Open Access Highly Accessed Research article

Overnight orthokeratology is comparable with atropine in controlling myopia

Hui-Ju Lin123, Lei Wan12, Fuu-Jen Tsai12, Yi-Yu Tsai3, Liuh-An Chen13, Alicia Lishin Tsai3 and Yu-Chuen Huang12*

Author Affiliations

1 Department of Medical Research, China Medical University Hospital, No. 2 Yuh Der Road, Taichung 404, Taiwan

2 School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan

3 Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan

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BMC Ophthalmology 2014, 14:40  doi:10.1186/1471-2415-14-40

Published: 31 March 2014



Many efforts have been invested in slowing progression of myopia. Among the methods, atropine administration and orthokeratology (OK) are most widely used. This study analyzed the efficacy of atropine and OK lens in controlling myopia progression and elongation of axial length.


This retrospective study included 105 patients (210 eyes) who wore OK lenses and 105 patients (210 eyes) who applied 0.125% atropine every night during the 3 following period. Student t-test, linear regression analysis, repeated measure ANOVA, and Pearson’s correlation coefficient were used for statistical analysis.


The change in axial length per year was 0.28 ± 0.08 mm, 0.30 ± 0.09 mm, and 0.27 ± 0.10 mm in the OK lens group, and 0.38 ± 0.09 mm, 0.37 ± 0.12 mm, and 0.36 ± 0.08 mm in the atropine group for years 1, 2, and 3, respectively. Linear regression analysis revealed an increase in myopia of 0.28 D and 0.34 D per year, and an increase in axial length of 0.28 mm and 0.37 mm per year in the OK lens and atropine groups, respectively. Repeated measure ANOVA showed significant differences in myopia (p = 0.001) and axial length (p < 0.001) between the atropine and OK lens groups; in astigmatism, there was no significant difference in these parameters (p = 0.320). Comparison of increases in axial length in relation to baseline myopia showed significant correlations both in the OK lens group (Pearson’s correlation coefficient, r = 0.259; p < 0.001) and atropine group (r = 0.169; p = 0.014). High myopia patients benefited more from both OK lenses and atropine than did low myopia patients. The correlation of baseline myopia and myopia progression was stronger in the OK lens group then in the atropine group.


OK lens is a useful method for controlling myopia progression even in high myopia patients.

Atropine; Axial length; Cornea endothelium; Myopia; Orthokeratology