Correlation of accommodation and lens location with higher-order aberrations and axial length elongation during orthokeratology lens wear

Abstract This study examined the effects of overnight orthokeratology (OK) on higher-order wavefront aberrations (HOA), axial length elongation, and accommodation. Low to moderate myopic subjects with healthy eyes wore OK lenses nightly for 9 months. Corneal topography wavefront aberrations and accommodation were measured approximately monthly. Linear mixed-effects models were used to examine the association between the change in peripheral corneal parameters relative to the central cornea with HOA, and the association of accommodation and axial length elongation with HOA. Thirty-three participants (mean age 19.61 years) were included. Mean baseline refraction was −2.97 D (range, −1.0 to −5.0 D). The level of spherical aberration (SA) was associated with a change in relative superior-central corneal thickness (β = −0.21, SE = 0.10, p < 0.037) and with the increased difference in superior-central corneal curvature (β = 0.34, SE = 0.15, p = 0.026). The change of coma increased with the change in relative superior corneal curvature (β = 0.84, SE = 0.18, p < 0.001). Axial length elongation was associated with both horizontal coma (β = 0.19, SE = 0.07, p = 0.018) and SA (β = 0.20, SE = 0.07, p = 0.003). While accommodation and axial length were correlated with HOA, axial length elongation was not correlated with accommodation in OK lens wearers.