AIM: To evaluate the published researches on the efficacy of atropine eye drops with different concentrations in delaying the progression of myopia in children and adolescents.

METHODS: Randomized controlled trials(RCT)in PubMed, the Cochrane Library, Embase, CNKI, VIP and WanFang Data databases were retrieved from the creation to May 2022. The quality of the included literature was evaluated by using the bias risk evaluation tool in Cochrane Intervention System Evaluation Manual. Meta-analysis was carried out via Review Manager 5.4.

RESULTS: A total of 14 RCT studies, involving 3 946 children and adolescents. Meta-analysis showed that compared with the control group, atropine eye drops with different concentrations could delay the progression of myopia in children and adolescents. The growth of axial length of the groups with 1%, 0.5%, 0.05%, 0.02% and 0.01% atropine eye drops respectively was lower than that of the control group, the difference was statistically significant(MD=-0.34, 95%CI:-0.39～-0.29, P<0.00001; MD=-0.51, 95%CI:-0.79～-0.24, P=0.0003; MD=-0.17, 95%CI:-0.30～-0.04, P=0.01; MD=-0.21, 95%CI:-0.30～-0.11, P<0.0001; MD=-0.09, 95%CI:-0.13～-0.05, P<0.0001), while the growth of axial length of group with 0.1% atropine eye drops was lower than that of control group, the difference was not statistically significant(MD=-0.50, 95%CI:-1.28～0.28, P=0.21).

CONCLUSION: Atropine eye drops with different concentrations can effectively delay the progression of myopia in children and adolescents, while 0.01% can delay the progression of myopia with the lowest incidence of adverse reactions.