The influence of orthokeratology compression factor on ocular higher-order aberrations.

Background: To investigate the influence of compression factor upon changes in ocular higher-order aberrations (HOAs) in young myopic children undergoing orthokeratology treatment.

Methods: Subjects aged between six and < 11 years, with low myopia (0.50-4.00 D inclusive), low astigmatism (≤ 1.25 D), and anisometropia (≤ 1.00 D), were randomly assigned to wear orthokeratology lenses of different compression factors in each eye (one eye 0.75 D and the fellow eye 1.75 D). HOAs were measured weekly over one month of lens wear. Wavefront analysis was conducted over a 5-mm pupil using a sixth order Zernike polynomial expansion. Linear mixed models were used to examine the individual Zernike co-efficients and specific root-mean-square (RMS) error (spherical, comatic, total HOAs) metrics and their changes between the two eyes during the study period.

Results: Twenty-eight myopic (mean manifest spherical equivalent refraction: -2.10 ± 0.58 D) children (median [range] age: 9.3 [7.8-11.0] years) were analysed. Significant interocular differences in HOAs at baseline were observed for and only (both p < 0.05). During the lens wear period, eyes fitted with the increased compression factor showed greater changes in primary spherical aberration ( , p = 0.04) and RMS values for spherical and total HOAs (both p < 0.01). Considering data from both eyes together, after adjusting for the paired nature of the data, some other Zernike terms ( and , both p < 0.01) and the RMS value of comatic aberrations (p < 0.001) significantly increased after one month of orthokeratology treatment. The increase in primary spherical aberration ( ) was positively correlated with the reduction in spherical equivalent refractive error, but only in eyes fitted with the increased compression factor (r = 0.69, p < 0.001).

Conclusions: Increasing the orthokeratology compression factor by 1.00 D significantly altered some HOAs, particularly spherical aberration. Given the association between positive spherical aberration and eye growth in children, further research investigating the influence of orthokeratology compression factor on axial eye growth is warranted.