Orthokeratology versus extended depth-of-focus soft contact lenses for myopia control: a 12-month comparative study...

To compare the efficacy of orthokeratology (OK) and extended depth-of-focus (EDOF) soft contact lenses in controlling myopia progression over a 12-month period.

Ambispective comparative study including 56 eyes from 28 myopic patients aged 6 to 16 years. Thirty eyes were fitted with EDOF soft contact lenses (prospective cohort), and 26 eyes with OK lenses (retrospective cohort). Axial length (AXL), spherical equivalent (SE), and binocular visual acuity (VA) were assessed at baseline, 6 months, and 12 months. Corneal parameters, including keratometry (K1,K2) and anterior chamber volume (ACV), were also evaluated.

AXL increased significantly over time in both groups (p < 0.001), with no significant differences between groups at any follow-up visit (all p > 0.05). Mean axial elongation at 12 months was 0.05 ± 0.09 mm in the EDOF group and 0.11 ± 0.10 mm in the OK group. These values are lower than those reported in untreated myopic children. A small but statistically significant myopic shift in SE was observed in the EDOF group over time (p < 0.001), whereas no significant refractive changes were detected in the OK group. Visual acuity remained stable in both groups throughout follow-up. Significant corneal changes were observed exclusively in the OK group, including reductions in K1 and K2 (p < 0.001) and a decrease in ACV (p < 0.05). Correlation analysis revealed that, in the OK group, baseline AXL and SE were significantly associated with axial elongation (p < 0.05), indicating a baseline-dependent treatment response.

Both OK and EDOF soft contact lenses were associated with reduced axial elongation over a 12-month period, with no significant differences in efficacy between treatments. OK demonstrated a distinct profile characterized by corneal remodelling and a response influenced by baseline ocular parameters, whereas EDOF lenses showed a structurally neutral and more consistent effect across patients.