title: Efficacy and Acceptability of Orthokeratology for Slowing Myopic Progression in Children: A Systematic Review and Meta-Analysis.
abstract: 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.
authors.affiliation: School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China ; Department of Ophthalmology, No. 180 Hospital of Chinese PLA, Quanzhou, Fujian, China.
authors.forename: Daizong
authors.initials: D
authors.lastname: Wen
authors.affiliation: School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China ; Key Laboratory of Vision Science, Ministry of Health P.R. China, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China.
authors.forename: Jinhai
authors.initials: J
authors.lastname: Huang
authors.affiliation: School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China ; Key Laboratory of Vision Science, Ministry of Health P.R. China, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China ; Key Laboratory of Vision Science, Ministry of Health P.R. China, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China.
authors.forename: Fangjun
authors.initials: F
authors.lastname: Bao
authors.affiliation: G.B. Bietti Foundation IRCCS, Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Savini
authors.affiliation: Department of Physics (Optics and Optometry), University of Florence, Florence, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Calossi
authors.affiliation: School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China ; Key Laboratory of Vision Science, Ministry of Health P.R. China, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China.
authors.forename: Haisi
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, No. 180 Hospital of Chinese PLA, Quanzhou, Fujian, China.
authors.forename: Xuexi
authors.initials: X
authors.lastname: Li
authors.affiliation: School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China ; Key Laboratory of Vision Science, Ministry of Health P.R. China, 270 West Xueyuan Road, Wenzhou, Zhejiang 325027, China.
authors.forename: Qinmei
authors.initials: Q
authors.lastname: Wang