Orthokeratology (OrthoK) overnight lenses were touted as a useful solution for myopia control in children by Bruce H. Koffler, MD, medical director of the Koffler Vision Group in Lexington, KY, during the American Academy of Ophthalmology’s 2018 annual meeting in Chicago.
Dr. Koffler cited the increasing prevalence of myopia to 42% between in the early 2000s, up from 25% in the early 1970s. It currently impacts 40% to 50% of the US population. He noted that studies have shown that even at the lower 25% rate leads to medical costs and lost productivity totaling an estimated $2 billion annually.
Dr. Koffler’s own experience with OrthoK involves children and adults. He previously published data involving 260 eyes in individuals between 9 and 60 years of age. At the time of analysis, they had completed one month of lens wear. Nearly all experienced 20/40 visual acuity or better, and 85% experienced 20/20 or better. He noted that the lens appears to work better in women vs men.
“Ideally, a myopia controlling device should maintain axial alignment centered with the eye regardless of the position of gaze,” explained Dr. Koffler. “The ideal system would be one that could be easily changed as the ocular power and peripheral aberration profiles changed.” Both contact lenses and OrthoK more easily check off these boxes, whereas refractive surgery, IOLs, and corneal implants do not.
Dr Koffler cited a second study by Prof Pauline Cho of Hong Kong Polytechnic University School of Optometry, which found that among ~100 patients 6 to 10 years of age, OrthoK slowed axial length elongation by an average of 43%. Axial length moves faster in 7 and 8 year olds, he said, which make OrthoK most effective.
Koffler B. New approaches to the prevention and treatment of myopia: Update 2018. Talk presented at: AAO 2018 annual meeting; October, 26-30, 2018; Chicago.