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Reduced Corneal Sensitivity and Sub-Basal Nerve Density in Long-Term Orthokeratology Lens Wear

Lum, Edward Ph.D.; Golebiowski, Blanka Ph.D.; Swarbrick, Helen A. Ph.D.

doi: 10.1097/ICL.0000000000000285
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Objectives: To investigate changes in corneal sensitivity and nerve morphology in orthokeratology (OK) contact lens wear.

Methods: In a cross-sectional study, 54 subjects (aged 18–45 years) were grouped into three categories: nonlens (NL), soft lens (SCL), and OK lens wearers. Corneal sensitivity was measured at the corneal apex and 2.5 mm temporal to the apex using the Cochet–Bonnet aesthesiometer. Corneal nerve morphology was assessed by sampling a 1 mm2 area of the corneal sub-basal nerve plexus using the Heidelberg Retinal Tomograph with Rostock Corneal Module at the corneal apex and 2.5 mm temporal to the apex. Nerve fiber density (NFD) was calculated by measuring the total length of nerve fibers per square millimeter using Image-Pro Analyser. Comparisons between groups were made using mixed analysis of variance and post hoc paired t tests with Bonferroni correction or the Kruskal–Wallis test and post hoc Mann–Whitney U tests as appropriate.

Results: There was a significant difference in corneal sensitivity between the three groups (P=0.027). Central threshold was significantly higher in the OK than NL group (0.69±0.42 g/mm2 vs. 0.45±0.12 g/mm2; P=0.048). Mid-peripheral threshold was not different between the three groups (P>0.05). There was a significant difference in NFD between the three groups (P<0.001). Central NFD was significantly less in the OK than NL and SCL groups (OK: 17.89±4.42 mm/mm2, NL: 25.87±5.00 mm/mm2; SCL: 24.52±4.93 mm/mm2; P<0.001). Mid-peripheral NFD was not different between the three groups (P>0.05).

Conclusions: Long-term OK lens wear is associated with a decrease in central corneal sensitivity and NFD. The mechanism underlying refractive change during OK treatment seems to impact both corneal sensitivity and nerve morphology.

School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.

Address correspondence to Edward Lum, Ph.D., School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia 2052; e-mail: e.lum@unsw.edu.au

E. Lum, Bausch & Lomb Boston, MA, BE Enterprises Pty Ltd, and Capricornia Contact Lens Pty Ltd, Australia; H. A. Swarbrick, Bausch & Lomb Boston, MA, BE Enterprises Pty Ltd, and Capricornia Contact Lens Pty Ltd, Australia. B Golebiowski has no conflicts of interest to disclose.

Supported under the Australian Research Council Linkage Project Grant scheme with industry collaborators Bausch & Lomb Boston (Wilmington, MA), BE Enterprises Pty Ltd (Brisbane, Australia) and Capricornia Contact Lens Pty Ltd (Brisbane, Australia).

Presented in part at the American Academy of Optometry Annual Meeting, October 24–27, 2012, Phoenix, AZ.

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Accepted April 11, 2016

© 2017 Contact Lens Association of Ophthalmologists, Inc.