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Short-Term Changes in Ocular Biometry and Refraction After Discontinuation of Long-Term Orthokeratology

Santodomingo-Rubido, Jacinto O.D., M.Sc., Ph.D.; Villa-Collar, César B.Sc., M.Sc., Ph.D.; Gilmartin, Bernard B.Sc., Ph.D., F.C.Optom.; Gutiérrez-Ortega, Ramón M.D., Ph.D.

doi: 10.1097/ICL.0000000000000014

Objective: To assess refractive and biometric changes 1 week after discontinuation of lens wear in subjects who had been wearing orthokeratology (OK) contact lenses for 2 years.

Methods: Twenty-nine subjects aged 6 to 12 years and with myopia of −0.75 to −4.00 diopters (D) and astigmatism of ≤1.00 D participated in the study. Measurements of axial length and anterior chamber depth (Zeiss IOLMaster), corneal power and shape, and cycloplegic refraction were taken 1 week after discontinuation and compared with those at baseline and after 24 months of lens wear.

Results: A hyperopic shift was found at 24 months relative to baseline in spherical equivalent refractive error (+1.86±1.01 D), followed by a myopic shift at 1 week relative to 24 months (−1.93±0.92 D) (both P<0.001). Longer axial lengths were found at 24 months and 1 week in comparison to baseline (0.47±0.18 and 0.51±0.18 mm, respectively) (both P<0.001). The increase in axial length at 1 week relative to 24 months was statistically significant (0.04±0.06 mm; P=0.006). Anterior chamber depth did not change significantly over time (P=0.31). Significant differences were found between 24 months and 1 week relative to baseline and between 1-week and 24-month visits in mean corneal power (−1.68±0.80, −0.44±0.32, and 1.23±0.70 D, respectively) (all P≤0.001). Refractive change at 1 week in comparison to 24 months strongly correlated with changes in corneal power (r=−0.88; P<0.001) but not with axial length changes (r=−0.09; P=0.66). Corneal shape changed significantly between the baseline and 1-week visits (0.15±0.10 D; P<0.001). Corneal shape changed from a prolate to a more oblate corneal shape at the 24-month and 1-week visits in comparison to baseline (both P≤0.02) but did not change significantly between 24 months and 1 week (P=0.06).

Conclusions: The effects of long-term OK on ocular biometry and refraction are still present after 1-week discontinuation of lens wear. Refractive change after discontinuation of long-term OK is primarily attributed to the recovery of corneal shape and not to an increase in the axial length.

Clínica Oftalmológica Novovision (C.V-C., R.G-O.), Madrid, Spain; Universidad Europea de Madrid (C.V-C.), Madrid, Spain; School of Life and Health Sciences (B.G.), Aston University, Birmingham, United Kingdom; and Menicon Co., Ltd (J.S-R.), Madrid, Spain.

Address correspondence to Jacinto Santodomingo-Rubido, O.D., M.Sc., Ph.D.; e-mail:

Supported in part by Menicon Co. Ltd.

Jacinto Santodomingo-Rubido is a full-time employee of Menicon. The other authors have no funding or conflicts of interest to disclose.

Accepted December 16, 2013

© 2014 Contact Lens Association of Ophthalmologists, Inc.