Scholarlink

Background <p>Orthokeratology (OK) has been widely adopted as a non-surgical intervention to slow myopia progression in children and adolescents. In China, where myopia prevalence is exceptionally high, OK lenses are commonly prescribed to school-aged children as an early intervention strategy. As these individuals reach adulthood, many pursue permanent refractive correction—such as small-incision lenticule extraction (SMILE)—to meet unaided visual acuity standards required for university entrance, military service, or certain occupations. However, the long-term morphological effects of OK wear and their potential impact on SMILE outcomes remain inadequately understood. This study aimed to evaluate ocular biometric and corneal morphological changes following long-term OK lens discontinuation and to compare the visual and surgical outcomes of SMILE between former OK users and spectacle-wearing controls.</p> Methods <p>This retrospective comparative study included 44 myopic eyes—22 from patients with a history of OK lens wear (average duration: 64.8 ± 22.6 months; discontinuation ≥ 3 months) and 22 from age- and refractive error–matched controls. Examinations were conducted pre-OK (baseline), pre-SMILE, and at 1 month, 6 months, and final follow-up. Parameters included uncorrected and corrected distance visual acuity (UDVA, CDVA), corneal topography, pachymetry, volume, curvature, and higher-order aberrations. Astigmatic outcomes were evaluated using Alpins vector analysis.</p> Results <p>After OK discontinuation, the OK group exhibited increased corneal astigmatism (<i>P</i> = 0.030), spherical aberration (<i>P</i> = 0.036), and total aberrations (<i>P</i> = 0.034), as well as decreased vertical coma (<i>P</i> = 0.004), central corneal thickness (<i>P</i> &lt; 0.001), and corneal volume (<i>P</i> = 0.001). Posterior corneal curvature steepened significantly (<i>P</i> &lt; 0.001), while anterior curvature remained stable. Further correlation analysis showed that a younger age at initial OK lens wear was significantly associated with greater posterior steepening after discontinuation at the 3&#xa0;mm, 5&#xa0;mm, and 7&#xa0;mm zones (all <i>P</i> &lt; 0.050). There was also a borderline negative correlation between the duration of OK lens wear and changes in posterior steep K value, suggesting longer wear may result in more pronounced steepening. At 6 months and final follow-up, both groups demonstrated comparable UDVA, CDVA, corneal shape, and higher-order aberrations (all <i>P</i> &gt; 0.050). Vector analysis revealed no significant group differences in astigmatic correction.</p> Conclusions <p>SMILE remains a viable option for former OK users; the observed reduction in CCT after lens discontinuation has minimal impact on refractive surgery selection.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Corneal morphological changes after discontinuation of long-term orthokeratology and SMILE surgery outcomes: a retrospective comparative study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月13日

查看全文
  • Kun Zhou,
  • Xiaohuan Ma,
  • Di Shen,
  • Wenjia Cao,
  • Xiyu Sun,
  • Mengchen Li,
  • Wei Wei

摘要

Background

Orthokeratology (OK) has been widely adopted as a non-surgical intervention to slow myopia progression in children and adolescents. In China, where myopia prevalence is exceptionally high, OK lenses are commonly prescribed to school-aged children as an early intervention strategy. As these individuals reach adulthood, many pursue permanent refractive correction—such as small-incision lenticule extraction (SMILE)—to meet unaided visual acuity standards required for university entrance, military service, or certain occupations. However, the long-term morphological effects of OK wear and their potential impact on SMILE outcomes remain inadequately understood. This study aimed to evaluate ocular biometric and corneal morphological changes following long-term OK lens discontinuation and to compare the visual and surgical outcomes of SMILE between former OK users and spectacle-wearing controls.

Methods

This retrospective comparative study included 44 myopic eyes—22 from patients with a history of OK lens wear (average duration: 64.8 ± 22.6 months; discontinuation ≥ 3 months) and 22 from age- and refractive error–matched controls. Examinations were conducted pre-OK (baseline), pre-SMILE, and at 1 month, 6 months, and final follow-up. Parameters included uncorrected and corrected distance visual acuity (UDVA, CDVA), corneal topography, pachymetry, volume, curvature, and higher-order aberrations. Astigmatic outcomes were evaluated using Alpins vector analysis.

Results

After OK discontinuation, the OK group exhibited increased corneal astigmatism (P = 0.030), spherical aberration (P = 0.036), and total aberrations (P = 0.034), as well as decreased vertical coma (P = 0.004), central corneal thickness (P < 0.001), and corneal volume (P = 0.001). Posterior corneal curvature steepened significantly (P < 0.001), while anterior curvature remained stable. Further correlation analysis showed that a younger age at initial OK lens wear was significantly associated with greater posterior steepening after discontinuation at the 3 mm, 5 mm, and 7 mm zones (all P < 0.050). There was also a borderline negative correlation between the duration of OK lens wear and changes in posterior steep K value, suggesting longer wear may result in more pronounced steepening. At 6 months and final follow-up, both groups demonstrated comparable UDVA, CDVA, corneal shape, and higher-order aberrations (all P > 0.050). Vector analysis revealed no significant group differences in astigmatic correction.

Conclusions

SMILE remains a viable option for former OK users; the observed reduction in CCT after lens discontinuation has minimal impact on refractive surgery selection.