Binocular function changes produced in response to overnight orthokeratology

Graefes Arch Clin Exp Ophthalmol. 2017 Jan;255(1):179-188. doi: 10.1007/s00417-016-3554-0. Epub 2016 Nov 21.

Abstract

Purpose: To analyze the binocular function changes produced on subjects undergoing overnight orthokeratology (OK) treatment over short-term (3 months) and long-term (3 years) wear.

Methods: A prospective, longitudinal study on young adult subjects with low to moderate myopia was carried out. Binocular function was assessed by the following sequence of tests: Distance and near horizontal phoria (Von Graefe technique), distance and near horizontal vergence ranges (Risley rotary prisms), accommodative convergence/accommodation (AC/A) ratio (gradient method) and the near point of convergence (standard push-up technique). The short-term sample consisted of: 21 subjects in the control group, 26 in a corneal refractive therapy (CRT) treatment lenses group and 25 in a Seefree treatment lenses group. Those subjects were evaluated at baseline and at a 3-month follow-up visit. Twenty one subjects were old CRT wearers that attended a 3-year follow-up visit (long-term group).

Results: A statistically significant difference over the 3-month treatment was found for divergence at distance: the break point decreased 1.4 Δ (p = 0.0006) in the CRT group and the recovery point increased 1.2 Δ (p = 0.001) in the Seefree group. Also, the Seefree group had an exophoric trend of 2.3 Δ at near (p = 0.02) and a base-out break decrease of 2.3 Δ (p = 0.03). For the long-term group, only the base-out break point at distant vision showed a statistically significant difference of 4.9 Δ (p = 0.02).

Conclusions: OK induces minimal changes in the binocular function for either short-term or long-term periods, apart from a near exophoric trend over the short-term period.

Keywords: Binocular function; Contact lenses; Fusional vergences; Myopia; Orthokeratology; Phoria.

MeSH terms

  • Adult
  • Exotropia / physiopathology
  • Exotropia / rehabilitation*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Myopia / physiopathology
  • Myopia / rehabilitation*
  • Orthokeratologic Procedures / methods*
  • Prospective Studies
  • Time Factors
  • Vision, Binocular / physiology*
  • Young Adult