Effect of orthokeratology on anisometropia control: A meta-analysis

Abstract

The effectiveness of orthokeratology in retarding anisometropic progression has been investigated in several small-sample studies. This quantitative analysis aimed to elucidate the efficacy of orthokeratology for anisometropia control. We searched PubMed, Embase, and Cochrane databases for relevant studies through September 2020. Axial length (AL) data at baseline and final follow-up were extracted, and AL elongation and difference were calculated. Methodological quality was evaluated using the risk of bias in non-randomized studies of interventions (ROBINS-I) tool. Meta-analyses were performed using a fixed-effect model based on the heterogeneity. A total of 10 cohort studies (nine retrospective studies; one prospective study) were included. The pooled results for the unilateral myopia group showed that the mean AL elongation difference between myopic and emmetropic eyes was -0.27mm (95% CI, -0.31 to -0.22; p<0.01) at the one-year follow-up (four studies) and -0.17mm (95% CI, -0.33 to -0.02; p=0.03) at the two-year follow-up (two studies). In the bilateral anisomyopic group, mean AL elongation difference between high and low myopic eyes was -0.06mm (95% CI, -0.09 to -0.04; p<0.01) at the one-year follow-up (seven studies) and -0.13mm (95% CI, -0.21 to -0.06; p<0.01) at the two-year followup (three studies). This study demonstrated that orthokeratology can effectively retard myopic progression and reduce anisomyopic values. However, additional wellstructured randomized controlled trials or prospective studies with longer follow-up periods are warranted to address this topic in more detail.