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      Change of Proliferation Rate of Corneal Epithelium in the Rabbit with Orthokeratology Lens

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          Objective: To investigate the cell proliferation rate of normal corneal epithelium with extended orthokeratology lens (OKL) wear in comparison with extended rigid gas-permeable (RGP) lens wear. Methods: Twenty-four rabbits were fitted unilaterally with either an OKL or an RGP lens, and the other eye was used as a control. They were injected with 5-bromo-2-deoxyuridine (BrdU) 24 h prior to being sacrificed. The rabbits were sacrificed at 1, 3, 7 and 14 days after lens fitting. The cornea from the superior limbus to the center was taken at 1.0-mm intervals. The BrdU-labeled cells were counted in medium power fields (×200) in each sample using light microscopy. Results: The number of BrdU-labeled cells in the RGP lens group initially increased, but the number decreased in the corneal center and superior limbus by 32 and 8%, respectively, after 14 days. There was no statistically significant change. However, the number of BrdU-labeled cells in the OKL group decreased after 3 days, and the number of BrdU-labeled cells was reduced in the center and superior limbus by 63 and 8%, respectively, after 14 days. The change in proliferation in the corneal center in the OKL-wearing rabbits was statistically significant compared to the control (p < 0.05). Conclusions: Wearing an OKL had a greater effect on the change of the proliferation pattern in the epithelium than wearing an RGP lens, which suggests that the OKL might be less physiologic than the RGP lens is.

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          Most cited references 12

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          Overnight orthokeratology.

          Orthokeratology is defined as the temporary reduction in myopia by the programmed application of rigid gas-permeable contact lenses. New reverse geometry contact lens designs and materials have led to a renewed interest in this field. The purpose of this study is to assess visual, refractive, topographic, and corneal thickness changes in subjects undergoing overnight orthokeratology. Ten myopic subjects (mean age, 25.9+/-3.9 years) were recruited for a 60-day trial of overnight orthokeratology using reverse geometry rigid contact lenses. After commencing lens wear, subjects were examined on days 1, 7, 14, 30, and 60 at several times throughout the day. High- and low-contrast logarithm of the minimum angle of resolution (logMAR) visual acuity, monocular subjective refraction, autorefraction, autokeratometry, corneal topography, corneal thickness, and slit lamp examinations were performed at each session. Eight subjects completed the study. Both high- and low-contrast uncorrected visual acuity improved significantly by day 7. The mean change in uncorrected high contrast visual acuity at day 60 was -0.55+/-0.20 logMAR (mean at day 60, -0.03+/-0.16; Snellen equivalent, 20/19). The mean change in uncorrected low-contrast visual acuity at day 60 was -0.48+/-0.26 logMAR (mean at day 60, +0.22+/-0.23; Snellen equivalent, 20/33). The mean subjective refraction and autorefraction were significantly reduced from baseline at day 60 (mean change in subjective refraction, +1.83+/-1.23 D; mean change in autorefraction, +0.64+/-0.52 D). Corneal topography showed significant central flattening (mean change in apical radius, +0.20+/-0.9 mm; mean change in shape factor, -0.11+/-0.18 at day 60). The central cornea also showed significant thinning (mean change, -12+/-11 microm at day 60). All visual, refractive, and topographic outcomes were sustained over the course of an 8-h day. Overnight orthokeratology is an effective means of temporarily reducing myopia. The possible mechanism of corneal remodeling through central corneal thinning is discussed.
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            The Children's Overnight Orthokeratology Investigation (COOKI) pilot study.

            Innovations in contact lens materials and designs allow patients to wear contact lenses during sleep to flatten the cornea and temporarily to reduce myopic refractive error and improve unaided visual acuity. We conducted the Children's Overnight Orthokeratology Investigation (COOKI) pilot study, a case series, to describe the refractive error and visual changes, as well as the slitlamp observations associated with overnight orthokeratology in children, over a period of 6 months. Twenty-nine 8- to 11-year-old children with myopia between -0.75 and -5.00 D and <-1.50 D corneal toricity were fitted with corneal refractive therapy contact lenses (Paragon Vision Sciences, Mesa, AZ). They were examined within 1 hour of awakening and about 6 hours later at 1 day, 1 week, 2 weeks, 1 month, 3 months, and 6 months after the first night of contact lens wear. At each visit, the logarithm of the minimum angle of resolution (logMAR) visual acuity, manifest refraction, slitlamp examination, and corneal topography were performed. Twenty-three subjects completed the 6-month study. Three subjects decided not to wear contact lenses, two did not achieve acceptable fits, and one moved from the area. At the 6-month afternoon visit, the mean +/- SD uncorrected high-contrast visual acuity was +0.08 +/- 0.15 logMAR (Snellen equivalent, 20/24), and the mean +/- SD spherical equivalent refraction was -0.16 +/- 0.66 D. The corneas of three-fifths of the subjects showed mild staining at the morning visit, and one-third of the patients showed mild corneal staining at the afternoon visit. The most common type of stain was central punctate staining. No subjects experienced lasting adverse visual effects from cornea-reshaping contact lens wear during the study period. Overnight cornea-reshaping contact lenses are efficacious for young myopic patients, and no children experienced a serious adverse event during the study.
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              Overnight orthokeratology: preliminary results of the Lenses and Overnight Orthokeratology (LOOK) study.

              The Lenses and Overnight Orthokeratology (LOOK) study is a pilot study designed to learn the procedures of orthokeratology lens fitting in preparation for a planned larger clinical trial and to obtain data with which to calculate a sample size for that larger study. Data are presented for the first 3 months of the LOOK study.

                Author and article information

                Ophthalmic Res
                Ophthalmic Research
                S. Karger AG
                April 2005
                20 May 2005
                : 37
                : 2
                : 94-103
                aDepartment of Ophthalmology, Seoul National University College of Medicine, and bSeoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, and cDepartment of Ophthalmology, Chungnam National University, Daejon, Korea
                84251 Ophthalmic Res 2005;37:94–103
                © 2005 S. Karger AG, Basel

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                Page count
                Figures: 4, Tables: 4, References: 31, Pages: 10
                Original Paper


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