Title: Investigation into the therapeutic efficacy and inflammatory modulatory effects of the combined use of 0.01% atropine eye drops and orthokeratology lenses in the management of myopia among adolescent patients
Abstract:
Objective: To evaluate the therapeutic efficacy and inflammatory modulatory effects of combining 0.01% atropine eye drops with orthokeratology (OK) lenses for controlling myopia progression and improving ocular surface health in adolescents.
Methods: This retrospective study analyzed clinical data from 90 adolescent patients (90 eyes) with myopia treated between April 2021 and June 2023. Patients were divided into a control group receiving orthokeratology lenses alone (n=45) and an observation group receiving orthokeratology combined with 0.01% atropine eye drops (n=45). Clinical outcomes before and after one year of treatment included refractive status, axial length (AL), corneal parameters, pupil diameter, ocular surface indices, tear film stability, corneal endothelial characteristics, tear inflammatory cytokines, and adverse events.
Results: After one year, both groups showed myopic progression; however, the combination therapy group demonstrated significantly better myopia control. Axial length elongation was significantly lower in the observation group compared with the control group (0.12 ± 0.08 mm vs 0.21 ± 0.09 mm, P<0.001). The observation group also showed smaller increases in refractive error, reduced corneal curvature and central corneal thickness changes, and greater pupil diameter increase. Ocular surface outcomes were improved, with lower OSDI scores (15.6 ± 3.8 vs 18.2 ± 4.3, P=0.002) and lower corneal staining scores (1.8 ± 0.7 vs 2.6 ± 0.9, P<0.001). Tear film stability was better preserved, with higher NIBUT and TBUT values. No significant differences were observed in corneal endothelial cell density or hexagonality. Tear inflammatory cytokines, including IL-1β, IL-6, and TNF-α, increased after treatment in both groups but were significantly lower in the combination therapy group (all P<0.01). Adverse reactions were mild and comparable between groups.
Conclusion: The combined use of 0.01% atropine eye drops and orthokeratology lenses provides superior myopia control compared with orthokeratology alone, while improving ocular surface stability and reducing inflammatory responses without increasing safety risks. This combination therapy may represent an effective and comprehensive strategy for adolescent myopia management.
