NCT07494799

Efficacy of Different Interventions for Progressive Myopia After Orthokeratology Lens Wear

A Prospective Study on the Efficacy of Different Interventions for Progressive Myopia in Children After Orthokeratology Lens Wear

• Status: Not Yet Recruiting
• Phase: —
• Study type: Observational
• Enrollment: 3,890 (estimated)
• Sponsor: Tianjin Medical University Eye Hospital · Academic / Other
• Sex: All
• Age: 8 Years – 12 Years
• Healthy volunteers: Not accepted

Summary

Myopia has emerged as a significant concern impacting the visual health of children and adolescents on a global scale. According to research conducted by Holden BA et al., it is projected that by the year 2050, the worldwide prevalence of myopia and high myopia will experience a substantial increase, affecting approximately 5 billion and 1 billion individuals, respectively, with particularly high prevalence rates observed in East Asia\[1\]. The persistent rise in myopia incidence, coupled with the escalation of complications associated with high myopia, is anticipated to exert complex socio-economic repercussions \[2\]. Consequently, the prevention of myopia onset and the management of axial length elongation have become critically important \[3\]. Orthokeratology (Ortho-K) is a procedure that involves the overnight application of specially designed reverse geometry rigid gas permeable contact lenses to achieve temporary corneal reshaping and reduce myopia during the day\[4,5\]. In children with mild to moderate myopia, Ortho-K has demonstrated visual correction efficacy ranging from 80% to 92%\[6,7\]. Nonetheless, its efficacy in controlling myopia progression may not match its corrective efficacy. The therapeutic effect of Ortho-K in decelerating axial elongation is reported to range from 43% to 63%. Despite the use of Ortho-K, approximately 15% of children continue to exhibit rapid axial elongation exceeding 0.36 mm per year.\[8,9\]. In recent years, adjunctive interventions such as low-concentration atropine eye drops, modification of the back optical zone diameter (BOZD) of orthokeratology (Ortho-K) lenses, and low-level red-light therapy (RLRL) have been proposed to augment the myopia control efficacy of Ortho-K. Zhao et al. \[10\] reported that after one year of treatment with either atropine orthokeratology (AOK) or Ortho-K lenses in children aged 5-14 years, the axial length (AL) increased by 0.14 mm and 0.29 mm, respectively. Another study involving children aged 8-12 years \[11\] demonstrated that after one year of treatment, the AOK group exhibited a 17% reduction in AL growth (0.20 mm vs. 0.24 mm). Research conducted by Xiong et al. \[12\] indicated that for children whose eyes elongated by at least 0.50 mm within one year of Ortho-K wear, the combination of RLRL therapy with Ortho-K significantly reduced axial elongation compared to Ortho-K alone. Additional studies have suggested that decreasing the BOZD can enhance the extent and degree of mid-peripheral corneal steepening, thereby decelerating axial elongation \[13-15\]. Most existing studies primarily compare a single intervention against a control group, thereby lacking direct "head-to-head" comparisons. Traditional meta-analyses are limited to comparing two interventions at a time and often fail to assess multiple treatments concurrently. Consequently, most meta-analyses offer only statistical insights into the efficacy of individual interventions. Clinically, it is common to combine two or more interventions to treat myopia, particularly in cases of rapidly progressive myopia. Previous research has indicated that combined interventions may have additive effects in the prevention and control of myopia; however, these findings require further empirical validation. This study employs a retrospective approach to evaluate the efficacy of various treatment strategies in managing axial elongation in children aged 8-12 years who experience rapid axial progression following Ortho-K lens wear. The objective is to provide a scientific foundation for the development of personalized myopia control plans.

Detailed description

Participants were categorized into four distinct groups based on the intervention strategy:1) OK group: Participants continued using Ortho-K lenses without any additional intervention; 2) OKA group: Participants used Ortho-K lenses supplemented with 0.01% atropine eye drops administered nightly in both eyes; 3) OKBC group: At the 12-month interval, participants transitioned to Ortho-K lenses featuring a reduced optical zone, maintaining the same lens brand and other parameters; 4) OKRL group: Participants used Ortho-K lenses in conjunction withe repeated low-level red-light (RLRL) therapy administered twice daily in both eyes. Measurements were systematically recorded at 6 and 12 months following the intervention.(Figure 1. Participants flowchart.) Ortho-K Lenses: This study did not impose restriction the design or brand of Ortho-K lenses. Lens replacement was permissible to satisfy refractive and fitting criteria, provided the brand remained unchanged from that used prior to enrollment. The OKBC group was uniquely permitted to modify the back optical zone diameter parameter of the Ortho-K lenses. 0.01% Atropine Eye Drops: These were supplied by Shenyang Xingqi Eye Medicine Co., Ltd. The prescribed usage involved instilling one drop in each eye 10 minutes before the nightly application of Ortho-K lenses . Repeated low-level red-light Therapy Device: This device was supplied by Suzhou Xuanjia Photoelectric Technology Co., Ltd. \[16\]. The prescribed usage protocol involved administering the therapy, twice daily, with each session lasting 3 minutes and a minimum intercal of 4 hours between sessions, conducted 7 days a week.

Conditions

• Progressive Myopia
• Pediatric Myopia
• Orthokeratology-related Myopia Progression

Interventions

Type	Name	Description
DEVICE	OK Lens Continuation Group	Continue wearing original orthokeratology lenses with unchanged parameters, follow-up every 6 months.
DRUG	OK Lens + 0.01% Atropine Group	Continue OK lenses + 0.01% atropine sulfate eye drops once daily at bedtime.
DEVICE	OK Lens with Reduced Optical Zone Group	Wear OK lenses with reduced optical zone diameter (adjusted by 0.5mm from original parameters).
DEVICE	OK Lens + Low-Intensity Red Light Group	Continue OK lenses + low-intensity red light therapy (630nm, 6 minutes daily).

Timeline

• Start date: 2026-04-01
• Primary completion: 2026-05-01
• Completion: 2027-04-01
• First posted: 2026-03-27
• Last updated: 2026-04-01

Regulatory

• FDA-regulated drug study
• FDA-regulated device study