AIM: To observe the effect of combining partial reduction orthokeratology(Ortho-K)and spectacles on slowing myopic progressionin high myopic adolescent.

METHODS: Sixty-nine eyes of 36 high myopic adolescent(aged 9～15 years)with spherical equivalent refraction ≥-6.00 diopters(D)(spherical component ≥-5.50D)were fitted with custom-made four-zone/five-curve Ortho-K lenses. The target of reduction was to achieve -5.00D for both eyes. The residual refractive errors after at least one month of Ortho-K wear were corrected with single-vision spectacles for clear vision in the daytime. The unaided visual acuity(UVA), refractive error(RE), axial length(AL), and ocular health were assessed before the Ortho-K lens wear, and followed up for 2a after Ortho-K.

RESULTS:(1)Changes in UVA: The mean UVA was 0.09±0.05 at baseline before Ortho-K; the mean UVA was 0.27±0.14, 0.54±0.18, 0.78±0.24, and 0.81±0.19, respectively after Ortho-K wear for l night, 1wk, 1, and 3mo. The differences of UVA were significant with baseline(P<0.05), and became stable 1mo after the treatment.(2)Changes in RE: The mean RE was -6.82±0.71D at baseline before Ortho-K and -6.86±0.77D after Ortho-K wear for 1a(P>0.05 compared to baseline). The mean RE was -7.11±0.81D after Ortho-K wear for 2a, and the amount of myopia increased -0.29±0.37D compared to baseline(P<0.05).(3)Changes in AL: The mean AL was 26.18±0.57mm at baseline before Ortho-K, and it was not significantly different(P>0.05)from the AL after Ortho-K wear for 6mo(26.19±0.54mm)and for 1a(26.21±0.47mm). The AL was 26.37±0.59mm after Ortho-K wear for 2a, and the mean increase was 0.19±0.28mm compared to baseline(P<0.05).(4)Grade 1 corneal staining was observed in some subjects at each visit. However, the staining was improved after lens cleaning, discontinuing lens wear, or applying artificial tears. No other adverse events were reported in all subjects during the 2a study.

CONCLUSION:Combining partial reduction Ortho-K and spectacles completely slowed myopic progression in high myopic adolescent after receiving the treatment for 1a, and partially reduced myopia progression after 2a of treatment. No severe ocular complications were found throughout the treatment. The combination treatment appeared to be effective and safe, but its long-term effect needs to be further assessed.