Real-world Evaluation of the Effectiveness of Highly Aspherical Lenslets and Orthokeratology In Anisomyopic Children

To investigate the effectiveness of spectacle lenses with highly aspherical lenslets (HAL) and orthokeratology (ortho-k) for myopia control and the change in the interocular axial length (AL) difference in binocular anisomyopic children over 1-year in a real-world setting.

Retrospective analysis of 74 bilateral anisomyopes (8-14 years; 39 HAL, 35 ortho-k). Axial elongation (AE) and interocular AL difference were compared in both groups; spherical equivalent refraction (SER), spherical refraction (SR), refractive astigmatism (RA) and corneal astigmatism (CA) were evaluated for the HAL group.

AE in the more myopic eye (MME) of the HAL group was significantly greater than the ortho-k group (0.24 ± 0.17 vs. 0.15 ± 0.15 mm, p = 0.007). However, the opposite finding was observed in the less myopic eye (LME) (0.20 ± 0.14 vs. 0.29 ± 0.23 mm, p = 0.01). The interocular AL difference was reduced in the ortho-k group (0.69 ± 0.41 vs. 0.54 ± 0.32 mm, p = 0.007), whereas no significant change was found in the HAL group (p = 0.09). AE was associated with baseline SER (β = 0.08, p = 0.008) in the ortho-k group and age (β = -0.04, p = 0.001) in the HAL group. The MME in the HAL group showed larger changes in SER (-0.39 ± 0.31 vs. -0.27 ± 0.30 D) and CA (-0.21 ± 0.29 vs. -0.11 ± 0.25 D) than the LME (both p ≤ 0.03). The change in SER was positively associated with age and baseline SER (β = 0.08; β = 0.07, both p ≤ 0.02) in the HAL group.

Ortho-k reduced AE, more so in the MME and reduced the interocular AL asymmetry. HAL slowed AE symmetrically, with greater control in older and less-myopic children.