Axial Length Shortening after Combined Repeated Low‐Level Red‐Light Therapy in Poor Responders of Orthokeratology in Myopic Children

Abstract

Purpose. To investigate the efficacy and safety of orthokeratology (ortho‐k) and repeated low‐level red‐light (RLRL) therapy in treating poor responders of ortho‐k in myopic children. Methods. Study participants were 100 myopic children who completed two years of ortho‐k treatment in a retrospective study. In the first year of ortho‐k treatment (phase one), they experienced axial elongation of 0.30 mm or greater (defined as poor responders to ortho‐k). Children were divided into two groups: the orthokeratology group (OK, n = 45) continued to receive ortho‐k monotherapy and the combination group (OK‐RLRL, n = 55) received RLRL in addition to ortho‐k for the next year (phase two). Axial elongation over time between the groups was compared. Results. The mean age, male‐to‐female ratio, axial length (AL), and axial elongation in phase one were comparable between OK and OK‐RLRL groups (all P > 0.05). During phase two, significant AL shortening was observed in the OK‐RLRL group compared with children in the OK group (−0.10 ± 0.16 mm vs 0.30 ± 0.19 mm, P < 0.001). Among these 55 myopic children in the OK‐RLRL group, 35 (63.6%), 25 (45.4%), 11 (20%), 6 (10.9%), and 3 (5.4%) of them had AL shortening over 0.05 mm/year, 0.10 mm/year, and 0.20 mm/year, 0.3 mm/year, and 0.4 mm/year, respectively. Older baseline age (β = −0.02), higher treatment compliance (β = −0.462), and AL change at 1 month (β = 1.263) were significantly associated with less AL elongation (all P < 0.05). Conclusions. For poor responders of orthokeratology, RLRL could slow axial elongation in addition to the ortho‐k treatment effect. Those who respond poorly to ortho‐k with elder age might benefit more from combined therapy.