School of Basic Medicine, Qingdao University, Qingdao, China.
School of Basic Medicine, Qingdao University, Qingdao, China.
J Fr Ophtalmol. 2022 Sep;45(7):718-727. doi: 10.1016/j.jfo.2022.02.003. Epub 2022 May 13.
To compare the effects of orthokeratology (OK) for early childhood myopia control and to contrast with clinical trial data published by various investigators.
The researchers studied papers in Pubmed, Embase, Clinicalkey and CNKI published before October 31, 2021, identified by searching for RCT (Randomized controlled trials) and cohort studies on the treatment of early childhood myopia with orthokeratology. The researchers extracted the mean deviation for axial elongation at each year of follow-up between the orthokeratology groups and control groups (myopic spectacles) and analyzed the results with stata 12.0 software.
The meta-analysis included 4 RCTs and 9 cohort studies with 744 samples (OK group 362, control group 382), aged 6 to 17 years. There was evidence of heterogeneity (I>50%) on axial elongation in the included data. At 1 year, 2 years, 3 years, 4 years, 5 years and 7 years of follow-up, the axial elongation figures were -0.15mm (95% [CI] (confidence interval), -0.16 to -0.14) in all studies, -0.28mm (95% [CI], -0.33 to -0.23) in all studies, -0.36mm (95% [CI], -0.45 to -0.27) in one study, -0.42mm (95% [CI], -0.52 to -0.32) in one study, -0.42mm (95% [CI], -0.77 to -0.07) in one study, -0.44mm (95% [CI], -0.65 to -0.23) in one study. The heterogeneity disappeared after dividing subgroups according to the length of follow-up.
Compared with the control group, the first two years of orthokeratology can control axial elongation in children and effectively delay the development of myopia. However, this effect was not obvious after 2 years. It is recommended to prescribe orthokeratology for two years to obtain the best effect. The length of therapy must be taken into account when studying the effects of orthokeratology.
比较角膜塑形术(OK)对儿童近视的控制效果,并与不同研究者发表的临床试验数据进行对比。
研究者检索 Pubmed、Embase、Clinicalkey 和 CNKI 中 2021 年 10 月 31 日前发表的关于 OK 治疗儿童近视的 RCT(随机对照试验)和队列研究论文。研究者提取随访每年 OK 组与对照组(近视眼镜)的眼轴伸长平均值,采用 stata12.0 软件进行分析。
该 meta 分析纳入 4 项 RCT 和 9 项队列研究共 744 个样本(OK 组 362 个,对照组 382 个),年龄 6 ~ 17 岁。纳入数据存在异质性(I>50%)。所有研究中,1 年、2 年、3 年、4 年、5 年和 7 年随访时眼轴伸长数据分别为-0.15mm(95%[CI],-0.16 ~ -0.14)、-0.28mm(95%[CI],-0.33 ~ -0.23)、-0.36mm(95%[CI],-0.45 ~ -0.27)、-0.42mm(95%[CI],-0.52 ~ -0.32)、-0.42mm(95%[CI],-0.77 ~ -0.07)、-0.44mm(95%[CI],-0.65 ~ -0.23)。根据随访时间的长短进行亚组分析后,异质性消失。
与对照组相比,角膜塑形术治疗的前两年可以控制儿童眼轴的伸长,有效延缓近视的发展。但 2 年后效果不明显,建议佩戴角膜塑形镜 2 年以获得最佳效果。在研究角膜塑形术的效果时,必须考虑治疗时间的长短。