Purpose: To compare the effects of a two-year course of 0.01% atropine and OK on axial length (AL) and the ocular surface.
Methods: We conducted a retrospective study in 350 children aged 8–12 years with myopia attending the refractive error clinic of the Aier Eye Hospital of Shenzhen Shendong between May 2020 and Aug 2022. Participants with spherical equivalent (SE) values at the first visit between −1.00 diopters (D) and −3.00 D were assigned to the low myopia cohort and participants with SE between −3.00 D and −6.00 D were assigned to the moderate myopia cohort. Participants were then randomly assigned to receive spectacles and 0.01% atropine (SA group) or orthokeratology (OK group). Comprehensive ophthalmologic examinations were performed at three month intervals.
Results: After two years, lower AL values were observed in the OK group compared with the SA group in the low myopia cohort and the moderate myopia cohort. We observed 0.01% atropine was more effective in the second year than the first year; however, OK was more effective in the first year. No statistically significant differences were observed in Schirmer’s test (Schirmer) or tear film break-up time (TBuT) assessments between before and after treatment in either cohort.
Conclusions: The clinical efficacy of OK in controlling axial elongation was greater than 0.01% atropine regardless of the SE after two years of treatment. While 0.01% atropine was more effective in the second year, OK was more effective in the first year. Neither 0.01% atropine nor OK had a significant effect on Schirmer or TBuT values after two years.