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Long‑term effects of orthokeratology on moderate myopia progression in children: A 3‑year prospective study

  • Authors:
    • Yibao Li
    • Rui Zhang
    • Yu Su
    • Rongfeng Liao
  • View Affiliations / Copyright

    Affiliations: Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China, Department of Ophthalmology, Anhui Women and Children's Medical Center, Hefei, Anhui 230001, P.R. China
    Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 55
    |
    Published online on: December 16, 2025
       https://doi.org/10.3892/etm.2025.13051
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Abstract

Myopia is a global health concern, with an increasing prevalence in pediatric populations. Orthokeratology (OK) lenses have been explored as a non‑invasive intervention that may slow axial elongation and improve refractive outcomes in children with myopia, potentially through peripheral retinal defocus remodeling. The present prospective cohort study evaluated the impact of OK lens wear on axial length, refractive error and visual parameters in myopic children over a 3‑year period. A total of 188 myopic children <18 years of age (100 males; 88 females; mean age, 12.5±2.1 years), with baseline spherical equivalent refractive errors ranging from ‑1.00 to ‑6.00 D were enrolled. Participants were fitted with OK lenses and monitored at 1 week, 1 month and every 3 months thereafter to monitor compliance, assess lens fit and address any adverse events. Axial length increased from 24.12±0.63 mm at baseline to 24.70±0.12 mm over 36 months (mean elongation, 0.58 mm; P<0.01). Refractive error improved from ‑3.25±1.05 to ‑2.82±0.18 D (mean change, +0.43 D; P<0.01). Patient compliance levels were categorized according to adherence and adverse effects: High (n=120), moderate (n=50) and low (n=18). Compliance significantly influenced outcomes, with highly compliant participants having a lower mean axial elongation (0.35±0.07 mm) compared with that of participants with the lowest compliance (0.72±0.12 mm; P<0.01). Adverse events were infrequent, including corneal staining (n=15; 8.0%), lens intolerance (n=10; 5.3%) and conjunctival redness (n=20; 10.6%). The mean resolution time of these adverse effects ranged from 3.2 to 6.0 days. These findings indicate that OK lenses significantly improved refractive error and visual acuity in children with myopia. Compliance was identified as a critical factor influencing treatment efficacy. Therefore, it is suggested that OK should be considered an integral component of moderate myopia management protocols for pediatric patients.
View Figures

Figure 1

Axial length changes in patients with
different levels of compliance. *P<0.05;
**P<0.01 vs. the high compliance group.

Figure 2

Changes in longitudinal axial length
observed during follow-up. *P<0.05;
**P<0.001 and ***P<0.001 vs. the 6
months group.

Figure 3

Forest plot depicting changes in axial
length at different time points during follow-up. SD, standard
deviation; IV, inverse variance; CI, confidence interval.

Figure 4

Mean resolution time of various
adverse effects.

Figure 5

Forest plot of the mean resolution
time of three adverse events in 45 patients.
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Copy and paste a formatted citation
Spandidos Publications style
Li Y, Zhang R, Su Y and Liao R: Long‑term effects of orthokeratology on moderate myopia progression in children: A 3‑year prospective study. Exp Ther Med 31: 55, 2026.
APA
Li, Y., Zhang, R., Su, Y., & Liao, R. (2026). Long‑term effects of orthokeratology on moderate myopia progression in children: A 3‑year prospective study. Experimental and Therapeutic Medicine, 31, 55. https://doi.org/10.3892/etm.2025.13051
MLA
Li, Y., Zhang, R., Su, Y., Liao, R."Long‑term effects of orthokeratology on moderate myopia progression in children: A 3‑year prospective study". Experimental and Therapeutic Medicine 31.2 (2026): 55.
Chicago
Li, Y., Zhang, R., Su, Y., Liao, R."Long‑term effects of orthokeratology on moderate myopia progression in children: A 3‑year prospective study". Experimental and Therapeutic Medicine 31, no. 2 (2026): 55. https://doi.org/10.3892/etm.2025.13051
Copy and paste a formatted citation
x
Spandidos Publications style
Li Y, Zhang R, Su Y and Liao R: Long‑term effects of orthokeratology on moderate myopia progression in children: A 3‑year prospective study. Exp Ther Med 31: 55, 2026.
APA
Li, Y., Zhang, R., Su, Y., & Liao, R. (2026). Long‑term effects of orthokeratology on moderate myopia progression in children: A 3‑year prospective study. Experimental and Therapeutic Medicine, 31, 55. https://doi.org/10.3892/etm.2025.13051
MLA
Li, Y., Zhang, R., Su, Y., Liao, R."Long‑term effects of orthokeratology on moderate myopia progression in children: A 3‑year prospective study". Experimental and Therapeutic Medicine 31.2 (2026): 55.
Chicago
Li, Y., Zhang, R., Su, Y., Liao, R."Long‑term effects of orthokeratology on moderate myopia progression in children: A 3‑year prospective study". Experimental and Therapeutic Medicine 31, no. 2 (2026): 55. https://doi.org/10.3892/etm.2025.13051
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