Comparison of the Myopia Control Effectiveness and Defocus of OK and HAL in Adolescents

Comparison of the Myopia Control Effectiveness and Defocus of OK and HAL in Adolescents | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparison of the Myopia Control Effectiveness and Defocus of OK and HAL in Adolescents Jia Yu, Yujuan Guo, Yuehua Zhou This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3852302/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose To compare the control effectiveness and periretinal defocus between orthokeratology(OK) and highly aspherical lenslets(HAL) in adolescents with myopia. Methods In this prospective study, 211 children( 211 eyes) were enrolled in Beijing Ming Vision and Ophthalmology between October 2022 and February 2023. According to the myopic correction method, the children were divided into three subgroups: OK, HAL, and Single-Vision spectacles (SVS); according to the spherical equivalent (SE), they were further divided into two subgroups: A-1.0 ≤ SE≤-2.0D, B-2.0 < SE≤-3.0 D.All children were followed up for12mo,and the changes in axial length and periretinal defocus before and after treatment were recorded and the factors affecting the corneal shaping force for one day post-OK were analyzed. Results AL growth in the OK and HAL was lower than that in the SVS after 6,9,12mo. Comparison of the difference in the amount of AL change between OK and HAL: 6mo( Z=-1.367 ,P = 0.317) ; 9mo(Z=-1.45, P = 0.211) ;12mo( Z=-1.52, P = 0.365 ), the difference was not statistically significant with (-1.0 ≤ SE≤-2.0D). The myopic defocus of RDV270-300° in the HAL subgroup was higher than that in the OK subgroup(Z = 1.382,P = 0.016),and in other areas,the myopic defocus was higher in the OK subgroup. Em,SRI ,and corneal thickness were significantly associated with shaping force. Conclusions OK is one of the most effective optical treatments for controlling myopia and the factors that affect the corneal shaping force under different corneal parameters are different.For mild myopia, HAL can achieve the same effectiveness as OK. Orthokeratology Highly Aspherical Lenslets Axial length Defocus Corneal shaping force Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 1 Introduction The incidence of myopia among Chinese adolescents ranks first worldwide, and myopia at a young age has become a common trend. Therefore,it is imperative to control the rate of myopia growth in adolescents who have already developed myopia. In recent years, the relationship between the progression of myopia in adolescents and retinal peripheral refraction measurement has become a hot topic in myopia-related research[ 1 – 2 ]. Orthokeratologylens (OK) and highly aspherical Lenslets (HAL) have been common myopia control methods in clinical practice in recent years, and the control of axial length(AL) has been clinically recognized[ 2 ]. OK is a specially designed hard contact lens, and through the mechanical and fluid mechanics generated by wearing the lenses, the distribution of epithelial cells on the anterior surface of the cornea is changed, so that the central curvature is flattened, the middle and periphery curvature is steepened, and the farsighted defocus state of the peripheral retina can be changed while correcting myopia to achieve the purpose of control the development of myopia[ 3 – 6 ]. The design of multi-point myopia defocus of microlenses in HAL can effectively control the development of myopia, and the control effect of the AL has been clinically recognized[ 7 ].Few studies have compared the myopia control effect of OK and HAL, and a comparison of their respective amounts of defocus. The purpose of this study was to compare the controlled effects of long-term wearing of OK and HAL in adolescents with myopia. Simultaneously, by analyzing the shaping force of wearing OK for one day,one can be more comprehensively evaluated. 2 Methods First,it was a prospective study. This study included 211 children( 211eyes) of 102 male and 109 female subjects (data from the right eye were selected for analysis) enrolled in the Beijing Ming Vision and Ophthalmology between October 2022 and February 2023. The mean age of the subjects were [10.35 ± 1.72] years(range:8 to The inclusion criteria were that the spherical equivalent(SE) was − 1.0 ≤ SE≤-3.0D[-2.35 ± 1.58] D with astigmatism of 1.50D or less,best-corrected distance visual of 20/20 or better before treatment. Exclusion criteria were systematic and ophthalmic diseases,corrected distance visual acuity < 20/25,history of ophthalmic surgery or disease,unwillingness to participate in the study,and inability to obtain high-quality images. According to the myopic correction method, the children were divided into three subgroups: OK, HAL, and Single-Vision spectacles (SVS); according to the spherical equivalent (SE), they were further divided into two subgroups: A-1.0 ≤ SE≤-2.0D, B-2.0 0.05)(Table 1 ,Fig. 1A,B). Informed consent was obtained from parents of each child. This study was approved by the Medical Ethics Committee of the Ineye Hospital of Chendu University of TCM(2022yh-024) and adhered to the Declaration of Helsinki. Table 1 Baseline data of the three groups Group n Male/Female Age (years) SE (D) AL (mm) Corneal curvature (D) OK 79 40/39 10.30 ± 1.07 -2.18 ± 1.49 24.37 ± 0.71 42.59 ± 0.57 HAL 61 29/32 10.28 ± 1.62 -2.21 ± 1.63 24.36 ± 1.16 42.57 ± 0.46 SVS 71 33/38 10.27 ± 1.34 -2.19 ± 1.14 24.39 ± 0.97 42.60 ± 0.64 F/x² 0.668 0.116 0.093 0.465 0.698 P 0956 0.894 0.914 0.712 0.503 A B Figure 1 Error bar plots. A kf of three subgroups. B AL of three subgroups. Ortho-K from Paragon CRT(Paragon Vision Sciences,Mesa,AZ,United States) was used for all the subjects. The lens’material was HDS100, the optical area diameter was 6.0 mm, the inner surface of the lens adopted a three-zone design, and the optometric retention on the CRT was + 1.25D. Lens’ fitting was evaluated using fluorescence,OK centered or decentered by less than 1.0 mm radially and it was determined by silt lamp examination,and the children were instructed to wear the OK for 8–10 hours pernight. After one day and one week of reexamination, no corneal staining or anterior corneal surface complications were observed. In the HAL subgroup,patients chose the same brand of lenses, which were multi-zone forward optics and high aspheric design, with an optical area of 9–10 mm, a defocus area of 11 star rings, and 1021 microlenses (+ 3.0D to + 5.0D), with a diameter area of 57.1 mm(Fig. 2 ). To avoid deviation in the measurement of defocus, the examination time of all children was uniformly scheduled from to 8:30 − 10:00 a.m.. At the beginning of OK wearing,baseline examination included unaided distance visual acuity, intraocular pressure, optometry, etc.; Em, △E(E f -E s ), horizontal curvature radius (r f ), corneal rule index (SRI), and curvature of the cornea were measured using Tomey(Topograpic Modelling System,TMS-4;Tomey Corporation,Nagoya,Japan ). The corneal biomechanical index (TBI) was measured using Pentacam, and the height difference of the 8 mm chordal length on the anterior surface of the cornea was measured using Medmont (Arlington,WA,United States). The endothelial cell density (CD), coefficient of variation in cell area (CV), and proportion of hexagonal cells (6A)were determined using a Corneal Endotheliometer. OCT was used to measure the total corneal thickness and epithelial and stromal thickness, and AL (ΔAL represents the growth of AL) was measured using Lenstar (Haag-Streit Lenstar LS 900). The RDV of different regions of the retina was measured by MRT(multispectral refraction topography), including the defocus within sector partition from the macula as the center:RDV0-30°, RDV30-60°, RDV60-90°, RDV90-120°, RDV120-150°, RDV150-180°, RDV180-210°, RDV210-240°,RDV240-270°,RDV270-300°,RDV300-330°, and RDV330-360°. During the process of measuring the defocus of the HAL, the children wore lenses and put the chin into the chinrest. While the machine is covered with a black cloth to prevent the reflection of the lenses, and the children place his head in the black cloth and push the front of the lenses against the bridge of the nose, the operating mode is set to "Frame Mirror".For cycloplegic refraction,tropicamide phenylephrine eye drops(Mydrin-P;Santen,Osaka,Japan) were used three times at intervals of 15 min. The SE was defined as the sum of the spherical diopters and half of the astigmatic diopters. The shaping force is the difference between the SE before and after wearing OK. The lens ‘dioptors of the HAL and SVS were selected according to the children’s refraction, and all examinations were performed by the same examiner. Children in the OK subgroup underwent visual acuity, SE, AL, corneal topography, and other related examinations at 1d, 1w, 1mo, 3mo and every 3mo after wearing the lenses. The children in the HAL and SVS subgroups underwent visual acuity, AL, and other related examinations every 3 months after wearing lenses; when myopia increased by more than − 0.75D, the lenses were replaced and full corrections were performed. Statistical analysis Data were analyzed using IBM SPSS Statistics for Windows(version23.0;IBM Corp.,Armonk,NY,USA). The chi-square test was used to compare enumeration data between the groups.The Shapiro-Wilk test was performed for data distribution assessment before parametric tests.The t test was used for comparing between-group data conforming to a normal distribution,whereas the independent t test was used for equal variance,and the Welch t test was used for unequal variance,and was represented by (mean ± SD).The Mann-Whitney U test was used for data that did not conform to normal distribution and was represented by [M(Q1,Q3)].Spearman’s correlation analysis was performed to analyze the correlation between data that did not conform to normal distribution. Differences were considered statistically significant at P < 0.05. 3 Results AL growth in subgroups OK and HAL was lower than that in subgroup SVS: 6mo(OK and SVS Z=-2.635,P= 0.025 ; HAL and SVS Z=-2.747,P=0.03 ); 9mo(OK and SVS Z=-3.08 ,P=0.047; HAL and SVS Z=-3.12,P=0.03); 12mo(OK and SVS Z=-3.21,P=0.039; HAL and SVS Z=-3.31,P=0.002 ). Comparison of the difference in the amount of AL change between OK and HAL: 6mo( Z=-1.367 ,P=0.317) ; 9mo(Z=-1.45 , P=0.211) ;12mo( Z=-1.52 , P= 0.365 ), the difference was not statistically significant (Table 2,Fig. 3A）. (Table 3, Fig. 3B) demonstrates that the AL growth of the children in subgroup B was lower than that in subgroup SVS at 6, 9, 12mo, and the children in subgroups Ok and HAL after wearing lenses: 6mo(OK and SVS Z=-2.899 ,P= 0.041 ; HAL and SVS Z=-3.02 ,P=0.022); 9mo(OK and SVS Z=-3.54 ,P=0.011; HAL and SVS Z=-3.677,P＜0.001); 12mo(OK and SVS Z=-3.741 , P＜0.001; HAL and SVS Z=-3.847 ,P＜0.001).A comparison of the difference in the amount of AL change between OK and HAL: 6mo( Z=-2.03 ,P=0.042) ; 9mo(Z=-2.69, P=0.03) ;12mo( Z=-2.98 ,P=0.01 ),the difference was statistically significant;the increase in AL in subgroup OK was less than that in HAL. After wearing the lenses, the AL of the three subgroups showed an increasing trend (Fig. 3C-G). Table 2. Comparison of AL in subgroup A n Pre AL AL-3mo AL-6mo AL-9mo AL-12mo OK 38 24.36（24.31，24.47） 24.38±0.15 24.42（24.34,24.53） 24.44±0.18 24.47±0.19 HAL 32 24.38（24.26，24.43） 24.39±0.13 24.41±0.12 24.45±0.12 24.48±0.12 SVS 34 24.33±0.14 24.45±0.11 24.51(24.44,24.58) 24.60±0.08 24.68(24.62,24.75) H/F 0.674 3.13 15.16 15.18 45.55 P 0.714 0.048* ＜0.001* ＜0.001* ＜0.001* *Statistically significant difference (P<0.05). Table 3. Comparison of AL in subgroup B n Pre AL AL-3mo AL-6mo AL-9mo AL-12mo OK 41 24.64±0.12 24.66±0.11 24.69±0.11 24.72±0.11 24.75±0.11 HAL 29 24.69(24.59,24.79) 24.72(24.62,24.83) 24.77(24.71,24.86) 24.85(24.75,24.90) 24.88±0.12 SVS 37 24.68±0.08 24.78±0.09 24.86±0.10 24.94±0.10 25.04±0.10 H/F 2.265 12.591 28.953 41.602 47.999 P 0.322 0.002* ＜0.001* ＜0.001* ＜0.001* *Statistically significant differences(P0.05), and the myopic defocus of RDV270-300° in subgroup HAL was higher than that in subgroup OK;the myopic defocus in other regions was higher in subgroup OK than in subgroup HAL, with a statistically significant difference (P<0.05);subgroup OK was higher than that in subgroup HAL (Table 4,Fig.4A-K). The Pie-shaped distribution of defocus in OK subgroup is shown in Fig. 4L. The Pie-shaped distribution of the defocus in the HAL subgroup is shown in Fig. 4M. Table 4. Comparison of the distribution of defocus in each sector centered on the macula after wearing lenses for 12 mo between OK and HAL RDV0-30° RDV30-60° RDV60-90° RDV90-120° RDV120-150° RDV150-180° OK -0.54（-0.97，-0.27） -0.17±0.14 -0.02（-0.07，-0.03） -0.06（-0.15，0.03） -0.41（-0.65，-0.22） -0.74(-1.15,-0.33) HAL -0.29(-0.54,-0.09) -0.13(-0.29,0.06) 0.13±0.43 -0.08（-0.3， 0.17） -0.13(-0.36,0.2) -0.3（-0.51，-0.11） Z -2.009 -0.716 -0.345 -2.033 -0.076 -0.014 P ＜0.001* 0.047* ＜0.001* 0.642 ＜0.001* ＜0.001* RDV180-210° RDV210-240° RDV240-270° RDV270-300° RDV300-330° RDV330-360° OK -0.8(-1.35,-0.34) -0.43（-0.71，-0.17） -0.33(0.52,-0.17) 0(-0.02,0.04) -0.25±0.19 -0.54（-1.05，-0.22） HAL -0.7（-1.23，-0.3） -0.2(-0.45,-0.02) -0.16±0.39 -0.17±0.31 -0.07(-0.37,0.28) -0.22(-0.49,0.06) Z -0.175 -1.99 -2.06 1.382 -3.08 -2.74 P 0.032* 0.022* 0.039* 0.016* ＜0.001* ＜0.001* *Statistically significant differences(P<0.05). One day post-OK, the shaping force of subgroup A was negatively correlated with SRI,total corneal thickness ,and corneal stromal thickness (P<0.05). The shaping force of subgroup B was positively correlated with Em and CV(P<0.05) and negatively correlated with the total corneal thickness (P<0.05)(Table 5,Fig.5,6). Table 5. The correlation between shaping force and various corneal parameters in two subgroups after wearing OK for one day rf Em △E SRI Height Difference Diameter TBI CD CV 6A Total Epithelial Stroma (mm) （/mm2） (%) （%） (μm) (μm) (μm) A(n=38) rs 0.184 -0.052 0.103 -0.352 0.122 0.488 0.134 -0.151 0.149 -0.243 -0.727 -0.082 -0.714 P 0.140 0.643 0.411 0.03* 0.362 0.085 0.202 0.324 0.226 0.120 <0.001* 0.501 <0.001* B(n=41) rs 0.073 0.523 -0.073 -0.220 -0.113 0.511 -0.176 -0.163 0.436 -0.225 -0.319 -0.274 -0.211 P 0.576 0.014* 0.633 0.149 0.421 0.213 0.247 0.241 0.004* 0.138 0.042* 0.059 0.176 Spearman’s correlation analyses;*Statistically significant differences(P<0.05). 4 Discussions The popularization of electronic information has greatly changed people' s living patterns, and the prevalence of myopia has increased annually. 8–12 years old is the stage of rapid growth of axial length; unhealthy habits coupled with genetic regulation from parents lead to uncontrolled myopia in adolescents[ 8 – 10 ]. Owing to near work for a long time, the effect of self-regulation is initiated, and the growth of axial length is promoted while hyperopic defocus is increased, further accelerating the development of myopia[ 11 , 12 ]. The Peripheral Refraction Difference Value(RDV) is the difference between the SE in a certain area around the retina and the SE in the central macular region[ 13 – 17 ]. A positive difference indicates periretinal hyperopic defocus and a negative difference indicates periretinal myopic defocus. At present, most methods for controlling myopia progression involve induction of myopic defocus around the retina. OK can control myopia by changing periretinal hyperopic defocus. The lens is attached to the epithelium of the cornea and redistributes the epithelial cell layer according to its fixed shape through the fluid mechanics of tears, resulting in myopic defocus in the peripheral retina[ 18 ]. Since the first clinical study on OK was published in 2005, there has been a significant increase in clinical studies on OK, with the longest clinical observation time being 10 years[ 19 , 24 ]. Currently, OK is considered to be one of the most effective optical treatments for controlling myopia. In recent years, HAL has received extensive attention as a new method for myopia control. Zhang et al. [ 20 ] were the first to study the changes in the peripheral diopter after wearing HAL, and the results showed that HAL could cause myopic defocus compared with SVS. In this study, after 12 months of follow-up, the AL of the three subgroups increased after wearing the lenses, and the change in AL was mainly caused by timing factors. In this study, the AL growth of the children at 6, 9, and 12 mo, OK and HAL was lower than that in SVS after wearing lenses in subgroups A and B, indicating that both OK and HAL had good myopia control effects. There was no significant change in AL between the OK and HAL subgroups in subgroup A (P > 0.05), indicating that mild myopia (-1.0 ≤ SE≤ -2.0D) could achieve effects similar to those of HAL and OK. However, there was a statistically significant difference in the amount of AL change between OK and HAL in subgroup B (P < 0.05), suggesting that the effect of OK on controlling AL was better than that of HAL, which is similar to the results of Choi et al. [ 21 ] and Jakobsen et al. [ 22 ]. This study showed that for mild myopia, the prevention and control effect of HAL and OK was similar, which may be due to the inclusion of 1021 microlenses (+ 3.0D to + 5.0D) in the middle and periphery of HAL, and the amount of peripheral retinal defocus generated by mild myopia of -1.0 ≤ SE≤-2.0D was relatively sufficient to control its progression. Although both OK and HAL are based on the principle of myopic defocus, they are very different in terms of design. OK flattens the center of the cornea by the central basal arc to provide a clear image, and the periphery makes the cornea steep by inverting the arc to form myopic defocus [ 25 , 26 ], while HAL forms myopic defocus through 1021 microlenses (+ 3.0D to + 5.0D). The difference in myopic prevention and control effects between the two subgroups may be due to the fact that OK achieves a more accurate myopia defocus effect through corneal shaping, while HAL is due to the presence of spectacular distance; as a result, the amount of defocus in the peripheral part of the lens does not act well in front of the peripheral retina. In this study, the results showed that the amount of myopic defocus in OK was better than that in HAL at RDV270-300° compared with OK, and the myopic defocus in all regions was better than that in the HAL, and the difference was statistically significant (P < 0.05). The reason for this analysis may be that while wearing eyeglasses, the glasses may move downward owing to the effect of gravity, and the lens deviation increases the amount of inferior defocus. The overall defocus distribution of Ok is characterized by the asymmetry of the peripheral retinal defocus between the horizontal and vertical diameters of the retina, with temporal defocus being the most obvious. Erdinest [ 23 ] showed that among the defocus of the four 90° wedge-shaped regions centered on the macula,RDV-T was the largest, followed by RDV-N, RDV-S, and RDV-I. The results of the present study were consistent with these findings. The corneal epithelium and stromal and endothelial layers play different roles in shaping force. The corneal epithelium undergoes rapid renewal, with new cells replacing naturally aging and damaged epithelial cells within 6 to 15 h. Corneal shaping changes the distribution of naturally growing and replacing corneal epithelial cells, making the epithelial cells thin in the middle and thick in the periphery. Therefore, by stopping wearing ortho-K, there is no restriction of the "mold" of the lens, and the layer of " contact lenses" made by the corneal epithelium is naturally renewed and shed; therefore, the thinner the epithelium, the faster the shaping. The stromal layer accounts for > 90% of total corneal thickness. Highly concentrated collagen fibers are necessary to maintain corneal strength and curvature, with the precorneal stroma playing a more important role. The thicker the stromal layer, the stronger is the ability of the cornea to resist external deformation. The biomechanical properties of the cornea enable it to dissipate the pressure exerted by lenses and eyelids on the cornea and maintain the original shape.The endothelial layer is a single layer of cells on the posterior surface of the cornea, which is a continuous hexagonal shape with tightly embedded cells.Endothelial cells are the key to maintaining corneal hydration and transparency, as they actively transport water. Corneal endothelial pumps prevent excessive water content. Under the action of Na + /K + ATPase and HCO 3 ATPase, water in the corneal stroma crosses the endothelium and enters the anterior chamber. The tight embedding of endothelial cells serves as a barrier to prevent water infiltration[ 27 ]. One day post-OK, the shaping force of subgroup A was negatively correlated with SRI, total corneal thickness, and corneal stromal thickness (P < 0.05). The reason for this may be that the corneal regularity index(SRI) reflects the asymmetry of the corneal surface, and the smaller the value, the more regular the corneal surface and the better the shaping effect.Shaping force of subgroup B were positively correlated with Em and CV(P < 0.05) and was negatively correlated with corneal total thickness (P < 0.05),reason for analysis separately: Em represents the average value of the corneal E value, which can reflect the overall morphology of the cornea. The larger the value, the smaller the rate of change between the central and midperipheral morphologies, and the better the positioning of the lens is relatively good. Another parameter-corneal endothelial cell is a layer of 5-micron hexagonal flat cells. After injury, adjacent cells cover the damaged area through cell recombination, enlargement,migration, and rebuilding of the complete endothelial monolayer structure, which reflects the degree of variation in the average size of endothelial cells. After mutation of the endothelial cells, the volume increases and the number of ion pumps on the cell membrane also increases. Under the action of an ion pump, the water in the corneal stroma crosses the endothelium and enters the anterior chamber. Corneal elasticity decreased, resulting in an increase in the corneal shaping force. The corneal stromal layer accounts for 90% of the total corneal thickness. The thicker the stromal layer is, the more collagen fibers it contains, resulting in a decrease in corneal elasticity and an increase in hardness, leading to a decrease in corneal plasticity. In this study,the peripheral retinal defocus of HAL was not completely precisely measured at the current level of detection. At meantime,the present study has a relatively shorter follow-up duration of only one year.In future studies,longer durations and more observation points should be considered,and there will be a more straightforward way to detect the HAL's peripheral retinal defocus. 5 Conclusion In summary, OK is one of the most effective optical treatments for controlling myopia, and the factors that affect the corneal shaping force under different corneal parameters are different.Different analyses should be performed on individualized corneal parameters of children. However, while OK has a good effect on controlling myopia, the scope of its use is relatively limited, such as being limited by age, refraction, and corneal curvature;the price is relatively high; the requirements for hygiene, nursing compliance, and other factors are high; and the occurrence of dry eye has become a common concern. The design of the defocus frame has wider clinical application value, and the control effectiveness of mild myopia can be the same as that of OK. We hope that the defocus design of functional lenses can be continuously improved in the future to promote new optical methods to control myopia progression. Declarations Funding This study was not supported by any grant. Conflict of Interest The authors declare that they have no conflicts of interest. Ethics approvalThis study was approved by the Institutional Ethics Commmittee Review Board of Ineye Hospital of Chengdu University of TCM. Consent for publicationNot applicable. Data Availability Statement All relevant data are within the manuscript and its Supporting information files. Author Contributions Jia Yu and Yuehua Zhou designed and implemented this study. Jia Yu contributed to the analysis and writing of the manuscript. Yujuan Guo conceived of and supervised the project. References Zhou FXX. and Y.Qian,Thickness profiles of the corneal epithelium along the steep and flat meridians of astigmatic corneas after orthokeratology,BMC Ophthalmology,vol.20,no.I,P.240,2020 .https://doi.org/10.1186/s12886-020-01477-y . Zhang J, Li. X.li,F,Li,and T.wang,Redistribution of the corneal epithelium after overnight wear of orthokeratology conract lenses for mypia reduction. Contace Lens Anterior Eye. 2020;43(3):232–7. https://doi.org/10.1016/j.clae.2020.02.015 . Chen RR, Chen Y, Lipson M, et al. The effect of treatment zone decentration on myopic progression during or-thokeratology. Curr Eye Res. 2020;45(5):645–51. https://doi.org/10.1080/02713683.2019.1673438 . Guo BY, Cheung SW, Kojima R, et al. One-year results of the Variation of Orthokeratology Lens Treatment Zone(VOLTZ) Study:a prospective randomised clinical trial. Ophthalmic Physiol Opt. 2021;41(4):702–14. https://doi.org/10.1111/opo.12834 . ZHU, Q,LIU Y,TIGHE, S et al. Retardation of myopia progression by multifocal soft contace lenses[J]. Int J Med Sci 2019,16(2):198–202. Swarbrick HA. P.Kang,and R.Peguda,Corneal total and epithelial thickness measured by sonogage ultrasound pachometry and high-resolution optical coherence tomography. Optom Vis Sci. 2020;97(5):346–50. https://doi.org/10.1097/OPX.0000000000001508 . Jonas JB. Ang M,Cho P,et al.IMI prevention of myopia and its progression.Invest Ophthalmol. Vis Sci. 2021;62(5):6. https://doi.org/10.1167/iovs.62.5.6 . Kong QH, Guo J, Zhou J, et al. Factors determining effective orthokeratology treatment for controlling juvenile myopia progression. Iran J Public Heath. 2017;46(9):1217–22. PMCID: PMC5632323. Zhang J, Li. X.li,F,Li,and T.wang,Redistribution of the corneal epithelium after overnight wear of orthokeratology conract lenses for mypia reduction. Contace Lens Anterior Eye. 2020;43(3):232–7. https://doi.org/10.1016/j.clae.2020.02.015 . Epub 2020 Feb 29. Chen Z, Xue F, Zhou J, et al. Prediction of orthokeratology lens decentration with corneal elevation. Optom Vis Sci. 2017;94(9):903–7. https://doi.org/10.1097/OPX.0000000000001109 . Wang AK. Yang CH.Influence of overnight orthokeratology lens treatment zone decentration on myopoa progression. J Ophthalmol. 2019;2019:2596953. https://doi.org/:10.1155/2019/2596953 . Pauné J, Fonts S, et al. The role of back optic zone diameter in myopia control with orthokeratology lenses. J Clin Med. 2021;10(2):336. https://doi.org/10.3390/jcm10020336 . Guo BY, Cheung SW, Kojima R, et al. One-year results of the Variation of Orthokeratology Lens Treatment Zone(VOLTZ)Study:a prospective randomized clinical trial. Ophthalmic Physiol Opt. 2021;41(4):702–14. https://doi.org/10.1111/opo.12834 . Sun L, Li ZX, Chen Y, et al. The effect of orthokeratology treatment zon decentration on myopia progression. BMC Ophthalmol. 2022;22(1):76. https://doi.org/10.1186/s12886-022-02310-4 . Huang YY, Li X, Ding CL, et al. Orthokeratology reshapes eyes to be less prolate and more symmetric. Conl Lens Anterior Eye. 2022;45(4):101532. https://doi.org/10.1016/j.clae.2021.101532 . Ni NJ, Ma FY, Wu XM, et al. Novel application of multispectral refraction topography in the observation of myopoc control effect by orthokeratology lens in adolescents. World J Clin Cases. 2021;9(30):8985–98. https://doi.org/10.12998/wjcc.v9.i30.8985 . Li T, Chen ZY,She M et al. Relative peripheral refraction in myopic children wearing orthkeratology lenses using a novel multispectral refraction toptgrapher.Clin Exp Optom,2022;[Epub ahead of print]. Li F, Jiang ZX,Han P, et al. A meta-analysis of central corneal thickness changes with overnight orthokeratology. Eye Contact Lens. 2016;42(2):141–6. https://doi.org/10.1097/ICL.0000000000000132 . Vander Veen DK, Kraker RT, Pineles SL et al. Use of orthokeratology for the prevention of myopic progression in children:a report by the American academy of ophthalmology.Ophthamology 2019;126(4):623–36. https://doi.org/10.1016/j.ophtha.2018.11.026 . Zhang HY, Lam CSY,Tang WC, et al. Defocus incorporated multiple segments spectacle lenses changed the relative peripheral refraction:a 2 year randomized clinical trial. Invest Ophthalmol Vis Sci. 2020;61(5):53. https://doi.org/10.1167/iovs.61.5.53 . Choi KY, Chun RKM, Tang WC, et al. Evaluation of an optical defocus treatment for myopia progression among school children during the CONID-19 pandemic. JAMA Netw Open. 2022;5(1):e2143781. https://doi.org/10.1001/jamanetworkopen.2021.43781 . Jakobsen TM, et al. Control of myopia using orthokeratology lenses in Scandinavian children aged 6 to 12 years.Eighteen-month data from the Danish Randomized Study:clinical study of near-sightedness;Treatment with Orthokeratology Lenses(CONTROL study). Acta Ophthalmol. 2021;100:175–82. https://doi.org/10.1111/aos.14911 . Erdinest N, London N,Lavy I, et al. Peripheral defocus and myopia management:a mini-review. Korean J Ophthalmol. 2023;37(1):70–81. https://doi.org/10.3341/kjo.2022.0125 . Lin WP, Li N, Gu TP, et al. The treatment zone size and its decentration influence axial elongation in children with orthokeratology treatment. BMC Ophthalol. 2021;21(1):362. https://doi.org/10.1186/s12886-021-02123-x . Baird PN, Saw SW, Lanca C, et al. Myopia Nat Rev Dis Primers. 2020;6(1):99. https://doi.org/10.1038/s41572-020-00231-4 . Hiraoka T. Myopia control with orthokeratology:a review. Eye Contact Lens. 2022;48(3):100–4. https://doi.org/10.1097/ICL.0000000000000867 . Yee RW. Matsuda M,Schultz RO,et al.Changes in the normal corneal endothelial cellular pattern as a function of age[J]. Curr Eye Res. 1985;4(6):671–8. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3852302","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":267540468,"identity":"05c53e4b-9b44-483b-aedd-ee592e68142a","order_by":0,"name":"Jia Yu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIiWNgGAWjYBACAwbGBokEMPNgA8MHAxs50rQwzihIMyZCCwODBIzDzPPhcCJBLebshxtvPKi5k7jh4OHGzzYGzAkM7IePbsCnxbInsdki4dizxA0HDjZL5xiw5THwpKXdwOuwA4ltEglsh0FaGoBaeIoZJHjM8Gs5/xCo5R9YS/NvCwOJxAaCWm4AbUlsA2tpk2YwMCBGy8Nmi8S+w8YzgVosewwSjNkI+uV8+sObP74dlu27cfzxjR9//svxsx8+hlcLDDg2SByAsNiIUQ4C9gz8DcSqHQWjYBSMgpEGAO5HWT8QGNTJAAAAAElFTkSuQmCC","orcid":"","institution":"Chengdu University of Traditional Chinese Medicine","correspondingAuthor":true,"prefix":"","firstName":"Jia","middleName":"","lastName":"Yu","suffix":""},{"id":267540469,"identity":"6fd171a4-9e57-4c88-8ed3-924520141fb8","order_by":1,"name":"Yujuan Guo","email":"","orcid":"","institution":"Chengdu University of Traditional Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Yujuan","middleName":"","lastName":"Guo","suffix":""},{"id":267540470,"identity":"fb40a211-c8cf-47e1-b586-ac5c1aa3b106","order_by":2,"name":"Yuehua Zhou","email":"","orcid":"","institution":"Chengdu University of Traditional Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Yuehua","middleName":"","lastName":"Zhou","suffix":""}],"badges":[],"createdAt":"2024-01-11 04:44:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3852302/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3852302/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49826885,"identity":"a03163e0-5978-4dd9-a41d-432d49905065","added_by":"auto","created_at":"2024-01-18 15:55:22","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":4716,"visible":true,"origin":"","legend":"\u003cp\u003eError bar plots.\u003cstrong\u003eA\u003c/strong\u003e kf of three subgroups. \u003cstrong\u003eB\u003c/strong\u003e AL of three subgroups.\u003c/p\u003e","description":"","filename":"F1.png","url":"https://assets-eu.researchsquare.com/files/rs-3852302/v1/ded6527d923c384a63772f68.png"},{"id":49826886,"identity":"01acfff7-23aa-4a53-b3d3-de8aae2ab040","added_by":"auto","created_at":"2024-01-18 15:55:22","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":100057,"visible":true,"origin":"","legend":"\u003cp\u003eLens’ display of HAL\u003c/p\u003e","description":"","filename":"F2.png","url":"https://assets-eu.researchsquare.com/files/rs-3852302/v1/fdda01366978949ef41c3303.png"},{"id":49826888,"identity":"119c8e1c-5ec3-4140-807a-ccbaddf9dd82","added_by":"auto","created_at":"2024-01-18 15:55:22","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":38827,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eA\u003c/strong\u003e Column chart of interocular difference in AL for different myopic correction methods in subgroup A . \u003cstrong\u003eB\u003c/strong\u003e Column chart of interocular difference in AL for different myopic correction methods in subgroup B.\u003cstrong\u003eC \u003c/strong\u003eInterocular difference in AL at 3mo between two groups. D Interocular difference in AL at 6mo between two groups. E Interocular difference in AL at 9mo between two groups. \u003cstrong\u003eF\u003c/strong\u003e Interocular difference in AL at 12mo between two groups.\u003cstrong\u003eG \u003c/strong\u003eHAL profile is the red line and the black line is OK. The shadowed area between the profiles represents the interocular difference in AL at different time points.\u003c/p\u003e","description":"","filename":"F3.png","url":"https://assets-eu.researchsquare.com/files/rs-3852302/v1/62a64e170ea6f3d9e39f7d49.png"},{"id":49828324,"identity":"51b268a8-4490-4be1-9c47-9faa5b85b3b9","added_by":"auto","created_at":"2024-01-18 16:03:22","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":88605,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eA\u003c/strong\u003e Boxplot of OK and HAL within \u0026nbsp;RDV0-30°.\u003cstrong\u003eB\u003c/strong\u003e Boxplot of OK and HAL within \u0026nbsp;RDV10-60°.\u003cstrong\u003eC \u003c/strong\u003eBoxplot of OK and HAL within \u0026nbsp;RDV60-90°.\u003cstrong\u003eD \u003c/strong\u003eBoxplot of OK and HAL within \u0026nbsp;RDV120-150°.\u003cstrong\u003eE \u003c/strong\u003eBoxplot of OK and HAL within \u0026nbsp;RDV150-180°.\u003cstrong\u003eF \u003c/strong\u003eBoxplot of OK and HAL within \u0026nbsp;RDV180-210°.\u003cstrong\u003eG \u003c/strong\u003eBoxplot of OK and HAL within \u0026nbsp;RDV210-240°.\u003cstrong\u003eH \u003c/strong\u003eBoxplot of OK and HAL within \u0026nbsp;RDV240-270°.\u003cstrong\u003eI \u003c/strong\u003eBoxplot of OK and HAL within \u0026nbsp;RDV270-300°.\u003cstrong\u003eJ \u003c/strong\u003eBoxplot of OK and HAL within \u0026nbsp;RDV300-330°.\u003cstrong\u003eK \u003c/strong\u003eBoxplot of OK and HAL within \u0026nbsp;RDV330-360°.\u003cstrong\u003eL\u003c/strong\u003eThe Pie-shaped distribution of defocus in the OK subgroup. \u003cstrong\u003eM\u003c/strong\u003e The Pie-shaped distribution of defocus in the HAL subgroup.\u003c/p\u003e","description":"","filename":"F4.png","url":"https://assets-eu.researchsquare.com/files/rs-3852302/v1/9e37319afd61f6506ea367f6.png"},{"id":49826889,"identity":"fe2ba4e8-a5a5-4a6e-b38f-a0c294232727","added_by":"auto","created_at":"2024-01-18 15:55:22","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":8794,"visible":true,"origin":"","legend":"\u003cp\u003eScatterplot of the relationship between shaping force and various corneal parameters in subgroup A after wearing OK for one day.\u003c/p\u003e","description":"","filename":"F5.png","url":"https://assets-eu.researchsquare.com/files/rs-3852302/v1/13d5dede1da8828fbc0c25c1.png"},{"id":49826890,"identity":"83808075-aea1-4923-bbe8-90aa53db5f86","added_by":"auto","created_at":"2024-01-18 15:55:22","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":8376,"visible":true,"origin":"","legend":"\u003cp\u003eScatterplot of the relationship between shaping force and various corneal parameters in subgroup B after wearing OK for one day.\u003c/p\u003e","description":"","filename":"F6.png","url":"https://assets-eu.researchsquare.com/files/rs-3852302/v1/9f59c239379f9e7941ef9452.png"},{"id":55264690,"identity":"a823b66a-7b0b-4920-a5b4-b6a1d7ac948d","added_by":"auto","created_at":"2024-04-25 01:46:46","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":732697,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3852302/v1/05ed0c68-5286-4386-84e0-0177e155c229.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comparison of the Myopia Control Effectiveness and Defocus of OK and HAL in Adolescents","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eThe incidence of myopia among Chinese adolescents ranks first worldwide, and myopia at a young age has become a common trend. Therefore,it is imperative to control the rate of myopia growth in adolescents who have already developed myopia. In recent years, the relationship between the progression of myopia in adolescents and retinal peripheral refraction measurement has become a hot topic in myopia-related research[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Orthokeratologylens (OK) and highly aspherical Lenslets (HAL) have been common myopia control methods in clinical practice in recent years, and the control of axial length(AL) has been clinically recognized[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. OK is a specially designed hard contact lens, and through the mechanical and fluid mechanics generated by wearing the lenses, the distribution of epithelial cells on the anterior surface of the cornea is changed, so that the central curvature is flattened, the middle and periphery curvature is steepened, and the farsighted defocus state of the peripheral retina can be changed while correcting myopia to achieve the purpose of control the development of myopia[\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The design of multi-point myopia defocus of microlenses in HAL can effectively control the development of myopia, and the control effect of the AL has been clinically recognized[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].Few studies have compared the myopia control effect of OK and HAL, and a comparison of their respective amounts of defocus. The purpose of this study was to compare the controlled effects of long-term wearing of OK and HAL in adolescents with myopia. Simultaneously, by analyzing the shaping force of wearing OK for one day,one can be more comprehensively evaluated.\u003c/p\u003e"},{"header":"2 Methods","content":"\u003cp\u003eFirst,it was a prospective study. This study included 211 children( 211eyes) of 102 male and 109 female subjects (data from the right eye were selected for analysis) enrolled in the Beijing Ming Vision and Ophthalmology between October 2022 and February 2023. The mean age of the subjects were [10.35\u0026thinsp;\u0026plusmn;\u0026thinsp;1.72] years(range:8 to\u003c/p\u003e \u003cp\u003eThe inclusion criteria were that the spherical equivalent(SE) was \u0026minus;\u0026thinsp;1.0\u0026thinsp;\u0026le;\u0026thinsp;SE\u0026le;-3.0D[-2.35\u0026thinsp;\u0026plusmn;\u0026thinsp;1.58] D with astigmatism of 1.50D or less,best-corrected distance visual of 20/20 or better before treatment. Exclusion criteria were systematic and ophthalmic diseases,corrected distance visual acuity\u0026thinsp;\u0026lt;\u0026thinsp;20/25,history of ophthalmic surgery or disease,unwillingness to participate in the study,and inability to obtain high-quality images. According to the myopic correction method, the children were divided into three subgroups: OK, HAL, and Single-Vision spectacles (SVS); according to the spherical equivalent (SE), they were further divided into two subgroups: A-1.0\u0026thinsp;\u0026le;\u0026thinsp;SE\u0026le;-2.0D, B-2.0\u003cem\u003e\u003c\u003c/em\u003eSE\u0026le;-3.0 D. No significant difference was observed in the baseline data of age, sex, SE, AL, and corneal curvature between the three subgroups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05)(Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e,Fig.\u0026nbsp;1A,B). Informed consent was obtained from parents of each child. This study was approved by the Medical Ethics Committee of the Ineye Hospital of Chendu University of TCM(2022yh-024) and adhered to the Declaration of Helsinki.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline data of the three groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMale/Female\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003cp\u003e(years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003cp\u003e(D)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAL\u003c/p\u003e \u003cp\u003e(mm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCorneal curvature\u003c/p\u003e \u003cp\u003e(D)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40/39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.30\u0026thinsp;\u0026plusmn;\u0026thinsp;1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.18\u0026thinsp;\u0026plusmn;\u0026thinsp;1.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24.37\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e42.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHAL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29/32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.28\u0026thinsp;\u0026plusmn;\u0026thinsp;1.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.21\u0026thinsp;\u0026plusmn;\u0026thinsp;1.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24.36\u0026thinsp;\u0026plusmn;\u0026thinsp;1.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e42.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSVS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33/38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.27\u0026thinsp;\u0026plusmn;\u0026thinsp;1.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.19\u0026thinsp;\u0026plusmn;\u0026thinsp;1.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24.39\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e42.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF/x\u0026sup2;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.668\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.465\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.698\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0956\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.894\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.914\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.712\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.503\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eA B\u003c/p\u003e \u003cp\u003e \u003cb\u003eFigure\u0026nbsp;1\u003c/b\u003e Error bar plots.\u003cb\u003eA\u003c/b\u003e kf of three subgroups. \u003cb\u003eB\u003c/b\u003e AL of three subgroups.\u003c/p\u003e \u003cp\u003eOrtho-K from Paragon CRT(Paragon Vision Sciences,Mesa,AZ,United States) was used for all the subjects. The lens\u0026rsquo;material was HDS100, the optical area diameter was 6.0 mm, the inner surface of the lens adopted a three-zone design, and the optometric retention on the CRT was +\u0026thinsp;1.25D. Lens\u0026rsquo; fitting was evaluated using fluorescence,OK centered or decentered by less than 1.0 mm radially and it was determined by silt lamp examination,and the children were instructed to wear the OK for 8\u0026ndash;10 hours pernight. After one day and one week of reexamination, no corneal staining or anterior corneal surface complications were observed. In the HAL subgroup,patients chose the same brand of lenses, which were multi-zone forward optics and high aspheric design, with an optical area of 9\u0026ndash;10 mm, a defocus area of 11 star rings, and 1021 microlenses (+\u0026thinsp;3.0D to +\u0026thinsp;5.0D), with a diameter area of 57.1 mm(Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eTo avoid deviation in the measurement of defocus, the examination time of all children was uniformly scheduled from to 8:30\u0026thinsp;\u0026minus;\u0026thinsp;10:00 a.m.. At the beginning of OK wearing,baseline examination included unaided distance visual acuity, intraocular pressure, optometry, etc.; Em, △E(E\u003csub\u003ef\u003c/sub\u003e-E\u003csub\u003es\u003c/sub\u003e), horizontal curvature radius (r\u003csub\u003ef\u003c/sub\u003e), corneal rule index (SRI), and curvature of the cornea were measured using Tomey(Topograpic Modelling System,TMS-4;Tomey Corporation,Nagoya,Japan ). The corneal biomechanical index (TBI) was measured using Pentacam, and the height difference of the 8 mm chordal length on the anterior surface of the cornea was measured using Medmont (Arlington,WA,United States). The endothelial cell density (CD), coefficient of variation in cell area (CV), and proportion of hexagonal cells (6A)were determined using a Corneal Endotheliometer. OCT was used to measure the total corneal thickness and epithelial and stromal thickness, and AL (ΔAL represents the growth of AL) was measured using Lenstar (Haag-Streit Lenstar LS 900). The RDV of different regions of the retina was measured by MRT(multispectral refraction topography), including the defocus within sector partition from the macula as the center:RDV0-30\u0026deg;, RDV30-60\u0026deg;, RDV60-90\u0026deg;, RDV90-120\u0026deg;, RDV120-150\u0026deg;, RDV150-180\u0026deg;, RDV180-210\u0026deg;, RDV210-240\u0026deg;,RDV240-270\u0026deg;,RDV270-300\u0026deg;,RDV300-330\u0026deg;, and RDV330-360\u0026deg;. During the process of measuring the defocus of the HAL, the children wore lenses and put the chin into the chinrest. While the machine is covered with a black cloth to prevent the reflection of the lenses, and the children place his head in the black cloth and push the front of the lenses against the bridge of the nose, the operating mode is set to \"Frame Mirror\".For cycloplegic refraction,tropicamide phenylephrine eye drops(Mydrin-P;Santen,Osaka,Japan) were used three times at intervals of 15 min. The SE was defined as the sum of the spherical diopters and half of the astigmatic diopters.\u003c/p\u003e \u003cp\u003eThe shaping force is the difference between the SE before and after wearing OK. The lens \u0026lsquo;dioptors of the HAL and SVS were selected according to the children\u0026rsquo;s refraction, and all examinations were performed by the same examiner.\u003c/p\u003e \u003cp\u003eChildren in the OK subgroup underwent visual acuity, SE, AL, corneal topography, and other related examinations at 1d, 1w, 1mo, 3mo and every 3mo after wearing the lenses. The children in the HAL and SVS subgroups underwent visual acuity, AL, and other related examinations every 3 months after wearing lenses; when myopia increased by more than \u0026minus;\u0026thinsp;0.75D, the lenses were replaced and full corrections were performed.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStatistical analysis\u003c/b\u003e \u003c/p\u003e \u003cp\u003eData were analyzed using IBM SPSS Statistics for Windows(version23.0;IBM Corp.,Armonk,NY,USA). The chi-square test was used to compare enumeration data between the groups.The Shapiro-Wilk test was performed for data distribution assessment before parametric tests.The t test was used for comparing between-group data conforming to a normal distribution,whereas the independent t test was used for equal variance,and the Welch t test was used for unequal variance,and was represented by (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD).The Mann-Whitney U test was used for data that did not conform to normal distribution and was represented by [M(Q1,Q3)].Spearman\u0026rsquo;s correlation analysis was performed to analyze the correlation between data that did not conform to normal distribution. Differences were considered statistically significant at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"3 Results","content":"\u003cp\u003eAL growth in subgroups OK and HAL was lower than that in subgroup SVS: 6mo(OK and SVS \u0026nbsp; Z=-2.635,P= 0.025 \u0026nbsp;; HAL and SVS \u0026nbsp;Z=-2.747,P=0.03 ); 9mo(OK and SVS \u0026nbsp;Z=-3.08 ,P=0.047; HAL and SVS \u0026nbsp;Z=-3.12,P=0.03); 12mo(OK and SVS \u0026nbsp;Z=-3.21,P=0.039; HAL and SVS \u0026nbsp;Z=-3.31,P=0.002 ). Comparison of the difference in the amount of AL change between OK and HAL: 6mo( Z=-1.367 ,P=0.317) ; 9mo(Z=-1.45 , P=0.211) ;12mo( Z=-1.52 , P= 0.365 ), the difference was not statistically significant (Table 2,Fig. 3A）. (Table 3, Fig. 3B) demonstrates that the AL growth of the children in subgroup B was lower than that in subgroup SVS at 6, 9, 12mo, and the children in subgroups Ok and HAL after wearing lenses: 6mo(OK and SVS \u0026nbsp;Z=-2.899 \u0026nbsp; ,P= 0.041 \u0026nbsp;; HAL and SVS \u0026nbsp;Z=-3.02 ,P=0.022); 9mo(OK and SVS \u0026nbsp;Z=-3.54 ,P=0.011; HAL and SVS \u0026nbsp;Z=-3.677,P＜0.001); 12mo(OK and SVS \u0026nbsp;Z=-3.741 \u0026nbsp; , P＜0.001; HAL and SVS \u0026nbsp;Z=-3.847 ,P＜0.001).A comparison of the difference in the amount of AL change between OK and HAL: 6mo( Z=-2.03 ,P=0.042) ; 9mo(Z=-2.69, \u0026nbsp;P=0.03) ;12mo( Z=-2.98 ,P=0.01 ),the difference was statistically significant;the increase in AL in subgroup OK was less than that in HAL. After wearing the lenses, the AL of the three subgroups showed an \u0026nbsp; increasing trend (Fig. 3C-G).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Comparison of AL in subgroup A\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\" valign=\"bottom\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003ePre AL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e\u0026nbsp;AL-3mo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e\u0026nbsp;AL-6mo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e\u0026nbsp;AL-9mo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e\u0026nbsp;AL-12mo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eOK\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e24.36（24.31，24.47）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e24.38\u0026plusmn;0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.42（24.34,24.53）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e24.44\u0026plusmn;0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e24.47\u0026plusmn;0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eHAL\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e24.38（24.26，24.43）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e24.39\u0026plusmn;0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.41\u0026plusmn;0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e24.45\u0026plusmn;0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e24.48\u0026plusmn;0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eSVS\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e24.33\u0026plusmn;0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e24.45\u0026plusmn;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.51(24.44,24.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e24.60\u0026plusmn;0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e24.68(24.62,24.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eH/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e0.674\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e3.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e15.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e15.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e45.55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e0.714\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e0.048*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Statistically significant difference (P\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e Comparison of AL in subgroup B\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003ePre AL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e\u0026nbsp;AL-3mo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e\u0026nbsp;AL-6mo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e\u0026nbsp;AL-9mo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e\u0026nbsp;AL-12mo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eOK\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.64\u0026plusmn;0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.66\u0026plusmn;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.69\u0026plusmn;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.72\u0026plusmn;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e24.75\u0026plusmn;0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eHAL\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.69(24.59,24.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.72(24.62,24.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.77(24.71,24.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.85(24.75,24.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e24.88\u0026plusmn;0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eSVS\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.68\u0026plusmn;0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.78\u0026plusmn;0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.86\u0026plusmn;0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e24.94\u0026plusmn;0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e25.04\u0026plusmn;0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eH/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e2.265\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e12.591\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e28.953\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e41.602\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e47.999\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e0.322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e0.002*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Statistically significant differences(P\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003eThere was no significant difference in myopic defocus between subgroups OK and HAL at RDV90-120\u0026deg; (P\u0026gt;0.05), and the myopic defocus of RDV270-300\u0026deg; in subgroup HAL was higher than that in subgroup OK;the myopic defocus in other regions was higher in subgroup OK than in subgroup HAL, with a statistically significant difference (P\u0026lt;0.05);subgroup OK was higher than that in subgroup HAL (Table 4,Fig.4A-K). The Pie-shaped distribution of defocus in OK subgroup is shown in Fig. 4L. The Pie-shaped distribution of the defocus in \u0026nbsp; the HAL subgroup is shown in Fig. 4M.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003eComparison of the distribution of defocus in each sector centered on the macula after wearing lenses for 12 mo between OK and HAL\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.166666666666667%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003eRDV0-30\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eRDV30-60\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003eRDV60-90\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003eRDV90-120\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003eRDV120-150\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003eRDV150-180\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.166666666666667%\"\u003e\n \u003cp\u003eOK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e-0.54（-0.97，-0.27）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e-0.17\u0026plusmn;0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e-0.02（-0.07，-0.03）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e-0.06（-0.15，0.03）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e-0.41（-0.65，-0.22）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e-0.74(-1.15,-0.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.166666666666667%\"\u003e\n \u003cp\u003eHAL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e-0.29(-0.54,-0.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e-0.13(-0.29,0.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e0.13\u0026plusmn;0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e-0.08（-0.3，\u0026nbsp;0.17）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e-0.13(-0.36,0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e-0.3（-0.51，-0.11）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.166666666666667%\"\u003e\n \u003cp\u003eZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e-2.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e-0.716\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e-0.345\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e-2.033\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e-0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e-0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.166666666666667%\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e0.047*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.708333333333332%\"\u003e\n \u003cp\u003e0.642\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003eRDV180-210\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003eRDV210-240\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003eRDV240-270\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003eRDV270-300\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003eRDV300-330\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003eRDV330-360\u0026deg;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003eOK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003e-0.8(-1.35,-0.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003e-0.43（-0.71，-0.17）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e-0.33(0.52,-0.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e0(-0.02,0.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e-0.25\u0026plusmn;0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e-0.54（-1.05，-0.22）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003eHAL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003e-0.7（-1.23，-0.3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003e-0.2(-0.45,-0.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e-0.16\u0026plusmn;0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e-0.17\u0026plusmn;0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e-0.07(-0.37,0.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e-0.22(-0.49,0.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003eZ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003e-0.175\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003e-1.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e-2.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e1.382\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e-3.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e-2.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.208333333333333%\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003e0.032*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003e0.022*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e0.039*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e0.016*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Statistically significant differences(P\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003eOne day post-OK, the shaping force of subgroup A was negatively correlated with SRI,total corneal thickness ,and \u0026nbsp;corneal stromal thickness \u0026nbsp;(P\u0026lt;0.05). The shaping force of subgroup B was positively correlated with Em and CV(P\u0026lt;0.05) and \u0026nbsp;negatively correlated with the total corneal thickness (P\u0026lt;0.05)(Table 5,Fig.5,6).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5.\u003c/strong\u003e The correlation between shaping force and various corneal parameters in two subgroups after wearing OK for one day\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.382978723404255%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003erf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003eEm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e△E\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003eSRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.638297872340425%\"\u003e\n \u003cp\u003eHeight Difference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e\u0026nbsp;Diameter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003eTBI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003eCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003eCV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003e6A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003eEpithelial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\"\u003e\n \u003cp\u003eStroma\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.195121951219512%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e(mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e \u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e（/mm2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e（%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e(\u0026mu;m)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e(\u0026mu;m)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.317073170731708%\"\u003e\n \u003cp\u003e(\u0026mu;m)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.382978723404255%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eA(n=38)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003ers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.638297872340425%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.488\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.727\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.082\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.714\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.643\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.411\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.03*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.363636363636363%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.362\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.085\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.324\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.226\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.501\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.382978723404255%\" rowspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003eB(n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003ers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.523\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.638297872340425%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.511\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.436\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.319\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.274\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.382978723404255%\" valign=\"bottom\"\u003e\n \u003cp\u003e-0.211\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.576\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.014*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.633\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.363636363636363%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.421\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.247\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.241\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.004*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.042*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.059\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.818181818181818%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.176\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eSpearman\u0026rsquo;s correlation analyses;*Statistically significant differences(P\u0026lt;0.05).\u003c/p\u003e"},{"header":"4 Discussions","content":"\u003cp\u003eThe popularization of electronic information has greatly changed people' s living patterns, and the prevalence of myopia has increased annually. 8\u0026ndash;12 years old is the stage of rapid growth of axial length; unhealthy habits coupled with genetic regulation from parents lead to uncontrolled myopia in adolescents[\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Owing to near work for a long time, the effect of self-regulation is initiated, and the growth of axial length is promoted while hyperopic defocus is increased, further accelerating the development of myopia[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The Peripheral Refraction Difference Value(RDV) is the difference between the SE in a certain area around the retina and the SE in the central macular region[\u003cspan additionalcitationids=\"CR14 CR15 CR16\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. A positive difference indicates periretinal hyperopic defocus and a negative difference indicates periretinal myopic defocus. At present, most methods for controlling myopia progression involve induction of myopic defocus around the retina. OK can control myopia by changing periretinal hyperopic defocus. The lens is attached to the epithelium of the cornea and redistributes the epithelial cell layer according to its fixed shape through the fluid mechanics of tears, resulting in myopic defocus in the peripheral retina[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Since the first clinical study on OK was published in 2005, there has been a significant increase in clinical studies on OK, with the longest clinical observation time being 10 years[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Currently, OK is considered to be one of the most effective optical treatments for controlling myopia. In recent years, HAL has received extensive attention as a new method for myopia control.\u003c/p\u003e \u003cp\u003eZhang et al. [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] were the first to study the changes in the peripheral diopter after wearing HAL, and the results showed that HAL could cause myopic defocus compared with SVS. In this study, after 12 months of follow-up, the AL of the three subgroups increased after wearing the lenses, and the change in AL was mainly caused by timing factors. In this study, the AL growth of the children at 6, 9, and 12 mo, OK and HAL was lower than that in SVS after wearing lenses in subgroups A and B, indicating that both OK and HAL had good myopia control effects. There was no significant change in AL between the OK and HAL subgroups in subgroup A (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), indicating that mild myopia (-1.0\u0026thinsp;\u0026le;\u0026thinsp;SE\u0026le; -2.0D) could achieve effects similar to those of HAL and OK. However, there was a statistically significant difference in the amount of AL change between OK and HAL in subgroup B (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), suggesting that the effect of OK on controlling AL was better than that of HAL, which is similar to the results of Choi et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] and Jakobsen et al. [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. This study showed that for mild myopia, the prevention and control effect of HAL and OK was similar, which may be due to the inclusion of 1021 microlenses (+\u0026thinsp;3.0D to +\u0026thinsp;5.0D) in the middle and periphery of HAL, and the amount of peripheral retinal defocus generated by mild myopia of -1.0\u0026thinsp;\u0026le;\u0026thinsp;SE\u0026le;-2.0D was relatively sufficient to control its progression.\u003c/p\u003e \u003cp\u003eAlthough both OK and HAL are based on the principle of myopic defocus, they are very different in terms of design. OK flattens the center of the cornea by the central basal arc to provide a clear image, and the periphery makes the cornea steep by inverting the arc to form myopic defocus [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], while HAL forms myopic defocus through 1021 microlenses (+\u0026thinsp;3.0D to +\u0026thinsp;5.0D). The difference in myopic prevention and control effects between the two subgroups may be due to the fact that OK achieves a more accurate myopia defocus effect through corneal shaping, while HAL is due to the presence of spectacular distance; as a result, the amount of defocus in the peripheral part of the lens does not act well in front of the peripheral retina. In this study, the results showed that the amount of myopic defocus in OK was better than that in HAL at RDV270-300\u0026deg; compared with OK, and the myopic defocus in all regions was better than that in the HAL, and the difference was statistically significant (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The reason for this analysis may be that while wearing eyeglasses, the glasses may move downward owing to the effect of gravity, and the lens deviation increases the amount of inferior defocus. The overall defocus distribution of Ok is characterized by the asymmetry of the peripheral retinal defocus between the horizontal and vertical diameters of the retina, with temporal defocus being the most obvious. Erdinest [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] showed that among the defocus of the four 90\u0026deg; wedge-shaped regions centered on the macula,RDV-T was the largest, followed by RDV-N, RDV-S, and RDV-I. The results of the present study were consistent with these findings.\u003c/p\u003e \u003cp\u003eThe corneal epithelium and stromal and endothelial layers play different roles in shaping force. The corneal epithelium undergoes rapid renewal, with new cells replacing naturally aging and damaged epithelial cells within 6 to 15 h. Corneal shaping changes the distribution of naturally growing and replacing corneal epithelial cells, making the epithelial cells thin in the middle and thick in the periphery. Therefore, by stopping wearing ortho-K, there is no restriction of the \"mold\" of the lens, and the layer of \" contact lenses\" made by the corneal epithelium is naturally renewed and shed; therefore, the thinner the epithelium, the faster the shaping. The stromal layer accounts for \u0026gt;\u0026thinsp;90% of total corneal thickness. Highly concentrated collagen fibers are necessary to maintain corneal strength and curvature, with the precorneal stroma playing a more important role. The thicker the stromal layer, the stronger is the ability of the cornea to resist external deformation. The biomechanical properties of the cornea enable it to dissipate the pressure exerted by lenses and eyelids on the cornea and maintain the original shape.The endothelial layer is a single layer of cells on the posterior surface of the cornea, which is a continuous hexagonal shape with tightly embedded cells.Endothelial cells are the key to maintaining corneal hydration and transparency, as they actively transport water. Corneal endothelial pumps prevent excessive water content. Under the action of Na\u003csup\u003e+\u003c/sup\u003e/K\u003csup\u003e+\u003c/sup\u003eATPase and HCO\u003csub\u003e3\u003c/sub\u003eATPase, water in the corneal stroma crosses the endothelium and enters the anterior chamber. The tight embedding of endothelial cells serves as a barrier to prevent water infiltration[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOne day post-OK, the shaping force of subgroup A was negatively correlated with SRI, total corneal thickness, and corneal stromal thickness (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The reason for this may be that the corneal regularity index(SRI) reflects the asymmetry of the corneal surface, and the smaller the value, the more regular the corneal surface and the better the shaping effect.Shaping force of subgroup B were positively correlated with Em and CV(P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and was negatively correlated with corneal total thickness (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05),reason for analysis separately: Em represents the average value of the corneal E value, which can reflect the overall morphology of the cornea. The larger the value, the smaller the rate of change between the central and midperipheral morphologies, and the better the positioning of the lens is relatively good. Another parameter-corneal endothelial cell is a layer of 5-micron hexagonal flat cells. After injury, adjacent cells cover the damaged area through cell recombination, enlargement,migration, and rebuilding of the complete endothelial monolayer structure, which reflects the degree of variation in the average size of endothelial cells. After mutation of the endothelial cells, the volume increases and the number of ion pumps on the cell membrane also increases. Under the action of an ion pump, the water in the corneal stroma crosses the endothelium and enters the anterior chamber. Corneal elasticity decreased, resulting in an increase in the corneal shaping force. The corneal stromal layer accounts for 90% of the total corneal thickness. The thicker the stromal layer is, the more collagen fibers it contains, resulting in a decrease in corneal elasticity and an increase in hardness, leading to a decrease in corneal plasticity.\u003c/p\u003e \u003cp\u003eIn this study,the peripheral retinal defocus of HAL was not completely precisely measured at the current level of detection. At meantime,the present study has a relatively shorter follow-up duration of only one year.In future studies,longer durations and more observation points should be considered,and there will be a more straightforward way to detect the HAL's peripheral retinal defocus.\u003c/p\u003e"},{"header":"5 Conclusion","content":"\u003cp\u003eIn summary, OK is one of the most effective optical treatments for controlling myopia, and the factors that affect the corneal shaping force under different corneal parameters are different.Different analyses should be performed on individualized corneal parameters of children. However, while OK has a good effect on controlling myopia, the scope of its use is relatively limited, such as being limited by age, refraction, and corneal curvature;the price is relatively high; the requirements for hygiene, nursing compliance, and other factors are high; and the occurrence of dry eye has become a common concern. The design of the defocus frame has wider clinical application value, and the control effectiveness of mild myopia can be the same as that of OK. We hope that the defocus design of functional lenses can be continuously improved in the future to promote new optical methods to control myopia progression.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eFunding \u0026nbsp;This study was not supported by any grant.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConflict of Interest \u0026nbsp;The authors declare that they have no conflicts of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEthics approvalThis study was approved by the Institutional Ethics Commmittee Review Board of Ineye Hospital of Chengdu University of TCM.\u003c/p\u003e\n\u003cp\u003eConsent for publicationNot applicable.\u003c/p\u003e\n\u003cp\u003eData Availability Statement \u0026nbsp;All relevant data are within the manuscript and its Supporting information files.\u003c/p\u003e\n\u003cp\u003eAuthor Contributions \u0026nbsp;Jia Yu and Yuehua Zhou designed and implemented this study. Jia Yu contributed to the analysis and writing of the manuscript. Yujuan Guo conceived of and supervised the project.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eZhou FXX. and Y.Qian,Thickness profiles of the corneal epithelium along the steep and flat meridians of astigmatic corneas after orthokeratology,BMC Ophthalmology,vol.20,no.I,P.240,2020\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e.https://doi.org/10.1186/s12886-020-01477-y\u003c/span\u003e\u003cspan address=\".10.1186/s12886-020-01477-y\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang J, Li. X.li,F,Li,and T.wang,Redistribution of the corneal epithelium after overnight wear of orthokeratology conract lenses for mypia reduction. Contace Lens Anterior Eye. 2020;43(3):232\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.clae.2020.02.015\u003c/span\u003e\u003cspan address=\"10.1016/j.clae.2020.02.015\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen RR, Chen Y, Lipson M, et al. The effect of treatment zone decentration on myopic progression during or-thokeratology. Curr Eye Res. 2020;45(5):645\u0026ndash;51. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/02713683.2019.1673438\u003c/span\u003e\u003cspan address=\"10.1080/02713683.2019.1673438\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuo BY, Cheung SW, Kojima R, et al. One-year results of the Variation of Orthokeratology Lens Treatment Zone(VOLTZ) Study:a prospective randomised clinical trial. Ophthalmic Physiol Opt. 2021;41(4):702\u0026ndash;14. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/opo.12834\u003c/span\u003e\u003cspan address=\"10.1111/opo.12834\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZHU, Q,LIU Y,TIGHE, S et al. Retardation of myopia progression by multifocal soft contace lenses[J]. Int J Med Sci 2019,16(2):198\u0026ndash;202.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSwarbrick HA. P.Kang,and R.Peguda,Corneal total and epithelial thickness measured by sonogage ultrasound pachometry and high-resolution optical coherence tomography. Optom Vis Sci. 2020;97(5):346\u0026ndash;50. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/OPX.0000000000001508\u003c/span\u003e\u003cspan address=\"10.1097/OPX.0000000000001508\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJonas JB. Ang M,Cho P,et al.IMI prevention of myopia and its progression.Invest Ophthalmol. Vis Sci. 2021;62(5):6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1167/iovs.62.5.6\u003c/span\u003e\u003cspan address=\"10.1167/iovs.62.5.6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKong QH, Guo J, Zhou J, et al. Factors determining effective orthokeratology treatment for controlling juvenile myopia progression. Iran J Public Heath. 2017;46(9):1217\u0026ndash;22. PMCID: PMC5632323.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang J, Li. X.li,F,Li,and T.wang,Redistribution of the corneal epithelium after overnight wear of orthokeratology conract lenses for mypia reduction. Contace Lens Anterior Eye. 2020;43(3):232\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.clae.2020.02.015\u003c/span\u003e\u003cspan address=\"10.1016/j.clae.2020.02.015\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2020 Feb 29.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen Z, Xue F, Zhou J, et al. Prediction of orthokeratology lens decentration with corneal elevation. Optom Vis Sci. 2017;94(9):903\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/OPX.0000000000001109\u003c/span\u003e\u003cspan address=\"10.1097/OPX.0000000000001109\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang AK. Yang CH.Influence of overnight orthokeratology lens treatment zone decentration on myopoa progression. J Ophthalmol. 2019;2019:2596953. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/:10.1155/2019/2596953\u003c/span\u003e\u003cspan address=\":10.1155/2019/2596953\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePaun\u0026eacute; J, Fonts S, et al. The role of back optic zone diameter in myopia control with orthokeratology lenses. J Clin Med. 2021;10(2):336. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/jcm10020336\u003c/span\u003e\u003cspan address=\"10.3390/jcm10020336\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuo BY, Cheung SW, Kojima R, et al. One-year results of the Variation of Orthokeratology Lens Treatment Zone(VOLTZ)Study:a prospective randomized clinical trial. Ophthalmic Physiol Opt. 2021;41(4):702\u0026ndash;14. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/opo.12834\u003c/span\u003e\u003cspan address=\"10.1111/opo.12834\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSun L, Li ZX, Chen Y, et al. The effect of orthokeratology treatment zon decentration on myopia progression. BMC Ophthalmol. 2022;22(1):76. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12886-022-02310-4\u003c/span\u003e\u003cspan address=\"10.1186/s12886-022-02310-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHuang YY, Li X, Ding CL, et al. Orthokeratology reshapes eyes to be less prolate and more symmetric. Conl Lens Anterior Eye. 2022;45(4):101532. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.clae.2021.101532\u003c/span\u003e\u003cspan address=\"10.1016/j.clae.2021.101532\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNi NJ, Ma FY, Wu XM, et al. Novel application of multispectral refraction topography in the observation of myopoc control effect by orthokeratology lens in adolescents. World J Clin Cases. 2021;9(30):8985\u0026ndash;98. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.12998/wjcc.v9.i30.8985\u003c/span\u003e\u003cspan address=\"10.12998/wjcc.v9.i30.8985\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi T, Chen ZY,She M et al. Relative peripheral refraction in myopic children wearing orthkeratology lenses using a novel multispectral refraction toptgrapher.Clin Exp Optom,2022;[Epub ahead of print].\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi F, Jiang ZX,Han P, et al. A meta-analysis of central corneal thickness changes with overnight orthokeratology. Eye Contact Lens. 2016;42(2):141\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/ICL.0000000000000132\u003c/span\u003e\u003cspan address=\"10.1097/ICL.0000000000000132\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVander Veen DK, Kraker RT, Pineles SL et al. Use of orthokeratology for the prevention of myopic progression in children:a report by the American academy of ophthalmology.Ophthamology 2019;126(4):623\u0026ndash;36. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ophtha.2018.11.026\u003c/span\u003e\u003cspan address=\"10.1016/j.ophtha.2018.11.026\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang HY, Lam CSY,Tang WC, et al. Defocus incorporated multiple segments spectacle lenses changed the relative peripheral refraction:a 2 year randomized clinical trial. Invest Ophthalmol Vis Sci. 2020;61(5):53. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1167/iovs.61.5.53\u003c/span\u003e\u003cspan address=\"10.1167/iovs.61.5.53\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChoi KY, Chun RKM, Tang WC, et al. Evaluation of an optical defocus treatment for myopia progression among school children during the CONID-19 pandemic. JAMA Netw Open. 2022;5(1):e2143781. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1001/jamanetworkopen.2021.43781\u003c/span\u003e\u003cspan address=\"10.1001/jamanetworkopen.2021.43781\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJakobsen TM, et al. Control of myopia using orthokeratology lenses in Scandinavian children aged 6 to 12 years.Eighteen-month data from the Danish Randomized Study:clinical study of near-sightedness;Treatment with Orthokeratology Lenses(CONTROL study). Acta Ophthalmol. 2021;100:175\u0026ndash;82. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/aos.14911\u003c/span\u003e\u003cspan address=\"10.1111/aos.14911\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eErdinest N, London N,Lavy I, et al. Peripheral defocus and myopia management:a mini-review. Korean J Ophthalmol. 2023;37(1):70\u0026ndash;81. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3341/kjo.2022.0125\u003c/span\u003e\u003cspan address=\"10.3341/kjo.2022.0125\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLin WP, Li N, Gu TP, et al. The treatment zone size and its decentration influence axial elongation in children with orthokeratology treatment. BMC Ophthalol. 2021;21(1):362. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12886-021-02123-x\u003c/span\u003e\u003cspan address=\"10.1186/s12886-021-02123-x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBaird PN, Saw SW, Lanca C, et al. Myopia Nat Rev Dis Primers. 2020;6(1):99. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1038/s41572-020-00231-4\u003c/span\u003e\u003cspan address=\"10.1038/s41572-020-00231-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHiraoka T. Myopia control with orthokeratology:a review. Eye Contact Lens. 2022;48(3):100\u0026ndash;4. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/ICL.0000000000000867\u003c/span\u003e\u003cspan address=\"10.1097/ICL.0000000000000867\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYee RW. Matsuda M,Schultz RO,et al.Changes in the normal corneal endothelial cellular pattern as a function of age[J]. Curr Eye Res. 1985;4(6):671\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Orthokeratology, Highly Aspherical Lenslets, Axial length, Defocus, Corneal shaping force","lastPublishedDoi":"10.21203/rs.3.rs-3852302/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3852302/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo compare the control effectiveness and periretinal defocus between orthokeratology(OK) and highly aspherical lenslets(HAL) in adolescents with myopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this prospective study, 211 children( 211 eyes) were enrolled in Beijing Ming Vision and Ophthalmology between October 2022 and February 2023. According to the myopic correction method, the children were divided into three subgroups: OK, HAL, and Single-Vision spectacles (SVS); according to the spherical equivalent (SE), they were further divided into two subgroups: A-1.0 ≤ SE≤-2.0D, B-2.0\u003cem\u003e\u0026lt;\u003c/em\u003eSE≤-3.0 D.All children were followed up for12mo,and the changes in axial length and periretinal defocus before and after treatment were recorded and the factors affecting the corneal shaping force for one day post-OK were analyzed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAL growth in the OK and HAL was lower than that in the SVS after 6,9,12mo. Comparison of the difference in the amount of AL change between OK and HAL: 6mo( Z=-1.367 ,P = 0.317) ; 9mo(Z=-1.45, P = 0.211) ;12mo( Z=-1.52, P = 0.365 ), the difference was not statistically significant with (-1.0 ≤ SE≤-2.0D). The myopic defocus of RDV270-300° in the HAL subgroup was higher than that in the OK subgroup(Z = 1.382,P = 0.016),and in other areas,the myopic defocus was higher in the OK subgroup. Em,SRI ,and corneal thickness were significantly associated with shaping force.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOK is one of the most effective optical treatments for controlling myopia and the factors that affect the corneal shaping force under different corneal parameters are different.For mild myopia, HAL can achieve the same effectiveness as OK.\u003c/p\u003e","manuscriptTitle":"Comparison of the Myopia Control Effectiveness and Defocus of OK and HAL in Adolescents","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-18 15:55:17","doi":"10.21203/rs.3.rs-3852302/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"931f542a-98c8-4120-b5a1-1506c4148c22","owner":[],"postedDate":"January 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-04-22T05:25:00+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-18 15:55:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3852302","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3852302","identity":"rs-3852302","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}