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Two-year add-on effect of using low concentration atropine in poor responders of orthokeratology in myopic children
  1. Zhi Chen,
  2. Jiaqi Zhou,
  3. Feng Xue,
  4. Xiaomei Qu,
  5. Xingtao Zhou
  1. Ophthalmology and Visual Science, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, Shanghai, China
  1. Correspondence to Dr Xingtao Zhou, Ophthalmology and Visual Science, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, Shanghai, China; xingtaozhou{at}


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.

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  • Contributors ZC, JZ, FX conducted the study, collected and analysed the data, and wrote the manuscript. XQ and XZ designed the study, provided critical supervision, did the proofreading and revised the manuscript.

  • Funding This work was supported by the National Natural Science Foundation of China grant number 81700870.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. The deidentified patient data were retrieved from clinic files.

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