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Areal summed corneal power shift is an important determinant for axial length elongation in myopic children treated with overnight orthokeratology
  1. Yin Hu1,
  2. Canhong Wen2,
  3. Zhouyue Li1,
  4. Wenchen Zhao1,
  5. Xiaohu Ding1,
  6. Xiao Yang1
  1. 1 State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
  2. 2 Department of Statistics and Finance, School of Management, University of Science and Technology of China, Hefei, China
  1. Correspondence to Dr Xiao Yang, State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou 510060, China; yangx_zoc{at}


Background The myopia control effect of orthokeratology (OK) varies among individuals. The variation might relate to the proposed ‘areal summation effect’ of lens-induced visual signals. The current study evaluated the areal summed corneal power shift (ASCPS) in myopic children treated with OK lenses and assessed whether the ASCPS achieved at early post-OK visit can predict the lens long-term effect on the axial length (AL) elongation.

Methods Study participants were 130 myopic children treated with OK lenses (age range, 8 to 15 years) in a prospective study. Corneal topography and AL were measured at baseline and 1, 3, 6, 9 and 12 months after OK lens wear. The ASCPS was derived from corneal topographic measurements and defined as the change in the areal summed corneal relative refraction at the follow-up visit from baseline. The impact of the ASCPS achieved at the 1 month post-OK visit on the 12 months AL elongation was examined using multivariate linear regression analysis.

Results Baseline age of the study participants was 11.8 ± 1.8 years and their mean spherical equivalent was −3.00±0.92 D. The ASCPS was 6.90±6.09 D*mm at the 1 month visit and remained stable throughout the follow-up period (p=0.5508, repeated-measures analysis of variance). Greater 1 month ASCPS was associated with slower AL elongation at the 12 months visit (β=−0.007, p=0.001).

Conclusions The ASCPS achieved at early post-OK visit is predictive for the lens long-term effect on the myopic AL elongation. The parameter is potential in guiding the OK lens practice to slow down axial growth in myopic children.

  • contact lens
  • imaging
  • optics and refraction

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  • Correction notice This paper has been corrected since it was published Online First. Some minus symbols went missing from table 1 during the production process and these symbols have now been updated.

  • Contributors YH: data analysis and interpretation and manuscript drafting. CW: data analysis. ZL: manuscript revision. WZ, XD: data acquisition. XY: study design.

  • Funding The study was supported by the Grant of Science and Technology Program of Guangzhou, China (201803010111).

  • Disclaimer The funding organisations had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval The study was approved by the Ethics Committee of the Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou and conducted in accordance with the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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