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Prediction of Orthokeratology Lens Decentration with Corneal Elevation

Chen, Zhi, MD, PhD; Xue, Feng, MD; Zhou, Jiaqi, MD, PhD; Qu, Xiaomei, MD, PhD; Zhou, Xingtao, MD, PhD for the Shanghai Orthokeratology and Study (SOS) Group

doi: 10.1097/OPX.0000000000001109

SIGNIFICANCE Lens decentration is common and unavoidable to some extent during ortho-k treatment. By using a simplified method, we are able to predict the magnitude and direction of ortho-k lens decentration, which provides useful insights in screening for ideal ortho-k candidates and to make a quick decision when decentration happens.

PURPOSE The aim of this study was to investigate the influence of corneal elevation asymmetry on ortho-k lens decentration.

METHODS Thirty-six eyes of 36 subjects were fitted with four-curve reverse geometry ortho-k contact lenses. Corneal topography was collected before and 1 month after ortho-k lens wear. The difference in corneal elevation at the 8-mm chord of the respective two principal meridians of corneal astigmatism was calculated. Vector analyses were performed on these differences to calculate the magnitude and direction of a vector (corneal asymmetry vector). The relationship between the angle and magnitude of corneal asymmetry vector and lens decentration was analyzed.

RESULTS Baseline refractive sphere and cylinder for the 36 tested eyes were −2.84 ± 1.04 diopters (D) (range, −4.75 to −1.00 D) and −0.21 ± 0.28 D (range, −1.00 to 0 D), respectively. The mean magnitude of lens decentration was 0.72 ± 0.26 mm (0 to 1.34 mm). For overall displacement, inferotemporal decentration was the most common as observed in 24 eyes (67%). The mean angle of the corneal asymmetry vector (202 ± 39 degrees) was significantly correlated to the mean angle of lens decentration (200 ± 39 degrees) (r = 0.76, P < .001). The magnitude of corneal asymmetry vector significantly contributed to the magnitude of lens decentration (standardized β = 0.448, P = .002) whereas the other tested variables did not affect lens decentration (all P > .05).

CONCLUSIONS Lens decentration is a common phenomenon in ortho-k that mostly happens toward the inferotemporal quadrant of the cornea. The magnitude and direction of lens decentration are predetermined by paracentral corneal asymmetry.

Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China (all authors)

Corresponding Author: Xingtao Zhou Department of Ophthalmology and Vision Science Eye and ENT Hospital Fudan University 19 Baoqing Road Xuhui District, Shanghai China e-mail:

Submitted: August 25, 2016

Accepted: April 30, 2017

Funding/Support: This work was supported in part by the National Natural Science Foundation of China (grant 81570879) and by the Outstanding Academic Leaders Program of Shanghai (grant XBR2013098).

Conflict of Interest Disclosure: None of the authors have reported a conflict of interest.

Author Contributions: Conceptualization: FX, XQ, XZ; Data Curation: ZC, FX; Formal Analysis: ZC, JZ; Funding Acquisition: XZ; Investigation: ZC, FX, JZ; Methodology; FX, JZ, XZ; Project Administration: XQ; Resources: JZ, XQ; Software: FX; Supervision: FX, XQ, XZ; Validation: JZ; Writing – Original Draft: ZC; Writing – Review & Editing: ZC.

© 2017 American Academy of Optometry