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<p>This prospective study aimed to investigate changes in corneal higher-order aberrations (HOAs) in myopic children using orthokeratology (ortho-k) lenses and their relationship with myopia progression. A total of 112 children aged 8–13 years were divided into group A (axial elongation ≤ 0.1&#xa0;mm/y with ortho-k) and group B (axial elongation &gt; 0.1&#xa0;mm/y with ortho-k). At baseline, 1, 6, and 12 months following the initiation of lens wear, HOAs and corneal peripheral defocus were evaluated. Ninety-three patients completed the 1-year follow-up. The mean axial elongation was − 0.07 ± 0.15&#xa0;mm/y in group A, versus 0.32 ± 0.17&#xa0;mm/y in group B. No statistical differences were observed in HOAs and corneal peripheral defocus at 1, 6, and 12 months (F = 0.653, 0.878; <i>P</i> &gt; 0.05). Multivariate linear regression showed axial elongation was negatively correlated with ∆HOAs, peripheral defocus, and ∆horizontal coma (standardized beta=-0.331, -0.318, -0.209; <i>P</i> = 0.006, 0.001, 0.010, respectively) and positively correlated with the treatment zone diameter (standardized beta = 0.261, <i>P</i> = 0.003). Multivariate logistic regression identified ∆HOAs, peripheral defocus, ∆horizontal coma, and treatment zone as key factors distinguishing group A from group B (OR = 0.009, 0.455, 0.123, 12.172; <i>P</i> = 0.036, 0.003, 0.032, 0.019, respectively). The ROC curve for ∆HOAs had an area of 0.803 with a cut-off value of 0.834&#xa0;μm. The ∆HOAs were more effective independent predictors of axial elongation than corneal peripheral defocus in children using ortho-k lenses. The ∆HOAs greater than 0.834&#xa0;μm may lead to axial elongation ≤ 0.1&#xa0;mm/y. These findings can be beneficial to fitting and optimizing ortho-k lenses.</p>

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Corneal higher-order aberrations as key predictive indicators of axial elongation in myopic children with orthokeratology: a single-center prospective cohort study

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  • 发表日期：

    2025年8月23日

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  • Ju Zhang,
  • Xiaoliang Zhang,
  • Ranyi Ding,
  • Yanan Ji,
  • Zhe Zhu,
  • Qingdong Bao,
  • Ting Wang,
  • Weiyun Shi

摘要

This prospective study aimed to investigate changes in corneal higher-order aberrations (HOAs) in myopic children using orthokeratology (ortho-k) lenses and their relationship with myopia progression. A total of 112 children aged 8–13 years were divided into group A (axial elongation ≤ 0.1 mm/y with ortho-k) and group B (axial elongation > 0.1 mm/y with ortho-k). At baseline, 1, 6, and 12 months following the initiation of lens wear, HOAs and corneal peripheral defocus were evaluated. Ninety-three patients completed the 1-year follow-up. The mean axial elongation was − 0.07 ± 0.15 mm/y in group A, versus 0.32 ± 0.17 mm/y in group B. No statistical differences were observed in HOAs and corneal peripheral defocus at 1, 6, and 12 months (F = 0.653, 0.878; P > 0.05). Multivariate linear regression showed axial elongation was negatively correlated with ∆HOAs, peripheral defocus, and ∆horizontal coma (standardized beta=-0.331, -0.318, -0.209; P = 0.006, 0.001, 0.010, respectively) and positively correlated with the treatment zone diameter (standardized beta = 0.261, P = 0.003). Multivariate logistic regression identified ∆HOAs, peripheral defocus, ∆horizontal coma, and treatment zone as key factors distinguishing group A from group B (OR = 0.009, 0.455, 0.123, 12.172; P = 0.036, 0.003, 0.032, 0.019, respectively). The ROC curve for ∆HOAs had an area of 0.803 with a cut-off value of 0.834 μm. The ∆HOAs were more effective independent predictors of axial elongation than corneal peripheral defocus in children using ortho-k lenses. The ∆HOAs greater than 0.834 μm may lead to axial elongation ≤ 0.1 mm/y. These findings can be beneficial to fitting and optimizing ortho-k lenses.