J Korean Ophthalmol Soc.  2016 Apr;57(4):546-554. 10.3341/jkos.2016.57.4.546.

Comparison of Changes in Ocular Surface Status after Wearing Orthokeratologic and Rigid Gas Permeable Lens

• Lee KW
• Jung JW

• KMID: 2212786
• DOI: http://doi.org/10.3341/jkos.2016.57.4.546

Abstract

PURPOSE
To evaluate the differences in dry eye and meibomian gland dysfunction (MGD) by comparing ocular surface status before and after wearing an orthokeratologic (OK) lens and rigid gas permeable (RGP) lens made of the same material.
METHODS
The ocular surface and meibomian gland statuses of 12 eyes of 12 OK lens wearers (OK lens group) and 16 eyes of 16 RGP wearers (RGP lens group) were evaluated before and 1 and 3 months after lens wearing. Ocular surface disease index (OSDI), tear film break-up time (TBUT), Schirmer's test I, and ocular surface staining score were evaluated for ocular surface parameters. Meibomian gland function was evaluated by assessing lid margin abnormality, meibomian gland expressibility, and meibum quality.
RESULTS
TBUT and ocular surface staining score after 1 and 3 months of wearing an OK lens were significantly aggravated (p= 0.004, p < 0.001). The MGD grade, lid margin abnormality, meibomian gland expressibility, and meibum quality were aggravated after 1 and 3 months of wearing an OK lens (p < 0.001, p < 0.001, p < 0.001, p= 0.002). After 1 and 3 months of wearing an RGP lens, OSDI, TBUT, and ocular surface staining score were aggravated (all p < 0.001). The MGD grade, lid margin abnormality, meibomian gland expressibility, and meibum quality were aggravated after 1 and 3 months of wearing an RGP lens (all p < 0.001). MGD grade, lid margin abnormality, meibomian gland expressibility, and meibum quality were significantly more aggravated in the RGP lens group than in the OK lens group after 3 months (p < 0.001, p < 0.001, p= 0.001, p < 0.001).
CONCLUSIONS
Use of OK and RGP lenses affects ocular surface status. Especially, meibomian gland parameters and OSDI showed greater changes in RGP lens wearers than OK lens wearers.

Keyword

Meibomian gland dysfunction; Ocular surface status; Orthokeratologic lens; Rigid gas permeable lens

MeSH Terms

Meibomian Glands
Tears

Figure

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  Figure 1. Comparison of changes in ocular surface parameters after 3 months of lens use between the orthokeratologic (OK) lens group and rigid gas permeable (RGP) lens group: ocular surface disease index (OSDI) (A), Schirmer I score (B), tear break-up time (TBUT) (C), and ocular surface staining score (D). *For changes from baseline to 1 and 3 months of use between the two groups, using repeated-measures analysis of variance (ANOVA) incorporating, where necessary, a Greenhouse-Geisser correction for non-sphericity; †Using a Mann Whitney test to compare the changes between the two groups.

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  Figure 2. Comparison of changes in meibomian gland parameters after 3 months of lens wearing in the orthokeratologic (OK) lens group and rigid gas permeable (RGP) lens group: meibomian gland dysfunction (MGD) grade (A), lid margin abnormality (B), meibomian gland expressiblility (C), and meibum quality (D). *For changes between baseline and 1 and 3 months of use between the two groups, using repeated-measures analysis of variance (ANOVA) incorporating, where necessary, a Greenhouse–Geisser correction for non-sphericity; †Generalized estimating equations model for noncontinuous scale values: MGD stage, n (%, proportion ≥ stage 2); Lid margin abnormality, n (%, proportion of ≥2); Meibomian gland expressibility, n (%, proportion of ≥1).

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  Figure 3. Changes in ocular surface status in a 17-year-old female who wore an rigid gas permeable (RGP) lens. Increased ocular surface staining was noted before (A) and after 3 months (B; arrows) of RGP lens use. Comparing to baseline (C), meibomian gland plugging and vascular engorgements were developed after 3 months of RGP lens use (D; arrows).

Reference

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