Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (6): 92-100.doi: 10.6040/j.issn.1673-3770.0.2021.037

Previous Articles     Next Articles

The effectiveness and safety of orthokeratology on controlling myopia of children: a meta-analysis

LIU Yi1,2, YU Mingkun1,3, SUN Wei2, SHAO Zhen1,2, HU Yuanyuan2, BI Hongsheng2   

  1. 1. First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong, China;
    2. Department of ophthalmology, Eye Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong, China;
    3. Evidence-based Medicine Center, Beijing University of Chinese Medicine, Beijing 100029, China
  • Published:2021-12-10

Abstract: Objective To access the effectiveness and safety of orthokeratology(OK)on slowing myopia progression in school-aged children in different treatment duration. Methods PubMed, Cochrane Library, Embase, OVID, CNKI, Wanfang database, VIP, and CBM were searched, including randomized controlled trials(RCT)and prospective non-randomized control studies(PNC). Two reviewers independently screened literature, extracted data, and assessed the quality of included studies. The Meta-analysis was performed using RevMan 5.3 version for statistical analysis. Results 4 RCTs and 12 PNCs involving 1 453 participants were included. There were significant differences in the effect of OK group versus control group on slowing axial elongation at 0.5, 1, 1.5, 2 years follow-up periods(0.5a:MD:-0.10 mm, 95%CI: -0.12 to -0.08, P<0.001; 1a: MD: -0.18 mm, 95%CI:-0.19 to -0.17, P<0.001; 1.5a: MD: -0.21 mm, 95%CI: -0.26 to -0.15, P<0.001; 2a: MD:-0.26 mm, 95%CI: -0.30 to -0.22, P<0.001). The myopia control rate decreased with the duration of treatment. Except for the 0.5 years follow-up period, when the effect of OK lens on the reduction of axial elongation in Asian children was better than that in Caucasian, there was no statistical difference in other follow-up periods(P>0.05). The RR of incidence of adverse events in the OK and the control groups at 2-year was 5.75(95%CI:2.23 to 14.81, P=0.000 3). Conclusion Orthokeratology is an effective and safe method on controlling the progression of myopia for school-aged children. However, long-term and additional RCT studies are required to find out its continuing effectiveness.

Key words: Orthokeratology, Myopia, School-aged Children, Myopia control, Axial length, Meta-analysis

CLC Number: 

  • R778.1
[1] Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050[J]. Ophthalmology, 2016, 123(5): 1036-1042. doi:10.1016/j.ophtha.2016.01.006.
[2] Vagge A, Ferro Desideri L, Nucci P, et al. Prevention of progression in myopia: a systematic review[J]. Diseases, 2018, 6(4): 92. doi:10.3390/diseases6040092.
[3] Morgan IG, French AN, Ashby RS, et al. The epidemics of myopia: Aetiology and prevention[J]. Prog Retin Eye Res, 2018, 62: 134-149. doi:10.1016/j.preteyeres.2017.09.004.
[4] Cho P, Tan Q. Myopia and orthokeratology for myopia control[J]. Clin Exp Optom, 2019, 102(4): 364-377. doi:10.1111/cxo.12839.
[5] P rssinen O, Kauppinen M. Risk factors for high myopia: a 22-year follow-up study from childhood to adulthood[J]. Acta Ophthalmol, 2019, 97(5): 510-518. doi:10.1111/aos.13964.
[6] 边思林, 刘华, 林江. 近视儿童角膜塑形镜与框架眼镜配戴一年临床效果的随机对照研究[J]. 中华实验眼科杂志, 2020, 38(2): 121-127. doi:10.3760/cma.j.issn.2095-0160.2020.02.008. BIAN Silin, LIU Hua, LIN Jiang. A randomized-controlled clinical study of one-year outcome between orthokeratology contact lens wear and glasses wear in myopic children[J]. Chinese Journal of Experimental Ophthalmology, 2020,38(2): 121-127. doi:10.3760/cma.j.issn.2095-0160.2020.02.008.
[7] Lyu TB, Wang LY, Zhou LT, et al. Regimen study of high myopia-partial reduction orthokeratology[J]. Eye Contact Lens: Sci Clin Pract, 2020, 46(3): 141-146. doi:10.1097/icl.0000000000000629.
[8] Charm J, Cho P. High myopia-partial reduction ortho-k: a 2-year randomized study[J]. Optom Vis Sci, 2013, 90(6): 530-539. doi:10.1097/opx.0b013e318293657d.
[9] Cho P, Cheung SW. Retardation of myopia in Orthokeratology(ROMIO)study: a 2-year randomized clinical trial[J]. Invest Ophthalmol Vis Sci, 2012, 53(11): 7077-7085. doi:10.1167/iovs.12-10565.
[10] 姜瑾. 角膜塑形镜、低浓度阿托品与框架眼镜控制青少年近视的疗效比较[J]. 国际眼科杂志, 2018, 18(7): 1349-1352. doi:10.3980/j.issn.1672-5123.2018.7.46. JIANG Jin. Effect of orthokeratology, low concentration atropine and frame glasses on juvenile myopia prevention and control[J]. International Eye Science, 2018, 18(7): 1349-1352. doi:10.3980/j.issn.1672-5123.2018.7.46.
[11] 李秀红, 钟梅, 朱豫, 等. 角膜塑形术在青少年近视控制中的作用[J]. 中华眼外伤职业眼病杂志, 2017, 39(7): 491-495. doi:10.3760/cma.j.issn.2095-1477.2017.07.003. LI Xiuhong, ZHONG Mei, ZHU Yu, et al. The control effect of orthokeratology on adolescent myopia[J]. Chinese Journal of ocular trauma and occupational eye disease, 2017, 39(7): 491-495. doi:10.3760/cma.j.issn.2095-1477.2017.07.003.
[12] Li Z, Cui D, Hu Y, et al. Choroidal thickness and axial length changes in myopic children treated with orthokeratology[J]. Cont Lens Anterior Eye, 2017, 40(6): 417-423. doi:10.1016/j.clae.2017.09.010.
[13] 符爱存, 吕勇, 姬娜, 等. 角膜塑形镜控制青少年近视进展效果的相关因素[J]. 中华眼视光学与视觉科学杂志, 2016, 18(2): 72-77. doi:10.3760/cma.j.issn.1674-845X.2016.02.003. FU Aicun, LYU Yong, JI Na, et al. Factors preventing myopia progression with orthokeratology correction[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2016, 18(2): 72-77. doi:10.3760/cma.j.issn.1674-845X.2016.02.003.
[14] Pauné J, Morales H, Armengol J, et al. Myopia control with a novel peripheral gradient soft lens and orthokeratology: a 2-year clinical trial[J]. Biomed Res Int, 2015, 2015: 507572. doi:10.1155/2015/507572.
[15] 李斌, 牛燕, 李超, 等. 初发性近视患者配戴角膜塑形镜和框架眼镜的疗效观察[J]. 眼科新进展, 2015, 35(1): 78-80. doi:10.13389/j.cnki.rao.2015.0022. LI Bin, NIU Yan, LI Chao, et al. Clinical observation on orthokeratology and glasses treatment of onset myopia[J]. Recent Advances in Ophthalmology, 2015, 35(1): 78-80. doi:10.13389/j.cnki.rao.2015.0022.
[16] 姜珺, 陈云云, 吴戈, 等. 不同矫正方式对儿童近视控制的效果[J]. 中华眼视光学与视觉科学杂志, 2014, 16(2): 73-77. doi:10.3760/cma.j.issn.1674-845X.2014.02.003. JIANG Jun, CHEN Yunyun, WU Ge, et al. Effect of four types of refractive correction on myopia progression in Chinese children[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2014, 16(2): 73-77. doi:10.3760/cma.j.issn.1674-845X.2014.02.003.
[17] 牛燕, 李斌, 姬娜. 角膜塑形镜治疗青少年中度近视的临床观察[J]. 中华眼视光学与视觉科学杂志, 2014, 16(2): 92-94. doi:10.3760/cma.j.issn.1674-845X.2014.02.008. NIU Yan, LI Bin, JI Na. Clinical assessment of orthokeratology treatment for adolescents with moderate myopia[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2014, 16(2): 92-94. doi:10.3760/cma.j.issn.1674-845X.2014.02.008.
[18] Chen C, Cheung SW, Cho P. Myopia control using toric orthokeratology(TO-SEE study)[J]. Invest Ophthalmol Vis Sci, 2013, 54(10): 6510-6517. doi:10.1167/iovs.13-12527.
[19] Santodomingo-Rubido J, Villa-Collar C, Gilmartin B, et al. Myopia control with orthokeratology contact lenses in Spain: refractive and biometric changes[J]. Invest Ophthalmol Vis Sci, 2012, 53(8): 5060-5065. doi:10.1167/iovs.11-8005.
[20] Hiraoka T, Kakita T, Okamoto F, et al. Long-term effect of overnight orthokeratology on axial length elongation in childhood myopia: a 5-year follow-up study[J]. Invest Ophthalmol Vis Sci, 2012, 53(7): 3913-3919. doi:10.1167/iovs.11-8453.
[21] Kakita T, Hiraoka T, Oshika T. Influence of overnight orthokeratology on axial elongation in childhood myopia[J]. Invest Ophthalmol Vis Sci, 2011, 52(5): 2170-2174. doi:10.1167/iovs.10-5485.
[22] Margulis AV, Pladevall M, Riera-Guardia N, et al. Quality assessment of observational studies in a drug-safety systematic review, comparison of two tools: the Newcastle-Ottawa Scale and the RTI item bank[J]. Clin Epidemiol, 2014, 6: 359-368. doi:10.2147/clep.s66677.
[23] Naidoo KS, Fricke TR, Frick KD, et al. Potential lost productivity resulting from the global burden of myopia: systematic review, meta-analysis, and modeling[J]. Ophthalmology, 2019, 126(3): 338-346. doi:10.1016/j.ophtha.2018.10.029.
[24] Lee JTL, Guo X, Li Z, et al. Progression and longitudinal biometric changes in highly myopic eyes[J]. Invest Ophthalmol Vis Sci, 2020, 61(4): 34. doi:10.1167/iovs.61.4.34.
[25] Cheng X, Xu J, Brennan NA. Accommodation and its role in myopia progression and control with soft contact lenses[J]. Ophthalmic Physiol Opt, 2019, 39(3): 162-171. doi:10.1111/opo.12614.
[26] Sankaridurg P, Conrad F, Tran H, et al. Controlling progression of myopia: optical and pharmaceutical strategies[J]. Asia Pac J Ophthalmol(Phila), 2018, 7(6): 405-414. doi:10.22608/apo.2018333.
[27] Smith EL, Hung LF, Huang J. Relative peripheral hyperopic defocus alters central refractive development in infant monkeys[J]. Vision Res, 2009, 49(19): 2386-2392. doi:10.1016/j.visres.2009.07.011.
[28] Faria-Ribeiro M, Queirós A, Lopes-Ferreira D, et al. Peripheral refraction and retinal contour in stable and progressive myopia[J]. Optom Vis Sci, 2013, 90(1): 9-15. doi:10.1097/opx.0b013e318278153c.
[29] Lam CSY, Tang WC, Tse DY, et al. Defocus Incorporated Multiple Segments(DIMS)spectacle lenses slow myopia progression: a 2-year randomised clinical trial[J]. Br J Ophthalmol, 2020, 104(3): 363-368. doi:10.1136/bjophthalmol-2018-313739.
[30] 周珺, 王肖, 吴晓璇, 等. 夜戴型角膜塑形镜矫正青少年近视疗效及其影响因素分析[J]. 中国实用眼科杂志, 2017, 35(2): 136-142. doi:10.3760/cma.j.issn.1006-4443.2017.02.009. ZHOU Jun, WANG Xiao, WU Xiaoxuan, et al. Clinic effect and relevant influencing factors of overninght orthokeratology in myopic adolescent[J]. Chinese Journal of Practical Ophthalmology, 2017, 35(2): 136-142. doi:10.3760/cma.j.issn.1006-4443.2017.02.009.
[31] 郭寅, 刘立洲, 彭丽, 等. 角膜塑形镜去片裸眼视力低下的影响因素及近视控制效果[J]. 中华眼视光学与视觉科学杂志, 2018, 20(12): 743-748. doi:10.3760/cma.j.issn.1674-845X.2018.12.008. GUO Yin, LIU Lizhou, PENG Li, et al. Factors associated with low visual acuity after orthokeratology lens removal and myopia control[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2018, 20(12): 743-748. doi:10.3760/cma.j.issn.1674-845X.2018.12.008.
[32] 张雅娟. 角膜塑形镜联合框架眼镜治疗青少年高度近视的效果[J]. 医疗装备, 2020, 33(14): 72-73.
[33] Sun Y, Xu F, Zhang T, et al. Orthokeratology to control myopia progression: a meta-analysis[J]. PLoS One, 2015, 10(4): e0124535. doi:10.1371/journal.pone.0124535.
[34] Si JK, Tang K, Bi HS, et al. Orthokeratology for myopia control: a meta-analysis[J]. Optom Vis Sci, 2015,92(3):252-257. doi: 10.1097/OPX.0000000000000505.
[35] Li SM, Kang MT, Wu SS, et al. Efficacy, safety and acceptability of orthokeratology on slowing axial elongation in myopic children by meta-analysis[J]. Curr Eye Res, 2016, 41(5): 600-608. doi:10.3109/02713683.2015.1050743.
[36] Wen D, Huang J, Chen H, et al. Efficacy and acceptability of orthokeratology for slowing myopic progression in children: a systematic review and meta-analysis[J]. J Ophthalmol, 2015, 2015: 360806.doi:10.1155/2015/360806.
[37] Cui YH, Li L, Wu Q, et al. Myopia correction in children: a meta-analysis[J]. Clin Investig Med Med Clinique et Exp, 2017, 40(3): E117-E126. doi:10.25011/cim.v40i3.28391.
[38] Prousali E, Haidich AB, Fontalis A, et al. Efficacy and safety of interventions to control myopia progression in children: an overview of systematic reviews and meta-analyses[J]. BMC Ophthalmol, 2019, 19(1): 106. doi:10.1186/s12886-019-1112-3.
[39] Huang JH, Wen DZ, Wang QM, et al. Efficacy comparison of 16 interventions for myopia control in children[J]. Ophthalmology, 2016, 123(4): 697-708. doi:10.1016/j.ophtha.2015.11.010.
[40] 靳敏肖. 角膜塑形镜治疗我国青少年低中度近视患者短期效果观察[J]. 临床合理用药杂志, 2019, 12(8): 155-156. doi:10.15887/j.cnki.13-1389/r.2019.08.103.
[41] 蒋丽君, 朱永唯, 章友美, 等. 角膜塑形镜矫治低中度近视的临床观察[J]. 中国基层医药, 2018, 25(17): 2236-2239. doi:10.3760/cma.j.issn.1008-6706.2018.17.015. JIANG Lijun, ZHU Yongwei, ZHANG Youmei, et al. Clinical observation of orthokeratology lens in the treatment of mild and moderate myopia[J]. Chinese Journal of Primary Medicine and Pharmacy, 2018, 25(17): 2236-2239. doi:10.3760/cma.j.issn.1008-6706.2018.17.015.
[42] Jiang J, Lian L, Wang F, et al. Comparison of toric and spherical orthokeratology lenses in patients with astigmatism[J]. J Ophthalmol, 2019, 2019: 4275269. doi:10.1155/2019/4275269.
[43] 李丽, 边思林, 林江. 成都市青羊区3~18岁儿童和青少年屈光状况及眼轴长度的现况分析[J]. 国际眼科杂志, 2021, 21(2): 325-330. doi:10.3980/j.issn.1672-5123.2021.2.27. LI Li, BIAN Silin, LIN Jiang. Current situation of refractive status and axial length in children and adolescents aged 3 - 18 years in Qingyang District of Chengdu[J]. International Eye Science, 2021, 21(2): 325-330. doi:10.3980/j.issn.1672-5123.2021.2.27.
[44] 曹朋, 李惠玲, 周学军. 角膜塑形镜配戴矫治低中高度近视的临床疗效观察[J]. 中国中医眼科杂志, 2019, 29(5): 375-379. doi:10.13444/j.cnki.zgzyykzz.2019.05.008. CAO Peng, LI Huiling, ZHOU Xuejun. Clinical observation of orthokeratology on low, moderate and high myopia[J]. China Journal of Chinese Ophthalmology, 2019, 29(5): 375-379. doi:10.13444/j.cnki.zgzyykzz.2019.05.008.
[1] DAI ChengOverview,LI BinzhongGuidance. Advances in multifocal soft corneal contact lens research [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 100-105.
[2] LIN Manqing, ZHOU Min, CHEN Tengyu, LI-Dan, FANG Caishan, WANG Ruizhi, ZHU Jinxiang, RUAN-Yan, XU Huixian, WANG Peiyuan. Meta-analysis of the efficacy and safety of traditional Chinese medicine for nasal irrigation in the treatment of chronic rhinosinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 209-225.
[3] JIANG Xuelian, ZHANG Jingyue, WEI Xudong. Evaluation of the efficacy and potential mechanism of biyuan tongqiao granules in chronic sinusitis treatment based on Meta-analysis bridging network pharmacology [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 226-236.
[4] HUANG Kaiyue, LI Xueqing, HAN Gouxin, ZHANG Qinxiu. Meta-analysis of acupoint catgut embedding in the treatment of allergic rhinitis based on the theory of “lung and spleen” [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 266-274.
[5] ZHANG Taoran, WANG Wei, LI Mingming, HUANG Yingxiang. Subfoveal choroidal thickness changes following intravitreal ranibizumab treatment in choroidal neovascularization due to pathological myopia [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 68-71.
[6] PENG Jiao, ZHONG Dingjuan, CHEN Jiao, ZUO Jun, WANG Hua. The effect of the relationship between the diameter of the optical zone and the diameter of the dark pupil on the visual quality of patients with different degrees of myopia after SMILE [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 100-107.
[7] LIU Shanshan, HAN Shujing, WANG Xiaoxu, LI Yanhong, NI Xin, ZHANG Jie. Hearing loss in children after bacterial meningitis: a systematic review and meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 48-54.
[8] LI Ying. Importance of standardized methods in corneal refractive surgery and the prevention of complications [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 1-6.
[9] ZHANG Ying, LEI Yulin, MA Zhixing, YANG Xinghua, ZHANG Jing, HOU Jie. Early clinical observation of corneal densitometry after SMILE combined with rapid corneal cross-linking [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 52-58.
[10] ZHONG Liping, GUAN Xilong, WANG Jingjing, TANG Yong. Intratympanic injections and systemic glucocorticoid treatment for sudden hearing loss: a systematic review and Meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 1-10.
[11] RAN Hongyun, JIANG Keke,,ZHANG Jie. Analysis of underlying factors of refractive errors in infants with retinopathy of prematurity [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 118-124.
[12] YUE Pengcheng, DU Qiuxuan, KONG Ling, QIAO Zhentao. A controlled Study of the accommodative parameters of eyes with uncorrected myopic anisometropia [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 76-80.
[13] LIU Ling,ZHANG Meixia. Drug therapy for myopia [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 123-128.
[14] LIN Xiaoyan, LI Jing, MA Zhiqi, LI Yilin, GAO Xinyi, LI Yong. Therapeutic and anti-allergic effects of probiotics on allergic rhinitis: a meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(3): 70-80.
[15] TAN Fengwu, DENG Yaping, LI Kehua. The therapeutic effects of low temperature plasma radiofrequency ablation and CO2 laser surgery on early glottic carcinoma: a Meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 63-71.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] LIN Bin,WANGHui-ge . Functional endoscopic sinus surgery, FESS[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(6): 481 -487 .
[2] GONG Lei,SUN Jie,XUE Zi-chao,LI Jing-hua,XUE Wei-guo . DNA analysis of the cell cycle in sino-nasal neoplasm[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 193 -195 .
[3] CHEN Wen-wen . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(5): 472 -472 .
[4] LUAN Jiangang,LIANG Chuanyu,WEN Yanjun,LI Jiong . Construction of RNAi expressing plasmid vector of pSIRENshuttle for EGFR gene silencing[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 4 -8 .
[5] MA Jing, ZHONG Cui-ping . Surgical method for nasopharyngeal fibroangioma encroaching on fossa pterygopalatina: with a report of 5 cases[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 30 -32 .
[6] LIU Qiang-he,LUO Xiang-lin,GENG Wan-ping,CHEN Chen,LEI Xun,LIU Fang-xian,DENG Ming . Age-related spiral ganglion neuron damages and hearing loss in senescence accelerated mice[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 215 -217 .
[7] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 223 -226 .
[8] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 246 -247 .
[9] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 250 -252 .
[10] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 260 -262 .