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 * ¿QUÉ ES LA ORTOQUERATOLOGÍA?
   
   Read in English:
   What Is Orthokeratology?
   Escrito por Reena Mukamal
   Revisado por Thomas L Steinemann MD
   
   Oct. 24, 2018
   
   La ortoqueratología u ortho-k, es el uso de lentes de contacto especiales
   diseñados y adaptados específicamente para reformar temporalmente la córnea a
   fin de mejorar la visión. Casi todos lentes de ortho-k se utilizan en la
   noche durante el sueño. Es como la ortodoncia para los ojos La mejoría de la
   visión es reversible pero puede mantenerse si se continúan utilizando los
   lentes en la forma indicada.
   
   
   ¿QUIÉN DEBE USAR LA ORTHO-K?
   
   La ortho-k se utiliza principalmente para corregir la miopía. Este problema
   de visión puede también corregirse generalmente con anteojos, con lentes de
   contacto normales, con LASIK o con PRK. La ortoqueratología es un sistema no
   quirúrgico para algunas personas que quieren dejar de usar anteojos y no
   tener que usar todo el tiempo los lentes de contacto.
   
   La ortho-k se recomienda a veces para corregir la visión de los niños. En
   algunos niños la visión puede seguir cambiando hasta la edad adulta y hasta
   los 20 años. La cirugía para corregir la visión como el LASIK no se
   recomienda hasta que la visión sea estable. No hay evidencia sólida de que la
   ortho-k pueda reducir la progresión de la miopía en niños, pero esto se está
   estudiando también como una posibilidad.
   
   
   ¿CÓMO FUNCIONA LA ORTHO-K?
   
   La córnea es una ventana traslúcida, en forma de cúpula, en la parte anterior
   del ojo, que enfoca la luz sobre la retina y es responsable por gran parte de
   la capacidad del ojo de enfocar. Su tejido es muy flexible.
   
   Su oftalmólogo hará un mapeo para medir la superficie de su córnea utilizando
   u instrumento conocido como topógrafo corneal y luego diseñará un lente
   especialmente para su ojo. El mapa de la córnea se crea reflejando luz de la
   superficie del ojo. La máquina no toca el ojo, por lo que no hay ningún
   dolor. El mapa topográfico de la córnea le muestra a su oftalmólogo la forma
   y las curvas de su córnea.
   
   Los lentes funcionan aplanando el centro de la córnea, cambiando así la forma
   como se fleja la luz al entrar al ojo. La mayoría de los lentes de
   ortoqueratología se usan durante la noche para aplanar la córnea, luego se
   retiran durante el día. Estos son lentes nocturnos, son lentes rígidos, gas
   permeables, lo suficientemente resistentes como para reformar la córnea, a la
   vez que permiten el paso del oxígeno de manera que su ojo permanece en buenas
   condiciones.
   
   Al retirar los lentes de ortho-k, la córnea permanece plana por un tiempo y
   la visión se corrige sin la necesidad de utilizar anteojos. Si se dejan de
   usar los lentes nocturnos, los ojos eventualmente regresarán a su forma
   original y el error refractivo regresará. Tendrá que seguir usando los
   anteojos regularmente para mantener la corrección visual.
   
   
   ¿QUÉ SE PUEDE ESPERAR DE LA ORTHO-K?
   
   Se pueden requerir dos semanas o más para lograr el máximo de corrección
   visual con la ortoqueratología, aunque hay quienes experimentan una
   significativa mejoría de la visión en solo días. En los estudios clínicos de
   la Administración de Alimentos y Drogas de los lentes ortho-k aprobados, la
   mayoría de los pacientes lograron una visión 20/40 o mejor.
   
   Es posible que requiera una serie de lentes ortho-k temporales para ver
   adecuadamente hasta que llegue a la prescripción deseada. Normalmente, hay
   que usar hasta tres pares de lentes ortoqueratológicos, de forma sucesiva,
   para lograr la mejor corrección visual. Cuando se haya logrado la
   prescripción deseada, utilizará la misma forma de lentes cada noche para
   mantener la corrección.
   
   Hasta que se acostumbre a usarlos, probablemente sentirá los lentes dentro de
   los ojos hasta que se duerma. Con el tiempo, generalmente la comodidad va
   mejorando. Una vez que sus córneas tienen la curvatura final deseada,
   utilizará un lente retenedor — con la frecuencia que su oftalmólogo le
   recomiende — para mantener su visión.
   
   
   ¿ES SEGURA LA ORTOQUERATOLOGÍA?
   
   La ortho-k se asocia con un incremento de riesgo de infección (queratitis
   microbiana/bacteriana). Este riesgo es especialmente preocupante en niños y
   adolescentes, que pueden ser menos capaces de los adultos de mantener una
   buena higiene de sus manos y una buena higiene de sus lentes de contacto.
   
   Cada año, cerca de un millón de americanos consulta al médico por infecciones
   oculares. El mayor factor de riesgo de infecciones es el uso de lentes de
   contacto. Las infecciones de los ojos pueden tener consecuencias graves,
   incluyendo limitación visual de por vida. Por esta razón, la ortho-k puede
   ser más peligrosa que los anteojos, que pueden utilizarse para corregir estas
   mismas condiciones. Esa es una de las razones de la importancia del consultar
   a un oftalmólogo si se está considerando la posibilidad de recurrir a la
   ortho-k.
   
   No hay límite al tiempo en el que se pueden utilizar los lentes de
   ortoqueratología. Debe consultar con su oftalmólogo y tener seguimientos
   frecuentes. Pero si sus ojos permanecen sanos y cómodos, la ortho-k podría
   ser utilizada durante años.
   
   
   ¿CUÁNTO CUESTAN LOS LENTES DE ORTOQUERATOLOGÍA?
   
   En la mayoría de los casos, la ortoqueratología podría ser un tratamiento
   efectivo. Suele haber otras alternativas más baratas y más conocidas para
   corregir los errores refractivos, como los anteojos. Pero puede haber algunos
   casos en los que el seguro puede recomendar y pagar los lentes de ortho-k. El
   costo de la ortho-k, incluyendo las consultas de seguimiento asociadas con la
   adaptación de los lentes, puede variar significativamente según el tipo y
   grado de error refractivo. Por lo general, los costos de la ortho-k van de
   $1.000 a $4.000. Los costos permanentes para reemplazo de lentes, soluciones
   para el cuidado de los lentes y examen de seguimiento podrían estar entre
   $300 y $500 por año.
   
   

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