PDF(Pubmed)
Abstract：
BACKGROUND: This meta-analysis reviews the evidence for the risks and benefits associated with orthokeratology (OK) treatment compared with other methods of myopia control in children and adults.
METHODS: A systematic search of Cochrane Central Register of Controlled Trials, Pubmed, Embase and Ovid was conducted from database inception to 22nd August 2021. Studies that reported on risks, visual and ocular biometric effects of OK in patients > 5 years of age with myopia (- 0.75 to - 6.00D) were included. Main outcomes are change in axial length and any adverse event.
RESULTS: Fourty-five papers were included in this systematic review and meta-analysis. The quality of data was variable and of moderate certainty, and selection bias likely skewed the results towards a relative benefit for OK. The rate of axial elongation in children was lower for OK treatment compared to other treatment modalities at one year (MD - 0.16 mm, 95% CI - 0.25 to - 0.07). Rate of change in axial length in children rebounded after OK discontinuation compared to participants who continued treatment (MD 0.10 mm, 95% CI 0.06 to 0.14). Adults and children wearing OK were up to 3.79 times more likely to experience an adverse event when compared with conventional contact lenses (OR 3.79, 95% CI 1.24 to ll.), though this evidence base is underdeveloped and requires additional well-designed studies for substantial conclusions to be drawn.
CONCLUSIONS: OK arrests myopia progression while in use, however, there remain unanswered questions about the optimal duration of treatment, discontinuation effects and long-term risk for adverse events.
METHODS: A systematic search of Cochrane Central Register of Controlled Trials, Pubmed, Embase and Ovid was conducted from database inception to 22nd August 2021. Studies that reported on risks, visual and ocular biometric effects of OK in patients > 5 years of age with myopia (- 0.75 to - 6.00D) were included. Main outcomes are change in axial length and any adverse event.
RESULTS: Fourty-five papers were included in this systematic review and meta-analysis. The quality of data was variable and of moderate certainty, and selection bias likely skewed the results towards a relative benefit for OK. The rate of axial elongation in children was lower for OK treatment compared to other treatment modalities at one year (MD - 0.16 mm, 95% CI - 0.25 to - 0.07). Rate of change in axial length in children rebounded after OK discontinuation compared to participants who continued treatment (MD 0.10 mm, 95% CI 0.06 to 0.14). Adults and children wearing OK were up to 3.79 times more likely to experience an adverse event when compared with conventional contact lenses (OR 3.79, 95% CI 1.24 to ll.), though this evidence base is underdeveloped and requires additional well-designed studies for substantial conclusions to be drawn.
CONCLUSIONS: OK arrests myopia progression while in use, however, there remain unanswered questions about the optimal duration of treatment, discontinuation effects and long-term risk for adverse events.
摘要：
背景：这项荟萃分析回顾了与儿童和成人近视控制的其他方法相比，与角膜塑形术（OK）治疗相关的风险和收益的证据。
方法：对Cochrane中央对照试验登记册的系统搜索，Pubmed,Embase和Ovid从数据库成立到2021年8月22日进行。报告风险的研究，纳入了5岁以上近视(-0.75~-6.00D)患者OK的视觉和眼部生物统计学效应。主要结果是轴向长度的变化和任何不良事件。
结果：本系统综述和荟萃分析包括45篇论文。数据的质量是可变的，具有中等的确定性，选择偏差可能会使结果偏向于对OK的相对好处。一年时，与其他治疗方式相比，OK治疗儿童的轴向伸长率较低（MD-0.16mm，95%CI-0.25至-0.07）。与继续治疗的参与者相比，中止OK后儿童的轴向长度变化率反弹（MD0.10mm，95%CI0.06至0.14)。与常规隐形眼镜相比，佩戴OK的成人和儿童发生不良事件的可能性高出3.79倍（OR3.79，95％CI1.24至11。),尽管这个证据基础不发达，需要额外的精心设计的研究才能得出实质性的结论。
结论：可以在使用过程中阻止近视进展，然而,关于最佳治疗持续时间的问题仍然没有答案，停药效果和不良事件的长期风险。
方法：对Cochrane中央对照试验登记册的系统搜索，Pubmed,Embase和Ovid从数据库成立到2021年8月22日进行。报告风险的研究，纳入了5岁以上近视(-0.75~-6.00D)患者OK的视觉和眼部生物统计学效应。主要结果是轴向长度的变化和任何不良事件。
结果：本系统综述和荟萃分析包括45篇论文。数据的质量是可变的，具有中等的确定性，选择偏差可能会使结果偏向于对OK的相对好处。一年时，与其他治疗方式相比，OK治疗儿童的轴向伸长率较低（MD-0.16mm，95%CI-0.25至-0.07）。与继续治疗的参与者相比，中止OK后儿童的轴向长度变化率反弹（MD0.10mm，95%CI0.06至0.14)。与常规隐形眼镜相比，佩戴OK的成人和儿童发生不良事件的可能性高出3.79倍（OR3.79，95％CI1.24至11。),尽管这个证据基础不发达，需要额外的精心设计的研究才能得出实质性的结论。
结论：可以在使用过程中阻止近视进展，然而,关于最佳治疗持续时间的问题仍然没有答案，停药效果和不良事件的长期风险。
