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J.J. Walline, M.J. Rah, L.A. Jones; Children’s Overnight Orthokeratology Investigation (COOKI) Pilot Study . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3288.
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Purpose: There is no published literature regarding overnight corneal reshaping with reverse geometry contact lenses for temporary myopia reduction in children. A case series of children fitted with these contact lenses can provide much needed information. The ultimate goal of the COOKI Study is to examine the effects of overnight corneal reshaping contact lenses on myopia progression in children, but the primary aim of this COOKI Pilot Study is to investigate the safety and efficacy. Methods: Children between 8 and 11 years old were fitted with Corneal Refractive Therapy contact lenses (Paragon Vision Sciences, Mesa, AZ). They were examined in the morning and at least six hours later one day, one and two weeks, and one, three, and six months after dispensing the contact lenses. At each visit, uncorrected logMAR visual acuity, manifest refraction, corneal topography, and slit lamp examination were performed. We report results from the right eyes only. Results: We enrolled 29 children and 11 have been examined at six months to date. The mean (± SD) age was 10.4 ± 0.99 years, 65.5% were female, and 48.3% were Caucasian. Four did not finish: two contact lens fits were not acceptable, and two discontinued for reasons unrelated to vision or comfort. Prior to contact lens wear, the mean uncorrected logMAR visual acuity was +0.68 ± 0.22 (Snellen 20/96), and the mean spherical equivalent refraction was –2.50 ± 1.37 D. At six months, the uncorrected visual acuity in the afternoon was +0.15 ± 0.22 (Snellen 20/28), and the spherical equivalent refraction was –0.26 ± 0.81. Six hours after removal of the contact lenses, the visual acuity improved by 0.01 ± 0.10 (one letter), and the spherical equivalent refraction became more myopic by –0.24 ± 0.78 D. At the six-month visit, 72.7% and 11.1% of the children exhibited any corneal staining at the morning and afternoon visits, respectively. No children experienced an adverse event during the course of the study. Conclusions: Overnight corneal reshaping is a safe, efficacious means of temporary myopia reduction in children.
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