Retrospective Comparative Analysis of Myopia Control Efficacy: Orthokeratology, Defocus-Incorporated Soft Contact Lenses and Their Combination with 0.01% Atropine in Chinese Children and Adolescents

Ophthalmic Physiol Opt. 2026 May 7. doi: 10.1007/s44402-026-00104-5. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the efficacies of orthokeratology (OK), defocus-incorporated soft contact lenses (DISC) and their combination with 0.01% atropine in slowing myopia progression in Chinese children and adolescents.

METHODS: This retrospective study analysed 336 myopic participants aged 6-15 years, including 144 males (42.9%) and 192 females (57.1%). The participants were divided into 4 groups: OK (n = 89), OK combined with 0.01% atropine (OKA, n = 84), DISC (n = 82) and DISC combined with 0.01% atropine (DISCA, n = 81). Axial length (AL) was measured at baseline and after 3, 6, 9 and 12 months. Differences in AL changes among the groups were compared and subgroup analyses were conducted based on the initial age and spherical equivalent to explore the effectiveness of interventions across age and refractive error.

RESULTS: After 12 months, OKA had less axial elongation than OK (-0.08, 95% CI [-0.11, -0.05]), DISC (-0.07, 95% CI [-0.10, -0.04]) and DISCA (-0.06, 95% CI [-0.10, -0.04]). Subgroup analyses revealed significant differences between the OK and OKA groups at three follow-up time points in the aged 6-9 year (0.04, 95% CI [0.003, 0.08], 0.05, 95% CI [0.008, 0.09], 0.08, 95% CI [0.04, 0.12]) and 0 to -2.75 dioptre (D) subgroups (0.04, 95% CI [0.001, 0.08], 0.06, 95% CI [0.02, 0.09], 0.10, 95% CI [0.06, 0.13]), with significant differences being observed at 12 months in the aged 10-15 year (0.07, 95% CI [0.01, 0.13]) and -3.00 to -6.00 D subgroups (0.08, 95% CI [0.01, 0.14]). Significant differences between OK and DISC were limited to the 0 to -2.75D subgroup at 3 months (0.05, 95% CI [0.009, 0.09]) and 12 months (0.04, 95% CI [0.001, 0.08]).

CONCLUSION: OKA demonstrated superior myopia control efficacy than OK, DISC and DISCA. The synergistic effect of 0.01% atropine combined with OK was more pronounced in younger age and low myopia subgroups. Notably, DISC showed significantly better efficacy than OK in children with low myopia.

PMID:42098575 | DOI:10.1007/s44402-026-00104-5