The Effectiveness of Different Optical Correction Methods in Children and Adolescents with Progressive Myopia Based on a Comparative Evaluation of the Accommodation and Axial Length of Eyes

Abstract

Objective: to determine optimal method of progressive myopia optical correction in children and adolescents.Patients and methods. Conducted 5-year prospective clinical and instrumental examination of 494 children with myopia using orthokeratology lenses, soft contact lenses and glasses. 61 children (the average age 11.7 ± 2.36 years) with myopia –2.87 ± 1.1 D and astigmatism –0.58 ± 0.27 D used orthokeratological lens. 92 children (the average age 12.8 ± 1.51 years) with myopia –3.66 ± 1.07 D, astigmatism –0.53 ± 0.18 D wore soft contact lens. 79 children (the average age 11.52 ± 1.78 years) with myopia –1.59 ± 1.08 D, astigmatism –0.71 ± 0.54 D used glasses with monofocal lenses, with full correction. The control group consisted of 249 children (the average age 9.1 ± 1.14 years) with initial emmetropia. Determination of refraction, subjective and objective determination of accommodation, and axial length of the eye (“IOL-master”) was conducted in children.Results. The maximum progression of myopia was observed in younger children (8–9 years). Correction of myopia with orthokeratology lenses (OKLs) was accompanied by the lowest dynamics of changes in axial length (axial elongation 0,44 ± 0,32 mm) compared to the correction with soft contact lenses (SCLs) (axial elongation 0,73 ± 0,36 mm), spectacle correction (axial elongation 1,39 ± 0,47 mm) and the control group (axial elongation 0,6 ± 0,41 mm). In all children with myopia, at the beginning of the study, there were reduced values reserve of relative accommodation and an objective accommodative response. Correction of myopia with OKLs (p = 0,0002) and SCLs (p = 0,036) provides the normalization of subjective and objective reserve indication of relative accommodation in both age group in comparison of spectacles correction.Conclusion. Correction with orthokeratology lens in children with progressive myopia contributes to the minimum growth length of the eye. Correction of myopia OKLs and MKL improves of subjective and objective indicators of relative accommodation reserve.