Efficacy of combined orthokeratology and 0.01% atropine solution for slowing axial elongation in children with myopia: a 2-year randomised trial

Eighty Japanese children, aged 8-12 years, with a spherical equivalent refraction (SER) of -1.00 to -6.00 dioptres (D) were randomly allocated into two groups to receive either a combination of orthokeratology (OK) and 0.01% atropine solution (combination group) or monotherapy with OK (monotherapy group). Seventy-three subjects completed the 2-year study. Over the 2 years, axial length increased by 0.29 +/- 0.20 mm (n=38) and 0.40 +/- 0.23 mm (n=35) in the combination and monotherapy groups, respectively (P=0.03). Interactions between combination treatment and age or SER did not reach significance level (age, P=0.18; SER, P=0.06). In the subgroup of subjects with an initial SER of -1.00 to -3.00 D, axial length increased by 0.30 +/- 0.22 mm (n=27) and 0.48 +/- 0.22 mm (n=23) in the combination and monotherapy groups, respectively (P=0.005). In the -3.01 to -6.00 D subgroup, axial length increased by 0.27 +/- 0.15 mm (n=11) and 0.25 +/- 0.17 mm (n=12) in the combination and monotherapy groups, respectively (P=0.74). The combination therapy may be effective for slowing axial elongation, especially in children with low initial myopia.