Effects of orthokeratology on binocular vision and myopia control in adolescents

This study aimed to compare the efficacy of myopia control in adolescents wearing orthokeratology lenses (OKL) or single-vision spectacles (SVS). This prospective study included 30 myopic adolescents wearing orthokeratology lenses (OKL group) and 30 wearing SVS (SVS group). To prevent pseudo-replication arising from the strong correlation between fellow eyes, only right-eye data were analyzed, except for binocular tests requiring measurements from both eyes. All participants underwent assessments of visual acuity (VA), refraction, axial length (AL), and binocular visual function, including accommodative response, accommodative amplitude, distance and near heterophoria, gradient accommodative convergence/accommodation (AC/A) ratio, and horizontal fusional vergence. Binocular function was evaluated at baseline and at 1, 3, and 6 months, while VA, refraction, and AL were measured at baseline, 1 week, and 1, 3, 6, and 12 months. At 12 months, AL progression was more severe in the SVS group than in the OKL group (P < .05). OKL improved uncorrected visual acuity to about -0.05 within 1 month and maintained stability, whereas SVS vision declined by 6 months. Best-corrected distance visual acuity improved markedly in the OKL group but only modestly in the SVS group. OKL rapidly corrected spherical equivalent refraction and reduced accommodative lag, with no group differences in accommodative amplitude. OKL effectively slowed axial elongation, improved VA, and reduced accommodative lag in myopic adolescents, demonstrating superior myopia-control efficacy compared with SVS.