The Effect of Atropine Alone or Combined with Orthokeratology for Children with Myopia: A Meta-Analysis

Objective: To evaluate the effect of atropine alone or combined with orthokeratology on myopia control by meta-analysis system. Methods: The current study searched PubMed, Cochrane Library, EMBASE, MEDLINE, Web of science, Ovid to collect eligible studies. The Weighted mean difference (WMD) of mean changes in axial elongation between the atropine alone or combined with orthokeratology group and the orthokeratology (ortho-k) group was used as evaluation index. Results: Twelve studies were eventually included, involving 671 children in the atropine alone and 547 children in the atropine combined with orthokeratology（AOK） group. This meta-analysis showed that the mean axial elongation of atropine alone was faster than that of ortho-k alone. [WMD=0.06mm, 95％CI(0.02~0.10), p＜0.007]. The function of AOK for slowing axial elongation was affected by the baseline diopter of children. The WMD in -1~-3D subgroup was -0.10 mm(95％CI,-0.14~-0.05,P＜0.00001),which mens that the AOK was more effective than OK alone in retarding axial elongation. In -3~-6D, WMD is -0.04mm (95% Cl, -0.11~0.03), and there is not statistically significant between two groups (P<0.30). Conclusion: This study suggested that ortho-k monotherapy is better in slowing axial elongation than atropine monotherapy in children with myopia. For children with low degree of myopia, the combination of ortho-k and 0.01% atropine is more effective than ortho-k monotherapy in slowing axial elongation in children. But there is no significant difference between two treatments in children with moderate degree of myopia.