Abstract:

Objective To investigate the effect of orthokeratology combined with visual training（OCVT） on accommodation in myopic children without symptomatic dysfunction. Design Prospective case series.  Participants 120 children without symptomatic dysfunction, average ages 11.18±1.89 years, average spherical equivalent refraction-3.17±1.13 diopters(D). Methods All subjects were divided into three groups according to their selected therapy in clinic, including OCVT group (37 cases), orthokeratology group (Ortho-k, 43 cases) and single vision spectacle lense group (SVL, 40 cases). These subjects were followed up at least for 12 months. The changes of accommodation from baseline visit to 12-month visit were compared between the three groups. A more detailed analysis by median age were made in the OCVT group. Main Outcome Measures Accommodative amplitude (AA), accommodative sensitivity (AS), accommodative lag (Lag), negative relative accommodation (NRA) and positive relative accommodation (PRA). Results A total of 103 participants completed the study, which including 31 cases in OCVT group, 37 cases in Ortho-k group and 35 cases in SVL group. The baseline of AA, AS, Lag, NRA, PRA were（14.21±2.05）D,（8.87±1.80）cpm,（0.71±0.38）D,（1.80±0.38）D,（-1.85±0.42）D in the OCVT group respectively.  After 1 year intervention, AA, AS, Lag, NRA, PRA improved to（15.34±2.16）D,（11.16±2.18）cpm,（0.31±0.27）D,（2.15±0.35）D,（-2.08±0.45）D respectively, the improvement effect was better than that of the Ortho-k group and the SVL group（all P＜0．05）. When split by median age group, the changes in AA, AS, Lag, NRA, PRA of younger subjects and older subjects were not significantly different（all P＞0.05）. Conclusion  OCVT is a good way to improve the accommodation of myopic children without symptomatic dysfunction, but the best type and time of the visual training need further research.

Key words: orthokeratology, visual training, accommodation, children