RESUMO
Background: This study aims to assess and compare the impact of Orthokeratology Double Reservoir Lens (DRL) versus Single Vision Lenses (SVL) on axial elongation and anterior chamber biometric parameters in myopic children over a 6- and 12-month treatment period in France. Methods: A retrospective study involving 48 patients aged 7 to 17 years, who underwent either orthokeratology treatment or single-vision spectacle correction, was conducted. Changes in refractive error, axial length, and anterior chamber depth were examined. Results: Twenty-five patients comprised the Orthokeratology (OK) group, while twenty-three were in the control group (single-vision spectacle group). Significant increases in mean axial length were observed over time in both the control (0.12 ± 0.13 mm and 0.20 ± 0.17 mm after 6 and 12 months, respectively; F (2,28.9) = 27.68, p < 0.001) and OK groups (0.02 ± 0.07 mm and 0.06 ± 0.13 mm after 6 and 12 months, respectively; F (2,29.1) = 5.30, p = 0.023). No statistically significant differences in axial length were found between male and female children (p > 0.620). Age-specific analysis revealed no significant axial elongation after 12 months in the 14-17 years group in the OK group. Anterior biometric data analysis at 6 and 12 months showed statistical significance only for the DRL group. Conclusion: Orthokeratology resulted in an 86 and 70% reduction in axial elongation after 6 and 12 months of lens wear, respectively, compared to the single-vision spectacles group. Myopia progression was more pronounced in younger children, underscoring the importance of initiating myopia control strategies at early ages.
RESUMO
PURPOSE: To describe the evolution of best spectacle-corrected visual acuity (BSCVA) after Descemet stripping automated endothelial keratoplasty (DSAEK) for very advanced pseudophakic bullous keratopathy (PBK) and to determine whether the thickness of corneal grafts in DSAEK surgery for advanced PBK correlates with BSCVA 6 months postoperatively. METHODS: In a prospective, single-center, observational study, 141 eyes treated with DSAEK surgery were studied, from patients requiring posterior lamellar transplantation for advanced PBK. Graft thickness was measured during the surgery and in vivo 6 months later. The primary end point was BSCVA in LogMAR at 6 months. RESULTS: BSCVA 6 months after surgery was slightly correlated with 6 months graft thickness (r = 0.24, P = 0.01), but not with preoperative graft thickness (r = 0.01, P = 0.93). After adjusting for preoperative BSCVA, a better 6 months BSCVA was best associated with thinner grafts at 6 months (P < 0.01), but not with preoperative graft thickness (P = 0.80). CONCLUSIONS: BSCVA after DSAEK was significantly related to graft thickness measured 6 months after surgery, suggesting that better BSCVA after DSAEK is related to a decrease in graft thickness after surgery and not to the use of a thinner graft during surgery. This decrease may be because of the good health of the endothelium, but this result may be biased because of the intrastromal scars inherent in severe PBK. This study shows that DSAEK is a good option for advanced PBK but has low visual acuity potential recovery because of stromal scarring. Therefore, a penetrating keratoplasty may be indicated to obtain maximal recovery of visual acuity or for monocular patients.
