title: Efficacy, Safety and Acceptability of Orthokeratology on Slowing Axial Elongation in Myopic Children by Meta-Analysis.
abstract: To compare the efficacy, safety and acceptability of a treatment group (Orthokeratology) to a control group (single vision Spectacles) on slowing axial elongation in children.
  
  
  
  We searched studies in MEDLINE, EMBASE and the Cochrane Library up to January 2015 for randomized controlled trials (RCTs) and observational studies. We pooled the mean differences between the Orthokeratology and Control groups for axial elongation and the OR for rates of adverse events and dropout.
  
  
  
  Three RCTs and six cohort studies with 667 children aged 6-16 years old were included. Two years' mean differences in axial elongation were -0.27 mm (95% confidence intervals [CI], -0.32 to -0.23) in all studies, -0.28 mm (95% CI, -0.35 to -0.20) in RCTs and -0.27 mm (95% CI, -0.32 to -0.22) in cohort studies (p < 0.01). At 6 months, 1 year, 1.5 years and 2 years, mean differences in axial elongation were -0.13 mm, -0.19 mm, -0.23 mm, and -0.27 mm (p < 0.01), respectively. The effect was greater in Asian children than Caucasian (-0.28 mm versus -0.22 mm) and in children with moderate to high myopia when compared to children with low myopia (-0.35 mm versus -0.25 mm). Orthokeratology had more non-significant adverse events (odd ratio [OR], 8.87; 95% CI, 3.79-20.74; p < 0.01) but comparable dropout rates (OR = 0.84, 95% CI, 0.40-1.74, p = 0.64) than control.
  
  
  
  Orthokeratology has significantly greater efficacy in controlling axial elongation in children compared to Spectacle correction. The safety and acceptability results are good, and there appears to be a greater myopia control effect in Chinese children compared to Caucasians, and in those with higher initial myopia.
authors.affiliation: a Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University , Beijing , China .
authors.forename: Shi-Ming
authors.initials: SM
authors.lastname: Li
authors.affiliation: a Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University , Beijing , China .
authors.forename: Meng-Tian
authors.initials: MT
authors.lastname: Kang
authors.affiliation: b Department of Epidemiology and Health Statistics , Peking University School of Public Health , Beijing , China .
authors.forename: Shan-Shan
authors.initials: SS
authors.lastname: Wu
authors.affiliation: c Anyang Eye Hospital, Henan Province , China and.
authors.forename: Luo-Ru
authors.initials: LR
authors.lastname: Liu
authors.affiliation: c Anyang Eye Hospital, Henan Province , China and.
authors.forename: He
authors.initials: H
authors.lastname: Li
authors.affiliation: d Lakewood Eye Care , Houston, TX , USA.
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Chen
authors.affiliation: a Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University , Beijing , China .
authors.forename: Ningli
authors.initials: N
authors.lastname: Wang
mesh_terms: D058452:Axial Length, Eye / Q000473:pathology*; D002648:Child; D018450:Disease Progression; D006801:Humans; D009216:Myopia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D054158:Orthokeratologic Procedures / Q000379:methods*; D012029:Refraction, Ocular / Q000502:physiology*; D016896:Treatment Outcome
keywords: Children; efficacy; myopia; orthokeratology; safety