Nonsurgical methods of vision correction retain a role in refractive surgery practice

Chicago-Corneal refractive therapy (orthokeratology) and contact lens fitting can have a complementary rather than a competitive role in a refractive surgery practice, said David Hardten, MD, at the annual meeting of the American Academy of Ophthalmology.

“Our goal as clinicians is to address our patients’ needs, and for certain patients who are not ready for surgery, orthokeratology, or contact lenses can provide an appropriate and effective solution,” said Dr. Hardten, adjunct associate professor of ophthalmology, University of Minnesota, Minneapolis. “Keep in mind as well that these individuals may become refractive surgery candidates in the future, and so it is to the benefit of your practice if you can retain them under your care by having these options available.”

He noted there have been advances in contact lenses and orthokeratology materials. As a result, those modalities are now much safer than they have been in the past, and with orthokeratology, the treatment effect can be achieved much faster and with overnight wear of just one or two pair of lenses. Furthermore, studies of patients undergoing modern orthokeratology show the technique is associated with high satisfaction rates (about 80% or higher).

Nevertheless, patients need to be fully informed about all of the advantages and disadvantages of orthokeratology and contact lenses as well as the risks and benefits of refractive surgery procedures.

“Patients need to understand the temporary nature of these lens-based modalities, their risks, and the inability of orthokeratology to predictably correct astigmatism among other issues, and in your discussion, it is also important to share the results currently achievable with customized wavefront laser surgery and its ability to provide more accurate and longer lasting vision correction,” Dr. Hardten said.