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Orthokeratology is here to stay
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![Michael D. DePaolis, OD, FAAO [photo]](/~/media/shared-images/michael-d-depaolis-od-faao.jpg)
Few topics in eye care invoke as varied feelings as that of orthokeratology. While certain clinicians passionately embrace the practice, some remain skeptical, while others – quite frankly – disdain the concept. Understandably, this wide range of sentiment can be traced to orthokeratology’s inception.
Though it has been part of the ophthalmic landscape for decades, the history of orthokeratology is more anecdote than evidence-based medicine. While the early days featured a few scientifically rigorous studies, the results were largely unimpressive, and orthokeratology was adopted by a select few. However, not to be discouraged, early orthokeratology pundits continued to refine their “craft” and spread the word.
Ortho-K now mainstream
Through the ensuing years orthokeratology gradually evolved from a fringe concept to a mainstream discipline. Technologies such as corneal topography provided the means by which to accurately monitor orthokeratology changes. Laboratories engineered reverse-geometry designs and employed computer-controlled lathes for precision manufacturing.
Researchers studied variables such as corneal flattening, corneal thickness, epithelial thinning and axial length to better understand why orthokeratology works. Perhaps most importantly, high Dk/t gas-permeable materials made overnight orthokeratology a very appealing reality for many patients. Although these developments were quite impressive, orthokeratology still lacked a mandate. That is, until now.
Scientific validation
The viability of every scientific endeavor is predicated on two premises. The first involves recognition and validation within the scientific community. For orthokeratology, this mandate came by way of regulatory recognition and approval. The U.S. Food and Drug Administration’s approval of Paragon’s Corneal Refractive Therapy (CRT) and Bausch & Lomb’s Vision Shaping Treatment (VST) validated overnight orthokeratology for many eye care providers.
The second premise is the development of a medium through which researchers can share information for advancing the discipline. Arguably, orthokeratology is better represented in today’s peer review literature and scientific symposia than at any time in the discipline’s history. These venues provide researchers with the media through which to report on the latest advances, including orthokeratology for the treatment of hyperopia, high astigmatism and presbyopia.
Undoubtedly, orthokeratology is here to stay. It has withstood rigorous scientific scrutiny, has become more science-based and is now more widely prescribed by eye care providers around the world. Perhaps most importantly, orthokeratology has become a safer, more efficacious and highly coveted alternative for vision correction.