Crystalline lens thickness change is associated with axial length elongation and myopia progression in orthokeratology

Zengying Wang; Yifei Meng; Zuocheng Wang; Lili Hao; Vania Rashidi; Haiyan Sun; Jun Zhang; Xiaokun Liu; Xuemin Duan; Zhaocai Jiao; Sufang Qie; Zhipeng Yan

doi:10.1016/j.clae.2021.101534

Crystalline lens thickness change is associated with axial length elongation and myopia progression in orthokeratology

Cont Lens Anterior Eye. 2022 Aug;45(4):101534. doi: 10.1016/j.clae.2021.101534. Epub 2021 Nov 10.

Authors

Zengying Wang¹, Yifei Meng¹, Zuocheng Wang², Lili Hao³, Vania Rashidi⁴, Haiyan Sun¹, Jun Zhang¹, Xiaokun Liu¹, Xuemin Duan¹, Zhaocai Jiao¹, Sufang Qie¹, Zhipeng Yan⁵

Affiliations

¹ The Department of Ophthalmology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei Province 050000, China.
² The Architecture of Hebei University, 13 Chaoyang West Street, Zhangjiagkou, Hebei Province, China.
³ The Fourth Hospital of Zhangjiakou, Hebei Province, China.
⁴ University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA.
⁵ The Department of Ophthalmology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei Province 050000, China. Electronic address: zhipengyan76@163.com.

PMID: 34772627
DOI: 10.1016/j.clae.2021.101534

Abstract

Aims: Considering individual variability in regards to the effects of orthokeratology (ortho-k) on myopia progression and controversies regarding the precise underlying mechanism, the aim of this study was to investigate several ocular measurements associated with axial length (AL) growth in children wearing ortho-k lenses.

Methods: In this retrospective chart review, medical records of 53 Chinese children who wore ortho-k lenses over the course of 12 months were reviewed. Baseline variables included age at initiation of ortho-k wear, refractive error (spherical equivalent, SE), central corneal thickness (CCT), and flat and steep keratometry of corneal principal meridians. The change of anterior chamber depth (ACD) and the change of crystalline lens thickness (CLT) between baseline and the 12-month follow-up were also analyzed. The contributions of all analyzed variables to AL change were assessed using univariate and multivariate regression analyses.

Results: Initially, the results of paired t-test showed that CLT and AL were significantly increased after 12 months of ortho-k wear compared with that at baseline (P = 0.001 and < 0.001). The ACD did not change significantly after 12 months compared with that at baseline (P = 0.491). Subsequently, univariate analyses showed that a reduced rate of AL elongation was found in children who were older age at initiation of ortho-k wear (P = 0.028), had greater SE (higher degree of myopia) at baseline (p = 0.006), had thicker CCT at baseline (P = 0.04), and had greater increase of CLT (P = 0.001) in 12 months. At last, only greater SE (higher degree of myopia) and greater increase of CLT were associated with smaller increases of AL in multivariable analyses, (P = 0.003 and 0.001).

Conclusions: Both CLT and AL were significantly increased in children with overnight ortho-k wear after 12 months of follow-up. Greater baseline SE and greater increase of CLT were associated with less increase in AL during ortho-k wear in children with myopia.

Keywords: Axial length; Crystalline lens thickness; Myopia; Ortho-k.

MeSH terms

Axial Length, Eye
Child
Humans
Lens, Crystalline*
Myopia* / therapy
Orthokeratologic Procedures* / methods
Refraction, Ocular
Retrospective Studies