Corneal versus ocular aberrations after overnight orthokeratology.

Purpose: To investigate relationships between changes to corneal and ocular aberrations induced by orthokeratology (OK) and their influence on visual function.

Methods: Eighteen subjects (aged 20 to 23 years) were fitted with OK lenses (BE Enterprises Pty Ltd, Australia), manufactured in Boston XO material (Bausch & Lomb Boston, Wilmington, MA), and worn overnight for seven nights. Corneal and ocular aberrations were simultaneously captured (Discovery, Innovative Visual Systems, Elmhurst, IL), and contrast sensitivity function was measured on days 1 and 7, within 2 and 8 hours after lens removal on waking. Data from the eye achieving the higher myopic correction were analyzed for changes over time.

Results: There was a significant refractive effect at all visits. Orthokeratology induced an increase in corneal and ocular root mean square higher order aberrations (HOAs) and a positive shift in spherical aberration (SA) on day 1, with further increases by day 7. Increases in root mean square coma became significant by day 7. Changes to corneal and ocular SA were similar on day 1; however, by day 7, there was a greater increase in corneal than ocular SA, indicating a change in internal SA. Orthokeratology led to an overall decrease in contrast sensitivity function, which was isolated to spatial frequency changes on day 1 at 1 cycle per degree and on day 7 at 1 and 8 cycles per degree.

Conclusions: A greater positive shift in corneal compared with ocular SA on day 7 suggests a negative shift in internal SA, which would be consistent with an increased accommodative response. Lack of any difference on day 1 indicates that this may be an ocular adaptation response toward neutralizing induced positive SA, rather than a direct effect of SA changes on the accommodation mechanism.