6-month (P=0.029). In the temporal cornea, there was no statistical difference during 6-month wearing (P>0.05). NFLdid not differ signifcantly during 6 months (P>0.05). NFO increased gradually after wearing lens and showed statistical signifcance at 6 months (P<0.001). NFWincreased signifcantly at 3 months (P=0.002) and further increased at 6 months (P<0.001). In the upper cornea, NFD increased slightly in the early stage and decreased at 6-month, showing no statistical difference (all P>0.05). NFL increased significantly at 3-month (P<0.001), and decreased to the baseline level at 6-month (P>0.05).NFO significantly increased at 3 and 6 months (P<0.001,P=0.022).The corneal optical density of the anterior corneal layer ≤2 mm and 2-6 mm increased at 6 months after wearing the lens, with statistical signifcance (P=0.011, P<0.001). Conclusions: The morphology of the corneal sub-basal nerve and corneal densitometry changed significantly in the myopic adolescents after wearing orthokeratology lens. The nerve fber density increased and then decreased after lens wearing, the degree of nerve course curvature increased, and the nerve fbers were generally thickened. The corneal transparency decreased steadily for 6 months after lens wearing.
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