Comparative Analysis of Orthokeratology Lenses and Low-Concentration Atropine Eye Drops on Axial Length Elongation

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Abstract
Purpose: To compare the effects on axial elongation and associated factors between orthokeratology lenses and 0.025% low-concentration atropine eye drops.Methods: A retrospective analysis was conducted on the medical records of children matched by sex and age, with a spherical equivalent difference within 0.125 diopters, who were followed for more than 2 years after starting treatment with orthokeratology lenses or 0.025% low-concentration atropine eye drops. The results of refractive error and axial length were analyzed using an independent t-test, paired t-test, Pearson correlation test, and multiple regression analysis.Results: Seventy-four patients (92 eyes) were included in this study. Before treatment, the axial length was 24.44 ± 0.91 mm in the orthokeratology lenses group and 24.67 ± 0.80 mm in the low-concentration atropine eye drops group. There were no statistically significant differences between the two groups in age at the start of treatment, sex, spherical equivalent, and axial length before treatment. At the 2-year follow-up, the mean axial length change was 0.53 ± 0.30 mm in the orthokeratology lenses group and 0.49 ± 0.26 mm in the low-concentration atropine eye drops group, respectively. There were no statistically significant differences between the two groups in the mean axial length change. Additionally, the age at the start of treatment showed a significant negative correlation with the axial length change in both the orthokeratology lenses group and the low-concentration atropine eye drops group (p = 0.001, p = 0.011, respectively).Conclusions: There was no significant difference in axial elongation for 2 years between orthokeratology lenses and 0.025% low-concentration atropine eye drops treatment groups. Since younger age was associated with faster eye growth, it is important to actively consider treatment in cases of early onset myopia.

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