{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T23:41:27Z","timestamp":1785368487156,"version":"3.55.0"},"reference-count":33,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Purpose: To investigate regional changes in tear film quality associated with orthokeratology (Ortho-K) lens wear using high-resolution spatial mapping and to evaluate the potential of artificial intelligence (AI) models in anticipating these changes. Methods: This study analysed tear film quality in 92 Ortho-K wearers divided into three groups based on lens wear duration (10\u201329 days, 30\u201390 days, and \u226591 days). Placido-based topographer measurement was used to generate regional tear film maps before and after treatment. A custom MATLAB pipeline enabled regional comparisons and statistical mapping. A feedforward neural network was trained to forecast local tear film quality using spatial data. Results: Single-value global mean metrics showed minimal changes in tear film quality across groups. However, regional mean mapping revealed significant mid-peripheral and peripheral deterioration over time, particularly in nasal and temporal corneal zones. These changes were often overlooked by global averaging and remained invisible through tear film breakup time (TBUT) measurements. The AI model predicted spatial tear quality with high accuracy (R \u2265 0.9 in testing), capturing nuanced regional variations. Conclusions: The regional analysis uncovers subtle, clinically relevant tear film disruptions caused by Ortho-K lens wear, particularly in peripheral areas. These insights challenge the adequacy of traditional single-value global mean assessments. The AI model demonstrates the potential for non-invasive, predictive evaluation of tear stability, supporting more personalised and effective Ortho-K care.<\/jats:p>","DOI":"10.3390\/bioengineering12101086","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T13:33:41Z","timestamp":1759757621000},"page":"1086","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["AI-Based Estimate of the Regional Effect of Orthokeratology Lenses on Tear Film Quality"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7292-8261","authenticated-orcid":false,"given":"Lo-Yu","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Optometry, Mackay Medical University, New Taipei 252, Taiwan"},{"name":"Research and Development Centre, Brighten Optix Corporation, Taipei 111, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9592-2020","authenticated-orcid":false,"given":"Wen-Pin","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Optometry, Mackay Medical University, New Taipei 252, Taiwan"},{"name":"Research and Development Centre, Brighten Optix Corporation, Taipei 111, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowan","family":"Abass","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Cambridge, Cambridge CB2 0SP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Wu","sequence":"additional","affiliation":[{"name":"Research and Development Centre, Brighten Optix Corporation, Taipei 111, Taiwan"},{"name":"College of Optometry, Pacific University, Forest Grove, OR 97116, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arwa","family":"Fathy","sequence":"additional","affiliation":[{"name":"Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rami","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Department of Materials, Design and Manufacturing Engineering, University of Liverpool, Liverpool L69 3GH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7637-7054","authenticated-orcid":false,"given":"Jay","family":"Davies","sequence":"additional","affiliation":[{"name":"Department of Materials, Design and Manufacturing Engineering, University of Liverpool, Liverpool L69 3GH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8622-4632","authenticated-orcid":false,"given":"Ahmed","family":"Abass","sequence":"additional","affiliation":[{"name":"Department of Materials, Design and Manufacturing Engineering, University of Liverpool, Liverpool L69 3GH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.exer.2003.09.019","article-title":"Functional aspects of the tear-film lipid layer","volume":"78","author":"Bron","year":"2004","journal-title":"Exp. 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