Orthokeratology lenses with increased compression factor (OKIC): A 2-year longitudinal clinical trial for myopia control

Cont Lens Anterior Eye. 2023 Feb;46(1):101745. doi: 10.1016/j.clae.2022.101745. Epub 2022 Aug 19.


Purpose: To investigate the effectiveness of orthokeratology (ortho-k) lenses and corneal changes with increased compression factor for myopia control over a 2-year period.

Methods: Young participants (age: 6-<12 years), with low myopia (0.50-4.00 D) and low astigmatism (≤1.25 D), were recruited and allowed to choose to wear either single-vision spectacles or ortho-k lenses (randomly assigned to compression factor of either 0.75 or 1.75 D). Axial length and cycloplegic refraction were measured at six monthly intervals for two years by a masked examiner. The myopia control effectiveness was determined by axial elongation.

Results: A significant number of control (63 %) dropped out, mainly due to concern about myopia progression (58 %). A total of 75 participants (mean age: 9.3 ± 1.0 years; control: n = 11, ortho-k [0.75 D]: n = 29, ortho-k [1.75 D]: n = 35) completed the study. Considering ortho-k groups only, the mean axial elongation of participants wearing ortho-k lenses of conventional compression factor (0.75 D) and increased compression factor (1.75 D) were 0.53 ± 0.29 and 0.35 ± 0.29 mm, respectively, over the 2-year study period. The between-group differences in corneal health were not significant at all visits.

Conclusion: Participants wearing ortho-k lenses of increased compression factor further slowed axial elongation by 34%, when compared with the conventional compression factor without compromising corneal health. Further investigations are warranted to confirm the potential mechanism of an increased compression factor for improved myopia control effectiveness.

Keywords: Myopia; Orthokeratology.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Astigmatism*
  • Axial Length, Eye
  • Child
  • Cornea
  • Humans
  • Myopia* / therapy
  • Orthokeratologic Procedures*
  • Refraction, Ocular
  • Vision Tests


  • ornithine alpha-ketoisocaproate