The Relationship Between Accommodative Function and Myopia Progression in Children Wearing Orthokeratology Lenses

Background: Orthokeratology (OK) lenses are used to control myopia progression in children. Few studies have explored the association between accommodative function and myopia progression in children wearing OK lenses. Objectives: To investigate the association between monocular and binocular accommodative function and myopia progression in children fitted with OK lenses. Methods: A total of 98 eyes from 49 children with 2-year continuous OK lens wear were enrolled in this retrospective study. Participants were stratified into slow and fast axial growth groups according to the 2-year axial length elongation. Temporal changes and time–group interaction effects on accommodative parameters were assessed using linear mixed models, with adjustments for age, sex, and baseline refractive status. Results: Significant time × axial growth group interactions for monocular accommodative amplitude (AMP) and accommodative facility (AF) were observed (both P <0.01). Baseline AMP and AF were identified as independent predictors of axial elongation, and lower baseline values were associated with greater axial elongation. For binocular accommodative function, significant main effects of time were detected only for negative relative accommodation and positive relative accommodation (both P <0.001), whereas no significant temporal or group effects were observed for binocular cross-cylinder and accommodative convergence/accommodation ratio. Conclusions: Baseline AMP and AF may be used as reference indicators for assessing the risk of myopia progression. Baseline binocular accommodative parameters demonstrated no significant association with subsequent axial elongation rate.