Efficacy and Acceptability of Orthokeratology for Slowing Myopic Progression in Children: A Systematic Review and Meta-Analysis

Abstract EN

Background.

To evaluate the efficacy and acceptability of orthokeratology for slowing myopic progression in children with a well conducted evidence-based analysis.

Design.

Meta-analysis.

Participants.

Children from previously reported comparative studies were treated by orthokeratology versus control.

Methods.

A systematic literature retrieval was conducted in MEDLINE, EMBASE, Cochrane Library, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov.

The included studies were subjected to meta-analysis using Stata version 10.1.

Main Outcome Measures.

Axial length change (efficacy) and dropout rates (acceptability) during 2-year follow-up.

Results.

Eight studies involving 769 subjects were included.

At 2-year follow-up, a statistically significant difference was observed in axial length change between the orthokeratology and control groups, with a weighted mean difference (WMD) of −0.25 mm (95% CI, −0.30 to −0.21).

The pooled myopic control rate declined with time, with 55, 51, 51, and 41% obtained after 6, 12, 18, and 24 months of treatment, respectively.

No statistically significant difference was obtained for dropout rates between the orthokeratology and control groups at 2-year follow-up (OR, 0.79; 95% CI, 0.52 to 1.22).

Conclusions.

Orthokeratology is effective and acceptable for slowing myopic progression in children with careful education and monitoring.