Discontinuation of Orthokeratology and Myopic Progression

Purpose: To report the effect of stopping orthokeratology (ortho-k) lens wear on the changes in refractive errors and axial elongation in a girl who has been wearing ortho-k lenses for myopic control for over 2 years.

Case Report: A girl with a history of fast myopic progression enrolled in ortho-k treatment when she was 6 years old. She switched to spectacle wear after receiving ortho-k treatment for 38 months and then switched back to ortho-k lens wear. Refractive errors and axial lengths were monitored for 8 months with ortho-k lens wear, followed by about 6½ months of lens discontinuation and spectacle wear, and finally another 6 months of resumed ortho-k lens wear. The residual refractive errors in the 8 months before discontinuation of ortho-k lens wear were not more than ±0.25 diopter (D) and -0.50 D in spherical and cylindrical powers, respectively, and the average increases in axial length were 0.02 mm (OD) and 0.03 mm (OS) per month. Myopia increased by 0.75 D (OD) and 1.25 D (OS) during the lens discontinuation period, with corresponding axial elongations of 0.06 mm (OD and OS) per month. No significant changes were observed in axial elongation or residual refractive errors during the 6-month period of resumed lens wear.

Conclusions: When a child who had been wearing ortho-k lenses for myopic control for over 2 years ceased lens wear, small net amounts of axial elongation were observed during the subsequent months with spectacle wear. These changes took place at a faster rate relative to the ortho-k lens wear period. Ortho-k lens wear appeared to slow myopic progression for this child.