Zusammenfassung
Ohne Sehhilfe durchs Leben zu gehen – ein durchaus realistischer Traum. In der
Liga der refraktiven Korrekturoptionen spielt die Orthokeratologie ihre sehr
eigene Rolle. Das Prinzip: Eine hoch gaspermeable, formstabile Kontaktlinse, die
nachts während des Schlafs getragen wird, verändert durch ihre spezielle
Geometrie die Radien der Cornea reversibel in genau der Art und Weise, dass die
Refraktion des Auges tagsüber unkorrigiert der Emmetropie nahekommt.
Abstract
Orthokeratology offers the unique possibility of correcting myopia: a special
reverse geometry contact lens used exclusively during sleeping hours at
nighttime. The authors give a comprehensive overview about the evolving
technique, including the careful selection of patients, and practical contact
lens fitting. They explain a series of daily life situations and point out dos
and donʼts. Limitations of orthokeratology are highlighted with regard to
refraction errors and anatomical conditions. Early regression and glare due to
corneal aberrations are common negative side effects. Critical complications
like bacterial keratitis, ocular surface disorders, and morphologic changes
through corneal molding as corneal hypoesthesia and ferritin deposits are
considered. Emerging applications are discussed: correction of presbyopia,
corneal crosslinking to stabilize the ortho-k effect, myopia control in
children, topographically controlled and individualized contact lens geometries
using advanced contact lens materials. Legal regulations concerning the driving
permission are outlined. Nevertheless, orthokeratology seems to be a
well-established niche technology predominantly useful in young, healthy, and
active myopic patients. The fitting and care of this refractive tool is
demanding and costly. However, these lenses fill the gap between every day
conventional contact lens and surgical refractive methods. Another growing
application of high interest is myopia control in children.
Schlüsselwörter
Orthokeratologie - Myopie - Kontaktlinse - Kinder
Key words
orthokeratology - myopia - contact lens - children
