IT IS NEITHER GOOD nor bad luck. A successful first fit comes from understanding and utilizing the technology available to modern clinicians. A solid understanding of shape, size, and elevation metrics leads to greater first-fit success—reducing the number of revisions, improving patient satisfaction, and decreasing chair time, thereby strengthening profitability.

Eccentricity as a Predictor of Success

Eccentricity (e-value) describes how fast or slow the cornea flattens from the central cornea to the peripheral cornea. An early orthokeratology (ortho-k) study suggested that corneas that have an e-value of 0.50 or higher tend to achieve greater changes in refractive power with lens wear. Although later studies have found that many factors contribute to the success of ortho-k lenses for each individual, considering the e-value of a cornea could help when assessing candidacy for successful ortho-k fitting and should not be overlooked during the initial patient evaluation.

Clinical Pearl: Utilizing e-value to predict the level of difficulty aids clinicians in setting expectations, selecting suitable lens designs, and quoting fees appropriately.

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