Orthokeratology lenses contribute to tear film disruption leading to dryness and discomfort in kids

China: When children are fitted with orthokeratology lenses, objective assessments of tear film quality are diminished, but they rebound to baseline following one month of lens removal, says an article published in the journal Contact Lens & Anterior Eye. 

Yin Guo and colleagues used an automated Medmont E300 corneal topographer to analyze the tear film surface quality following orthokeratology. In this retrospective study, children who had worn orthokeratology lenses for more than a year were chosen. Tear film disruption (TFD) and central tear film disruption (cTFD) were assessed with a Medmont E300 corneal topographer during the first and each follow-up visit after orthokeratology lens fitting, yielding a nominal value ranging from 0 (perfect) to 1 (worst) (poor). The surface quality of the tear film before and after ortho-k therapy was examined.

The key findings of this study were as follows:

1. A total of 145 youngsters utilizing orthokeratology lenses were assessed.

2. Tear film disruption and central tear film disruption rose considerably at 1-day follow up (TFD, t = -17.3; cTFD, t = -10.4).

3. This difference persisted during the 12-month visit (TFD, F = 51.1; cTFD, F = 28.0).

4. A subset of 11 youngsters were given a one-month break before being fitted with OrthoK lenses of a different design.

5. Similarly, Tear film disruption increased significantly compared to pre-orthoK images (0.172 0.161), but recovered to baseline levels following lens removal (0.084 0.059).

6. Tear film disruption and central tear film disruption values rose in eyes with monocular lens wear but remained steady in lateral eyes, according to a subgroup of monocular OrthoK wearers (n = 23).

In conclusion, the findings of this study clearly point out that it is critical to ensure that the surface quality of the tear film is regularly evaluated throughout the usage of orthoK lenses.

Reference:

Guo, Y., Liu, L., Peng, L., Fu, J., Guo, W., & Tang, P. (2022). Effect of overnight orthokeratology lenses on tear film stability in children. In Contact Lens and Anterior Eye (p. 101592). Elsevier BV. https://doi.org/10.1016/j.clae.2022.101592