The Influence of Different OK Lens Designs on Peripheral Refraction.

Purpose: To compare peripheral refraction changes along the horizontal and vertical meridians induced by three different orthokeratology (OK) lens designs: BE, Paragon CRT, and Contex lenses.

Methods: Nineteen subjects (6M, 13F, mean age 28 ± 7 years) were initially fitted with BE OK lenses in both eyes which were worn overnight for 14 days. Central and peripheral refraction and corneal topography were measured at baseline and after 14 nights of lens wear. After a minimum 2-week washout period, one randomly selected eye was re-fitted with a Paragon CRT lens and the other eye with a Contex OK lens. Measurements were repeated before and after 14 nights of lens wear.

Results: The three different OK lenses caused significant changes in peripheral refraction along both the horizontal and vertical visual fields (VFs). BE and Paragon CRT lenses induced a significant hyperopic shift within the central ±20° along the horizontal VF and at all positions along the vertical meridian except at 30° in the superior VF. There were no significant differences in peripheral refraction changes induced between BE and Paragon CRT lenses. When comparing BE and Contex OK lens designs, BE caused greater hyperopic shifts at 10° and 30° in the temporal VF and at center, 10°, and 20° in the superior VF along the vertical meridian. Furthermore, BE lenses caused greater reduction in Flat and Steep K values compared to Contex OK.

Conclusions: OK lenses induced significant changes in peripheral refraction along the horizontal and vertical meridians. Despite the clinically significant difference in central corneal flattening induced by BE and Contex OK lenses, relative peripheral refraction changes differed minimally between the three OK lens designs. If the peripheral retina influences refractive error development, these results suggest that myopia control effects are likely to be similar between different OK lens designs.