Combined Orthokeratology and Low-Dose Atropine for Myopia Control in Children: A 12-Month Retrospective Clinical Study.

The increasing prevalence of childhood myopia and its association with vision-threatening complications have made myopia control a major public health concern. Orthokeratology lenses and low-dose atropine eye drops are commonly used interventions for slowing axial elongation in myopic children. This retrospective clinical study evaluated the effectiveness of combining orthokeratology lenses with 0.01% atropine eye drops over 12 months. Medical records of 60 children aged 8-12 years treated between June 2022 and December 2024 at Qichun County People's Hospital, China, were reviewed. Thirty children received combination therapy, while 30 received orthokeratology alone. Baseline demographic and ocular biometric parameters were comparable between groups. Follow-up examinations were performed every 3 months and included cycloplegic refraction, axial length measurement, pupil diameter evaluation, and accommodative assessment. The primary outcome was 12-month axial elongation. Mean axial elongation was significantly lower in the combination group than in the Orthokeratology-only group (0.10 ± 0.14 mm vs 0.20 ± 0.15 mm; p = 0.01). Multivariate regression analysis showed that combination therapy was independently associated with reduced axial elongation (β = -0.10; 95% CI: -0.17 to -0.03; p = 0.02). The combination group showed a significant increase in pupil diameter during the first 4 months, while accommodative amplitude remained stable in both groups. No serious treatment-related adverse events were observed. These findings suggest that combining orthokeratology with low-dose atropine may provide additional benefit in slowing the progression of childhood myopia, although larger prospective studies are needed to confirm long-term efficacy and safety.