Combined Atropine with Orthokeratology for Myopia Control: Study Design and Preliminary Results

Curr Eye Res. 2019 Jun;44(6):671-678. doi: 10.1080/02713683.2019.1568501. Epub 2019 Jan 24.

Abstract

Purpose: The purpose of this study is to present the study design and one month's preliminary results of a 2-year randomized trial, Combined Atropine with Orthokeratology (AOK), for myopia control study. Methods: Children aged 6 to <11 years and with 1.00-4.00 D myopia were randomly assigned to AOK group or ortho-k alone (OK) group. Subjects are required to attend routine ortho-k aftercare visits (first-overnight, 1 week, 2 weeks, 3 weeks, 1 month, and every 3 months after commencement of lens wear). Clinical outcomes, including lens performance, changes in refractive error, unaided vision, ocular adverse events, corneal staining, lens binding and centration, and axial length, are also assessed at 6-monthly data collection visit. Results: Data of 30 AOK and 34 OK subjects who had completed the 1-month visit were analyzed. No significant differences in baseline data were found between the two groups (P > 0.05). At the 1-month visit, first-fit success rate was 95%, with full myopia reduction. Mild corneal staining was observed in 23.3% and 30.9% and mild self-reported lens binding in 50% and 41% in AOK and OK groups, respectively, after 1-month lens wear. Mean (±standard deviation) change in axial length was significantly higher in AOK than OK subjects (AOK: -0.05 ± 0.05 mm; OK: -0.02 ± 0.03 mm) (P = 0.003). Conclusions: After 1 month of treatment, first-fit success rate of ortho-k lenses was high in both groups of subjects; addition of 0.01% atropine in AOK subjects did not affect the lens performance or clinical responses. These results provide the assurance that it is acceptable to continue this longitudinal study, as longer study duration, usually 2 years, is required to determine the effectiveness of treatment for myopia control.

Keywords: 0.01% atropine; Myopia control; combined therapy; orthokeratology.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atropine / therapeutic use*
  • Axial Length, Eye / physiopathology
  • Child
  • Combined Modality Therapy
  • Corneal Topography
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Muscarinic Antagonists / therapeutic use*
  • Myopia / physiopathology
  • Myopia / therapy*
  • Orthokeratologic Procedures / methods*
  • Prospective Studies
  • Refraction, Ocular / physiology
  • Refractive Errors / physiopathology
  • Research Design
  • Treatment Outcome
  • Visual Acuity / physiology

Substances

  • Muscarinic Antagonists
  • Atropine