Observational Comparison of the Safety and Effectiveness of Myopic Children Wearing Defocus Incorporated Soft Contact Lenses or Orthokeratology Lenses

  Objective  To observe and compare the effectiveness and safety of controlling myopia in children by wearing defocus incorporated soft contact (DISC) lenses or orthokeratology (OrthoK) lenses.

  Methods  A total of 75 children who came to our hospital between January 2018 and September 2020 were enrolled for this retrospective study. The DISC group consisted of 30 myopic children (60 eyes) wearing peripheral defocal soft incorporated contact lenses during daytime. There were 10 males and 20 females aged (9.9±1.00) years old in this group and their spherical equivalent refractions were (−2.78±0.70) D. The OrthoK group consisted of 45 myopic children (90 eyes) wearing OrthoK lenses. There were 30 female and 15 males aged (9.67±1.11) and their spherical equivalent refractions were (−2.67±0.71) D. All subjects had previously worn prescription glasses for 12 months or longer before they started wearing contact lenses. The subjects were followed up for 12 months once they started wearing contact lenses. The axial changes and corneal and conjunctival complications of the two groups of myopic children were compared and analyzed.

  Results  Myopic children in both groups experienced relatively rapid increase in ocular axial length while they were wearing prescription glasses, with the ocular axial length increase in the prescription-glass-wearing period being (0.34±0.09) mm in the OrthoK group and (0.37± 0.07) mm in the DISC group. In the 12 months of wearing contact lenses, the ocular axial length of children in the OrthoK group increased by (0.18±0.04) mm, while that of the DISC group increased by (0.19±0.05) mm. The increase in ocular axial length was reduced in both groups after the children were switched to the new myopia prevention methods, showing significant difference (P<0. 05). The two groups using two different contact lenses had similar axial length increase, showing no significant difference (P>0.05). During the 12-month period while the subjects wore the two types of contact lenses, the incidence of chronic follicular conjunctivitis was 11.20% in the OrthoK group and 20.00% in the DISC group, with that of the DISC group being slightly higher without showing significant difference (P>0.05). The incidence of grade-1corneal staining was 66.70% in the OrthoK group and 56.70% in the DISC group, and the incidence of grade-2 corneal staining was 17.80% in the OrthoK group and 16.70% in the DISC group. In other words, the OrthoK group had slightly higher findings, but the difference was not significant (P>0.05). The incidence of contact lens-associated papillary conjunctivitis was 2.20% in the OrthoK group and 10.00% in the DISC group, which was slightly higher than that in the orthokeratology lens group, but the difference was not significant(P>0.05).

  Conclusion  Both DISC lenses and OrthoK lenses can effectively control the increase in axial length in myopic children, and their have better effects than those of prescription glasses. The two tyes of contact lenses showed similar effects for controlling axial length increase. Both contact lenses have fewer corneal and conjunctival complications and better safety.