@article{Zhao2026, 
author = {Li-Qiong Zhao and Zi-Xun Wang and Ying Li and Bi-Ying Wang and Bei Du and Jane Beeman and Rui-Hua Wei and Lin Liu},
title = {Long-term observation of the endothelium morphology and corneal thickness in myopic adolescents treated with orthokeratology: a 10-year retrospective study},
year = {2026},
journal = {International Journal of Ophthalmology},
volume = {19},
number = {5},
pages = {939-944},
keywords = {myopia, orthokeratology, corneal endothelium morphology, central corneal thickness, percentage of hexagonal cells, long-term safety},
url = {https://www.sciopen.com/article/10.18240/ijo.2026.05.14},
doi = {10.18240/ijo.2026.05.14},
abstract = {AIMTo assess the long-term safety of orthokeratology (ortho-k) in myopic children by evaluating changes in corneal endothelial morphology and central corneal thickness (CCT) after prolonged ortho-k lens wear.METHODSThis study included 65 myopic children (130 eyes). The ortho-k group comprised 39 children who had worn ortho-k lenses for more than 10y. The control group included 26 children who wore single-vision spectacles for myopia correction. Clinical data and adverse events were documented throughout the follow-up period. Endothelial cell density (ECD), coefficient of variation (CV) of cell area, percentage of hexagonal cells (%SIX), and CCT were measured at baseline and at the final follow-up visit.RESULTSThe 39 participants (18 males, 21 females) enrolled in the ortho-k group completed the 10-year follow-up examinations successfully. The ages ranged from 7 to 12 (9.24±1.26)y. In the control group, 26 participants (13 males, 13 females) were successfully recalled and completed their 10th year examinations. The ages ranged from 7 to 12 (9.62±1.68)y. In the ortho-k group, ECD was 3119.86±202.07 cells/mm² at baseline and 3057.42±264.52 cells/mm² at the 10-year follow-up (P=0.058). CV was 30.78%±6.70% and 32.45%±7.87% (P=0.053). %SIX was 62.23%±13.07% and 60.31%±11.59% (P=0.234). CCT decreased by 8±4 μm at the 6-month visit and remained stable thereafter (538.85±43.61 μm at 6mo vs 540.78±41.44 μm at 10y, P=0.528). At the 10-year follow-up, no significant between-group differences were observed in ECD, CV, %SIX, or CCT (all P>0.05).CONCLUSIONThis 10-year retrospective study demonstrates that long-term ortho-k lens wear has no significant adverse effects on corneal endothelial morphology or CCT compared with spectacle wear. Ortho-k shows excellent long-term safety with regard to corneal endothelial parameters and CCT, comparable to that of conventional spectacle correction in myopic children.}
}