Corneal Recovery After Long-Term Orthokeratology And Outcomes Of Subsequent Smile: A Retrospective Study
Published 2025 - 43rd Congress of the ESCRS
Reference: FP26.01 | Type: Free paper | DOI: 10.82333/602k-3b44
Authors: Wei Wei* 1 , Tian Liang 2 , Qi Li 3 , Di Shen 2 , Kun Zhou 2 , Xiaohuan Ma 2
1Department of Ophthalmology,First Affiliated Hospital of Northwestern University; Xi’an No.1 Hospital; Shaanxi Institute of Ophthalmology; Shaanxi Key Laboratory of Ophthalmology; Clinical Research Center for Ophthalmology Diseases of Shaanxi Province,Xi’an,China;Department of Ophthalmology,First Affiliated Hospital of Northwestern University; Xi’an No.1 Hospital; Shaanxi Institute of Ophthalmology; Shaanxi Key Laboratory of Ophthalmology; Clinical Research Center for Ophthalmology Diseases of Shaanxi Province,Xi’an,China, 2Department of Ophthalmology,First Affiliated Hospital of Northwestern University; Xi’an No.1 Hospital; Shaanxi Institute of Ophthalmology; Shaanxi Key Laboratory of Ophthalmology; Clinical Research Center for Ophthalmology Diseases of Shaanxi Province,Xi’an,China, 3First Affiliated Hospital of Northwestern University; Xi’an No.1 Hospital; Shaanxi Institute of Ophthalmology; Shaanxi Key Laboratory of Ophthalmology; Clinical Research Center for Ophthalmology Diseases of Shaanxi Province,Xi’an,China
Purpose
To evaluate corneal changes following the discontinuation of long-term orthokeratology (OK) lenses and compare subsequent small incision lenticule extraction (SMILE) outcomes with a spectacle-wearing control group at multiple postoperative intervals.
Setting
A single-center retrospective study conducted at the Laser Vision Center, Xi’an First Hospital, Xi’an, China, from August 2014 to August 2023.
Methods
This study included 22 myopic patients (22 eyes) who had used OK lenses for an average of 67.10 ± 22.32 months and then discontinued lens wear for at least 3 months prior to SMILE. Another 22 myopic patients (22 eyes) wearing spectacles served as controls. All eyes were examined at four time points: preoperatively, 1 month post-SMILE, 6 months post-SMILE, and the last available follow-up. At each stage, participants underwent comprehensive ocular evaluations. Data collected included manifest refraction, axial length (AL), central corneal thickness (CCT), corneal volume (CV), and corneal topographic parameters (anterior/posterior keratometry and higher-order aberrations). Statistical significance was set at p < 0.05.
Results
Preoperatively, the OK group demonstrated slightly increased corneal astigmatism and spherical aberration, as well as reductions in CCT and CV, compared to their pre-OK baseline. Anterior corneal curvature was relatively stable, but mild posterior corneal steepening was noted. At 1 and 6 months post-SMILE, both groups showed comparable improvements in UCVA, BCVA, and refractive outcomes. By the last available follow-up, no significant differences were found between the OK and control groups with respect to visual acuity, refraction, or corneal topography (p > 0.05).
Conclusions
Long-term OK lens use leads to transient corneal changes—mainly decreased corneal thickness/volume and mild posterior steepening—which do not compromise SMILE outcomes when lenses are discontinued for at least three months. Further prospective studies are encouraged to confirm these findings and assess long-term postoperative stability.