School of Clinical Medicine (C.G., S.W., Y.Z.), Capital Medical University, Beijing, China ; and Department of Ophthalmology (J.H.), Tangdu Hospital, the Air Force Medical University, Xi'an, Shaanxi, China.
Eye Contact Lens. 2021 Feb 1;47(2):98-103. doi: 10.1097/ICL.0000000000000746.
Previous studies have found that atropine can slow axial elongation and control the progression of myopia. Some ongoing trials have applied atropine combined with orthokeratology for myopia control, but few studies explored the effect of the strategy on axial elongation. This meta-analysis made a preliminary evaluation of the effect of atropine combined with orthokeratology on axial elongation to provide a reference for further researches.
We performed a specific search on PubMed, EMBASE, Cochrane library, Web of Science, Ovid and Chinese electronic databases of VIP and Wanfang for randomized controlled trials, cohort studies and case-control studies conducted up to December 2019. The weighted mean difference (WMD) of mean change in axial elongation between the combination group of atropine and orthokeratology and the orthokeratology group was used for evaluation. Publication bias was detected using the Funnel plots test.
A total of five studies involving 341 participants younger than 18 years old met our inclusion criteria. The axial elongation was lower in the combination group of atropine and orthokeratology than that of the orthokeratology group (0.25 vs. 0.35; WMD=-0.09 mm, [95% confidence intervals, -0.15 to -0.04], Z=3.39, P=0.0007).
This meta-analysis demonstrates atropine combined with orthokeratology is effective in slowing axial elongation in myopia children. This effect may be superior to that of the orthokeratology alone.
先前的研究发现阿托品可以减缓眼轴伸长，控制近视进展。一些正在进行的试验应用阿托品联合角膜塑形术控制近视，但很少有研究探讨该策略对眼轴伸长的影响。本荟萃分析初步评估了阿托品联合角膜塑形术对眼轴伸长的影响，为进一步研究提供参考。
我们在 PubMed、EMBASE、Cochrane 图书馆、Web of Science、Ovid 和中国维普和万方电子数据库中进行了特定搜索，检索截至 2019 年 12 月的随机对照试验、队列研究和病例对照研究。使用加权均数差值（WMD）评估阿托品联合角膜塑形术组与角膜塑形术组之间眼轴伸长平均变化的差异。使用漏斗图检验检测发表偏倚。
共有 5 项研究纳入了 341 名年龄小于 18 岁的参与者，符合纳入标准。阿托品联合角膜塑形术组的眼轴伸长低于角膜塑形术组（0.25 对 0.35；WMD=-0.09mm，[95%置信区间，-0.15 至-0.04]，Z=3.39，P=0.0007）。
本荟萃分析表明，阿托品联合角膜塑形术可有效减缓近视儿童的眼轴伸长。这种效果可能优于单独使用角膜塑形术。
