How Orthokeratology Affects Accommodative Response and Binocular Vision: A Systematic Review and Meta-Analysis

Area of Science:

• Ophthalmology
• Optometry
• Vision Science

Background:

• Orthokeratology (OK) is used to slow myopia progression, but its impact on accommodation is debated.
• Understanding OK's effect on accommodation is crucial for its role in myopia control.

Purpose of the Study:

• To systematically review and meta-analyze the influence of Orthokeratology on accommodative response in myopic patients.
• To evaluate OK's effect on accommodation lag (AL), positive relative accommodation, and accommodation amplitude (AA).

Main Methods:

• Searched Cochrane, Embase, and PubMed for studies up to April 2024.
• Included 14 studies (1,404 patients) comparing OK with control groups.
• Analyzed accommodation lag, positive relative accommodation, and accommodation amplitude using meta-analysis.

Main Results:

• Orthokeratology significantly reduced accommodation lag at 3 months (MD: -0.38D).
• Orthokeratology significantly increased accommodation amplitude at 12 months (MD: 0.64D).
• No significant differences in positive relative accommodation were found at 3 months.

Conclusions:

• Orthokeratology effectively reduces accommodation lag and enhances accommodation amplitude over time.
• These accommodative changes suggest a mechanism for OK's efficacy in myopia control.
• OK positively influences the accommodative response in myopic individuals.