Clinical efficacy of toric orthokeratology in myopic adolescent with moderate to high astigmatism.

Purpose: To observe the efficacy of toric design orthokera- tology (ortho-k) for correcting myopia and astigmatism in myopic adolescents with moderate to high astigmatism.

Methods: This was a self-controlled clinical study. Twenty-four subjects (42 eyes) aged 9 to 16 years with myopia of 2.50-6.00 D complicated with rule astigmatism of 1.50-3.50 D were fitted with Lucid Night Toric Ortho-k Lenses (LUCID,KO- REA). The changes in uncorrected visual acuity (UCVA), spherical degree, refraction, axial length (AL), and corneal status were assessed at baseline, 1 night, 1 week, 1 month, 3 months, 6 months, and 1 year after the commencement of ortho-k lens wear.

Results: The success rate of the first lens fit was 92.8%. The UCVA after ortho-k wearing was improved significantly compared to the baseline during each visit (all P < 0.01), and became stable 1 month after ortho-k. The manifest myopia was significantly reduced from (-3.41 ± 1.27) D to (-0.41 ± 0.37) D by toric ortho-k and the degree of astigmatism from (-1.81 ± 0.53)D to (-0.41 ± 0.39) D after 1 month of lens wear (P < 0.01). The mean AL was (24.47 ± 0.91) mm at baseline, which did not significantly differ from (24.49 ± 0.87) mm and (24.48 ± 0.94) mm after 6 months and 1 year, respectively, of lens wear (both P > 0.05). Grade 1 corneal staining was observed at 1 week (23.8%), 1 month (21.4%), and 1 year (16.7%) following lens wear, and was improved by lens cleaning, discontinuing lens wear, and moistening the cornea with eye drops. No severe adverse events were reported.

Conclusion: The toric ortho-k lens was effective and safe for correction of low to moderate myopia in children with moderate to high astigmatism. The lens also effectively controlled axial length elongation during 1 year of observation. However, the long-term efficacy remains to be elucidated.