Research Review

Reasons for the Discontinuation of Orthokeratology Lens Use

September 15, 2022

By Dwight Akerman, OD, MBA, FAAO, FBCLA, FIACLE

Although orthokeratology is widely prescribed for myopia control, some children discontinue orthokeratology lens use. This study analyzed the data of patients fitted with an orthokeratology lens in the past four years and the reasons for discontinued lens use. This retrospective study analyzed the data of patients, ages 8 to 18 years, fitted with orthokeratology lenses from 2017 to 2020. The reasons for discontinuation of lens wear were analyzed and compared.

A total of 2,499 patients’ files of adapted orthokeratology wearers were analyzed. The duration of lens wear was 24 (13.5 to 34.5) months. A total of 50 patients (2%) discontinued lens use, including 25 patients (50.0%) who could not adhere to lens use for various reasons, nine patients (18.0%) with a short sleep time, eight patients (16.0%) with economic difficulties, and five patients (10.0%) who experienced a poor myopia control effect after wearing the lenses. Corneal infiltrates affected lens use in three patients (6.0%). In addition, 30 patients underwent surgical correction when they reached adulthood. Several patients discontinued OrthoK lens use during the adaptation period. The reasons were mainly that the children could not tolerate contact lens discomfort. These patients were not included in the analysis.

The researchers point out that the peer-reviewed literature reports that 10%–50% of wearers drop out of soft contact lens wear within three years of commencement, the most common reason being contact lens discomfort. The discontinuation rate for OrthoK lenses is significantly lower than that for soft corneal contact lenses, and the reasons are different. 

Many peer-reviewed papers have confirmed the efficacy of OrthoK in juvenile-onset myopes. In this study, five patients discontinued lens use because of poor myopia progression control, accounting for 10% of the patients who discontinued lens use and 0.2% of all patients who were fitted for lenses during the four-year study period.

The researchers concluded that OrthoK lenses are effective and safe for myopia control, and only a small number of patients (2%) discontinued lens use over the four year study period.

Abstract

Analysis of the Reasons for the Discontinuation of Orthokeratology Lens Use: A 4-Year Retrospective Study

Ma, Lina M.Sc.; Xu, Man M.Sc.; Wang, Jing M.Sc.; Niu, Xiaoguang M.Sc.

Purpose: Although orthokeratology has a positive effect on myopia control, some patients discontinue orthokeratology lens use. This study analyzed the data of all patients who had been fitted with an orthokeratology lens in the past 4 years and the reasons for discontinued lens use, with the aim of improving the prevention and control of myopia.

Methods: This retrospective study analyzed the data of patients aged 8 to 18 years fitted with orthokeratology lenses from 2017 to 2020. The ametropic spherical lens powers ranged from −6.00 D to −0.75 D, and the cylindrical lens powers were more than −1.50 D. The reasons for discontinuation of lens wear were analyzed and compared. The period of lens wear (median [range]) was 24 (13.5–34.5) months.

Results: A total of 2,499 patients’ files were retrieved. The duration of lens wear was 24 (13.5–34.5) months. A total of 50 patients discontinued lens use, including 25 patients (50.0%) who could not adhere to lens use for various reasons, nine patients (18.0%) with a short sleep time, eight patients (16.0%) with economic difficulties, and five patients (10.0%) who experienced a poor effect after wearing the lenses. Corneal infiltrates affected lens use in three patients (6.0%). In addition, 30 patients underwent surgical correction when they reached adulthood.

Conclusion: Although orthokeratology lenses are effective and safe, there are still a small number of patients who discontinued lens use for various reasons. Adherence and precautions should be emphasized during the process.

Ma, L., Xu, M., Wang, J., & Niu, X. (2022). Analysis of the Reasons for the Discontinuation of Orthokeratology Lens Use: A 4-Year Retrospective Study. Eye & Contact Lens, 10-1097.

DOI:10.1097/ICL.0000000000000910

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