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Compliance with orthokeratology lens wear: a systematic review and meta-analysis
Yanming Zhu1,2, Xingcheng Zhong3, Yongpeng Zhang4
1School of Medicine, Xiamen University, Xiamen, Fujian, 361102, China. 15160653726@163.com.
Purpose:
This study aims to systematically assess the level of compliance during orthokeratology lens (OK lens) wear among children and adolescents, and to analyze the potential related factors influencing compliance with OK lens wear, thereby providing evidence‑based support for standardized management in clinical settings.
Methods:
PubMed, Web of Science, Embase, Cochrane Library, CNKI, SinoMed, WanfangData, and VIP Database were systematically searched for relevant literature published from the inception of each database up to September 24, 2025. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Meta‑analysis, sensitivity analysis, subgroup analysis, and publication bias test were conducted using the software R.
Results:
In total, 26 studies were included. The follow‑up compliance rates at 1 week, 1 month, 3 months, 6 months, and 12 months were 96.93%, 92.05%, 83.55%, 67.73%, and 75.09%, respectively. The wearing compliance rates at 3 months and 12 months were 91.15% and 70.76%, respectively. The care and cleaning compliance rate was 84.72%. Overall compliance rate was 87.59%. Publication year and study design were initially considered as sources of heterogeneity and were examined through subgroup analyses. Follow‑up compliance rates in studies published between 2020 and 2025 were generally lower than those in studies published from 2010 to 2019. In interventional studies, the wearing compliance rate and the cleaning compliance rate in the experimental groups were significantly higher than those in the control groups (95.18% vs. 66.20%; 99.05% vs. 65.17%).
Conclusion:
Given the heterogeneity across studies in definitions and assessment time points, the pooled estimates should be interpreted with caution. Accordingly, the overall level of compliance with OK lens wear among children and adolescents is considered moderate to high. However, it tends to decline over time. In clinical practice, follow‑up management during the medium‑ and long‑term stages after OK lens wear should be strengthened, and long‑term standardized use of OK lenses among children should be ameliorated.