Abstract
Purpose
The study aimed to observe and analyze the dynamic accommodation and binocular vision changes in myopic children after they switched from spectacles to orthokeratology (ortho-k) lenses.
Methods
Thirty-six myopic children aged 8-14 years were enrolled in this prospective, self-controlled study from West China Hospital. General information was gathered, and examinations were performed at baseline and at 1, 3, 6, and 12 months after switching to ortho-k lenses. The examination included assessments of distance/near visual acuity, distance/near horizontal and vertical ocular alignment, distance/near horizontal vergence range, accommodative amplitude, monocular/binocular accommodative facility, accommodative response, positive and negative relative accommodation (PRA/NRA), accommodation convergence/accommodation (AC/A), stereopsis, and reading ability.
Results
After the children switched to ortho-k lenses, distance and near ocular alignment showed an exophoric shift (distance: p = 0.001, near: p = 0.002), and the horizontal vergence range decreased by different degrees (convergence: distance blur point (p = 0.002), distance break point (p = 0.005), near blur point (p = 0.011), near break point (p = 0.043); divergence: distance break point (p < 0.001), distance recover point (p < 0.001), near recover point (p = 0.005)). The stereopsis ability (p < 0.001), monocular/binocular accommodative facility (p < 0.001), and PRA (p = 0.010) increased. The accommodative lag (p < 0.001), accommodative amplitude (p < 0.001), and calculated and gradient AC/A (calculated: p = 0.001, gradient: p = 0.025) decreased. The adjusted horizontal and vertical reading times and their ratio decreased (all p < 0.001).
Conclusion
The subjects showed distance and near exophoric shifts after switching to ortho-k lenses; improvements in accommodative function, stereopsis, and ocular motility; and a decrease in the binocular horizontal vergence range. The relationships between these changes and the ortho-k myopic control effects require further investigation.
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Acknowledgements
The authors thank Jianglan Wang and Yue Yan, optometrists (West China Hospital, Sichuan University, Chengdu, China), for their suggestions about patient follow-up; and Xiao He, manager of the laboratory (Sichuan University, Chengdu, China), for his kind help by providing the laboratory space. We would also like to thank Pro. Liu’s postgraduate team for providing the information for the patients who met the criteria.
Availability of data and material
The data that support the findings of this study are openly available in Figshare at https://doi.org/10.6084/m9.figshare.12423461.v1 [doi].
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Yutong Song, Shenlin Zhu, Bi Yang, Xue Wang, Wei Ma, Guangjing Dong, and Longqian Liu. The first draft of the manuscript was written by Yutong Song and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The study was approved by the West China Ethics Committees in 2016 before the study began.
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Song, Y., Zhu, S., Yang, B. et al. Accommodation and binocular vision changes after wearing orthokeratology lens in 8- to 14-year-old myopic children. Graefes Arch Clin Exp Ophthalmol 259, 2035–2045 (2021). https://doi.org/10.1007/s00417-021-05106-2
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DOI: https://doi.org/10.1007/s00417-021-05106-2