The influence of overnight orthokeratology on ocular surface and meibomian glands in children and adolescents

Kyung Sun Na, Young Sik Yoo, Ho Sik Hwang, Jee Won Mok, Hyun Seung Kim, Choun Ki Joo

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54 Scopus citations

Abstract

Purpose: The aim of this study was to investigate the influence of overnight orthokeratology (OOK) on ocular surface and meibomian glands in children and adolescents. Methods: Prospective, noncomparative study included the ocular surface disease index (OSDI), tear osmolarity, corneal and conjunctival fluorescein staining, tear film breakup time (TBUT), the Schirmer I test, and meiboscore using noncontact meibography. Immunofluorescence confocal microscopy of interleukin-1β (IL1β), interleukin-6 (IL6), epidermal growth factor (EGF), and matrix metalloproteinase (MMP)-9 using impression cytology filter paper was performed. The tests were performed before and at 6, 12, 24, and 36 months after OOK wear. Results: Fifty-eight subjects using OOK were observed. Significant increases in OSDI score (P=0.0009) and corneal and conjunctival staining score (P<0.0001) were observed compared with baseline values at 36 and 24 months, respectively. Ocular surface and meibomian changes were noted in 2 patients (3.5%). One patient exhibited an increase in OSDI score, concurrent with a decrease in TBUT at 36 months and minor loss of the meibomian gland at the distal portion of the lower lid at 24 months. The other patients exhibited the development of papillary hypertrophy and meibomian gland distortion at 24 months. No significant changes were detected in IL1β, IL6, EGF, or MMP expression after OOK use. Conclusion: Based on the findings, OOK was a relatively safe modality. However, given the potential changes in the meibomian gland and tear film stability, special attention must be paid to children with baseline meibomian gland distortions or a history of allergic conditions.

Original languageEnglish
Pages (from-to)68-73
Number of pages6
JournalEye and Contact Lens
Volume42
Issue number1
DOIs
StatePublished - 2016

Bibliographical note

Publisher Copyright:
© Contact Lens Association of Opthalmologists, Inc.

Keywords

  • Meibomian glands
  • Ocular surface
  • Overnight orthokeratology
  • Tear film

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