Two-year add-on effect of using low concentration atropine in poor responders of orthokeratology in myopic children

Methods Axial elongation in 73 eyes of 73 subjects who completed 3 years of orthokeratology (ortho-k) treatment was retrospectively reviewed. During their first year of ortho-k treatment (phase 1), they all demonstrated an axial elongation of 0.30 mm or greater. They were then divided into two groups: orthokeratology and atropine (OKA) group (n=37) being treated with nightly 0.01% atropine in addition to ortho-k treatment for another 2 years and orthokeratology (OK) group (n=36) continued to be treated with ortho-k without atropine (phase 2). Axial elongation over time and between groups was compared. Results Baseline biometrics was similar between the two groups in phase 1 (all p>0.05). The mean axial elongation was 0.47 +/- 0.15, 0.21 +/- 0.15, 0.23 +/- 0.13 mm for the OKA group and 0.41 +/- 0.09, 0.30 +/- 0.11, 0.20 +/- 0.13 mm for the OK group during the first, second and third year, respectively. The cumulative axial elongation over 3 years was 0.91 +/- 0.30 mm for the OKA group and 0.91 +/- 0.24 mm for the OK group. The overall AL change was not significantly different between the two groups (p=0.262). Baseline myopic refractive error had a significant impact on axial elongation over 3 years of treatment (p<0.001). None of baseline age (p=0.129), lens design (p=0.890) or treatment modality (p=0.579) had a significant impact on axial elongation. Conclusions For fast myopia progressors and poor responders of ortho-k, combining 0.01% nightly atropine did not significantly change the3-year axial elongation outcome as compared to ortho-k mono-therapy.

Automated summary

In a retrospective study of 73 subjects who completed 3 years of orthokeratology treatment, it was found that adding nightly 0.01% atropine to the treatment did not significantly affect axial elongation compared to ortho-k monotherapy. Baseline myopic refractive error was found to have a significant impact on axial elongation over the 3-year treatment period.