Short- and Long-Term Changes in Corneal Aberrations and Axial Length Induced by Orthokeratology in Children Are Not Correlated

Purpose: To assess the correlation between changes in corneal aberrations and the 2-year change in axial length in children fitted with orthokeratology (OK) contact lenses. Methods: Thirty-one subjects 6 to 12 years of age and with myopia 20.75 to 24.00DS and astigmatism # 1.00DC were fitted with OK. Measurements of axial length and corneal topography were taken at regular intervals over a 2-year period. Corneal topography at baseline and after 3 and 24 months of OK lens wear was used to derive higher-order corneal aberrations (HOA) that were correlated with OK-induced axial length changes at 2 years. Results: Significant changes in C21 3; C04; C44; root mean square (RMS) secondary astigmatism and fourth and total HOA were found with both 3 and 24 months of OK lens wear in comparison with baseline (all P < 0.05). Additionally, significant changes in C33 and RMS tetrafoil were found at 3 months and in second-order RMS at 24 months of OK lens wear in comparison with baseline (all P > 0.05). However, none of the changes in corneal aberrations were significantly correlated with the 2-year change in axial elongation (all P < 0.05). Coma angle of orientation changed significantly pre-OK in comparison with 3 and 24 months post-OK as well as secondary astigmatism angle of orientation pre-OK in comparison with 24 months post-OK (all P, 0.05). However, coma, trefoil, secondary astigmatism, and tetrafoil angles of orientation pre-OK or post-OK were not significantly correlated with the 2-year change in axial elongation (all P > 0.05). Discussion: Short-term and long-term OK lens wear induces significant changes in corneal aberrations that are not significantly correlated with changes in axial elongation after 2-years.