Abstract
Purpose :
To evaluate if a history of orthokeratology (orthoK) treatment for the control of myopia will adversely affect the stability of laser vision correction (LASIK) in a young adult
Methods :
A retrospective review of patients treated with orthoK in childhood, then transitioned to LASIK. Patients were all treated at a single clinic for both orthoK and LASIK.
We identified all patients undergoing LASIK who had a history of orthoK of at least 3 years, at some time prior to LASIK. No patient had been treated with more than one strategy for myopia control. Patients were transitioned off orthoK using serial manifest refractions and topography mapping. When stable measurements were achieved at least 1 month apart, patients underwent LASIK surgery using Allegretto Wave excimer laser (200Hz, 500 Hz) with usual protocols. Visual acuity, manifest refraction were measured at months 3, 6 and 12. Enhancement occurrence was recorded as yes or no.
Results :
We reviewed 12 female and 16 male patients (56 eyes). Average age at orthoK start was 12.8 years (range 8-33). Average myopic spherical equivalence was -4.52 diopters (range -1.37 D to -9.88 D). Once the patient decided to proceed to LASIK, patient was transitioned off orthoK lenses. The average age at transition was 25 years (range 19-44). Patients then underwent wavefront optimized LASIK using the Allegretto wave laser (200 or 500 Hz). Best corrected visual acuity at 6 months post LASIK was same as pre LASIK, and manifest refraction was a spherical equivalence of -0.07 D (range -0.25 D to +0.75 D). No candidate required enhancement to achieve target vision.
Conclusions :
The impact of high myopia is not just limited to ocular health but has a long-term burden on the health-care system and quality of life. Therefore, numerous methods have been strategized to achieve myopia control. There is concern for rebound phenomenon that may be observed following cessation of any of these strategies, resulting in delayed myopia progression. This could adversely affect the outcome of LASIK surgery and increase risk of enhancement. In our cohort, whose myopia and keratometry profile at time of LASIK resembles many outcome studies for general population undergoing LASIK, there was no increased risk of enhancement rate post LASIK. This suggests that the risk of rebound myopia progression post orthoK treatment is low, and that LASIK outcomes are not adversely affected by a history of treatment with orthoK.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.