Investigation into the Therapeutic Efficacy and Inflammatory Modulatory Effects of the Combined Use of 0.01% Atropine Eye Drops and Orthokeratology Lenses in the Management of Myopia Among Adolescent Patients.

OBJECTIVE

To evaluate the therapeutic efficacy and inflammatory modulatory effects of combined 0.01% atropine eye drops and orthokeratology (OK) lenses in controlling myopia progression among adolescent patients.

METHODS

This retrospective study analyzed clinical data from 90 adolescent patients (90 eyes) with myopia treated from April 2021 to June 2023. Patients were divided into two groups: control group (n=45, treated with OK lenses alone) and observation group (n=45, treated with OK lenses combined with 0.01% atropine). Baseline and 1-year post-treatment measurements included refractive status, axial length (AL), corneal parameters, ocular surface indices, tear film stability, endothelial cell morphology, inflammatory cytokine levels in tears, and incidence of adverse events.

RESULTS

After 1 year, both groups showed myopic progression, but the observation group exhibited significantly less axial elongation (0.12 ± 0.08 mm vs 0.21 ± 0.09 mm; p < 0.001) and smaller increases in refractive error (p < 0.001). Corneal curvature and central corneal thickness were also significantly lower in the observation group (p < 0.05). The pupil diameter increased more in the observation group (p = 0.002), consistent with atropine's pharmacologic effect. Ocular surface damage was less severe, with lower OSDI (p = 0.002) and staining scores (p < 0.001). Tear film stability was better preserved, as reflected by higher NIBUT and TBUT values (p < 0.05). No significant differences in endothelial cell density or hexagonality were observed (p > 0.6). Tear cytokine levels (IL-1β, IL-6, TNF-α) increased in both groups but were significantly lower in the observation group (all p < 0.01). The incidence of adverse reactions was low and comparable between groups (p = 0.235), with no severe events reported.

CONCLUSION

The combination of 0.01% atropine eye drops with orthokeratology lenses is more effective than orthokeratology alone in controlling myopia progression and mitigating ocular surface inflammation in adolescents, without increasing adverse effects.