International ophthalmology news specially invited member of the international society of orthokeratology, President of the European Society of orthokeratology, winner of the national optometry award of Spain, from the prestigious Centro m é DICO teknon hospital in Barcelona, Spain In an exclusive interview, Professor paune introduced the new astigmatism correction design of orthokeratology lens developed by his team, and analyzed and prospected the development direction of orthokeratology lens.

Innovation and double zone design

The incidence rate of myopia has been increasing in recent years. Therefore, the research on the prevention and delaying of myopia has been paid close attention to. Orthokeratology is one of the most effective methods. The traditional spherical orthokeratology lens is neutral when the astigmatism is greater than 1.5D, which can not correct astigmatism. In this kind of patients with high corneal astigmatism, the contact lens eccentricity often occurs, and can induce astigmatism and poor vision, so it is not suitable for patients with corneal astigmatism greater than 1.5D. Even for lower degrees of astigmatism, the contact lens will often be eccentric without proper contact lens and toric curve. However, many children with myopia are accompanied by astigmatism, and the incidence of astigmatism is about 21% in 3-6 years old people and 34% in 15-17 years old people. With the development of toric orthokeratology lens, the problem of contact lens centering can be greatly improved, and astigmatism can be corrected.

In order to keep the orthokeratology lens in the center, it is necessary to choose the appropriate peripheral radian. Professor Jaume paune has developed a spherical and toric designed orthokeratology lens. Their research results show that the use of dual optical area design, that is, the peripheral radian and collimator radian are toric, while the central area is spherical, which does not fully correct the four cylinder degrees. In their study, they found that about 20% of highly astigmatism eyes are still under correct correction. In order to solve this problem, Professor Jaume paune has also developed a dual toric orthokeratology lens, which means that the peripheral and central areas are toric design, and the steep surface is more flat than the front surface. The purpose is to correct the full degree of the cornea. In order to prevent the deviation of orthokeratology lens and maintain good neutrality, the orthokeratology designed by toric was used for astigmatism with the highest 1.25d, while the orthokeratology lens designed by toric was needed for higher degree astigmatism, which achieved satisfactory clinical results.

Focus on R & D, a sword in ten years

Professor Jaume paune has been developing this design since 2004, and has been improved year by year. In the past 20 years, orthokeratology lens has experienced great development and great progress, from daytime wear to overnight wear, and then to the development of different designs such as peripheral radian, and now mainly focuses on myopia control. At present, the main purpose of orthokeratology lens is to control the progress of myopia. Therefore, toric orthokeratology lens is needed to delay the progress of myopia in astigmatism children, and the myopia of these 30% children can not be increased.

Professor Jaume paune has encountered many difficulties in the design process for more than ten years. The biggest challenge mainly comes from two aspects: first, in order to make the design process faster and more efficient, his team introduced different diopters, different adaptation methods, and analyzed various results to find the optimal solution. The second challenge is to study which corneal morphology can effectively control the progression of myopia. Therefore, it is necessary to observe the whole retinal imaging pathway such as retina and choroid, and there is still a long way to go. Finally, we will find out what kind of corneal morphology is the best for controlling myopia, which is also the biggest challenge at present.

The advantages and future of orthokeratology

There are a variety of methods to control myopia, including bifocal frame glasses, contact lenses, orthokeratology lenses, drug methods such as atropine and pirenzepine, and refractive surgery. Compared with other methods, orthokeratology is a good, convenient and reversible system. Patients who wear orthokeratology glasses overnight do not need to wear any lenses during the day. If they want to stop wearing orthokeratology lenses at any time, they can return to wearing frame glasses or undergo surgery. But if you have surgery, it's permanent. It has both advantages and disadvantages, depending on the outcome. Therefore, orthokeratology lens is a very safe and reversible treatment. It is perfect for people who want to change their refractive status all day long, especially for children. Adults are free to choose orthokeratology or surgery. But in some cases, especially in people with low to moderate myopia, orthokeratology is a good treatment system.

Professor Jaume paune is looking forward to the future. He said that in the future, we need to develop special designs to control the progress of myopia. Small optical area design, radian of aspheric surface and so on are our future development directions. Myopia will not only be delayed in the future, but also be avoided in the future 10 years.