Factors Determining Effective Orthokeratology Treatment for Controlling Juvenile Myopia Progression

BACKGROUND We aimed to identify factors influencing the therapeutic outcome of orthokeratology on controlling juvenile myopia progression, and the risk factors for complications. METHODS Myopic patients (n=724) in Shenzhen Second Hospital from Jan 2011 to Jan 2016 fitted with orthokeratology lenses and followed-up for 6-65 months were reviewed retrospectively. Univariate and multivariate logistic regression analyses were used to screen for the factors that can improve treatment outcome and prevent the development of complications. RESULTS Patients where the orthokeratology treatment was effective displayed a shorter myopia time, smaller diopter and corneal curvature, larger corneal endothelium density, high proportion of overnight wear and longer wearing times compared with patients whose treatments were ineffective. Additionally, wearing Ortho-k for 6 or 12 months yielded improved corrective effect and achieved higher comfort level. Logistic regression analyses showed that myopia time, diopter, corneal curvature e value, corneal endothelium density, time with Ortho-k and corrective effect after wearing Ortho-k for 6 or 12 months were all independent factors influencing the treatment effects. Results showed corneal curvature, anterior chamber depth and central corneal thickness were independent risk factors. CONCLUSION This study systematically identified the factors leading to effective treatments, and those carrying a risk for complications, to provide guidance for the prescription and follow-up of orthokeratology in the treatment of juvenile myopia.