Influence of induced decentered orthokeratology lens on ocular higher-order wavefront aberrations and contrast sensitivity function

PurposeTo quantitatively evaluate the effect of overnight orthokeratology lenses intentionally left decentered after 3 months of wear and assess the influence on clinical outcomes such as ocular higher-order wavefront aberrations and contrast sensitivity function.SettingDepartment of Ophthalmology, Tsukuba University Hospital, Ibaraki, Japan.MethodsThis prospective study assessed refraction, visual acuity, corneal topography, wavefront aberration, and contrast sensitivity function before and 3 months after overnight orthokeratology treatment. Decentration of the treatment zone from the center of the entrance pupil was determined using computerized videokeratography (TMS-4) and data-analysis software (MatLab). The relationship between decentration and the clinical parameters was analyzed.ResultsThe mean age of the 23 patients (46 eyes) was 24.2 years±3.3 (SD) and the mean spherical equivalent refraction before treatment, −2.38±0.98 diopters. The mean magnitude of decentration (0.85±0.51 mm) was statistically significantly correlated with the amount of myopic correction (P<.05), increases in coma-like aberration (P<.01), increases in spherical-like aberration (P<.01), and reductions in contrast sensitivity function (P<.0001). Changes in contrast sensitivity function were also statistically significantly correlated with the amount of myopic correction (P<.05), changes in coma-like aberration (P<.01), and changes in spherical-like aberration (P<.01). Stepwise multiple regression analysis showed that the magnitude of decentration was the only explanatory variable related to contrast sensitivity function (P<.0001).ConclusionDecentered treatment of orthokeratology resulted in decreased contrast sensitivity after treatment, showing that centration of the procedure is crucial to good outcomes.