PURPOSE To review the published evidence to evaluate the ability of orthokeratology (Ortho-K) treatment to reduce myopic progression in children and adolescents compared with the use of spectacles or daytime contact lenses for standard refractive correction. METHODS Literature searches of the PubMed database, the Cochrane Library, and the databases of clinical trials were last conducted on August 21, 2018, with no date restrictions but limited to articles published in English. These searches yielded 162 citations, of which 13 were deemed clinically relevant for full-text review and inclusion in this assessment. The panel methodologist then assigned a level of evidence rating to the selected studies. RESULTS The 13 articles selected for inclusion include 3 prospective, randomized clinical trials; 7 nonrandomized, prospective comparative studies; and 3 retrospective case series. One study provided level I evidence, 11 studies provided level II evidence, and 1 study provided level III evidence. Most studies were performed in populations of Asian ethnicity. Change in axial length was the primary outcome for 10 of 13 studies and change in refraction was the primary outcome for 3 of 13 studies. In these studies, Ortho-K typically reduced axial elongation by approximately 50% over a 2-year study period. This corresponds to average axial length change values of approximately 0.3 mm for Ortho-K patients compared with 0.6 mm for control patients, which corresponds to a typical difference in refraction of approximately 0.5 diopters (D). Younger age groups and individuals with larger than average pupil size may have a greater effect with Ortho-K. Rebound can occur after discontinuation or change to alternative refractive treatment. CONCLUSIONS Orthokeratology may be effective in slowing myopic progression for children and adolescents, with a potentially greater effect when initiated at an early age (6-8 years). Safety remains a concern because of the risk of potentially blinding microbial keratitis from contact lens wear.

中文翻译：

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角膜塑形术在预防儿童近视进展中的应用：美国眼科学会的一份报告。

目的回顾已发表的证据，评估与使用眼镜或日间隐形眼镜进行标准屈光矫正相比，角膜塑形术（Ortho-K）治疗减少儿童和青少年近视进展的能力。方法对PubMed数据库，Cochrane图书馆和临床试验数据库进行的文献检索最后一次于2018年8月21日进行，没有日期限制，但仅限于以英文发表的文章。这些检索产生了162次引用，其中13次被认为与全文审查和临床评估有关。然后，小组方法学家为所选研究指定了证据等级。结果入选的13篇文章包括3项前瞻性，随机临床试验；7项非随机，前瞻性比较研究；和3个回顾性案例系列。一项研究提供了I级证据，11项研究提供了II级证据，1项研究提供了III级证据。大多数研究是在亚洲人的人群中进行的。轴向长度变化是13项研究中10项的主要结果，屈光度变化是13项研究中3项的主要结果。在这些研究中，Ortho-K通常在2年的研究期间内将轴向伸长率降低了约50％。这对应于Ortho-K患者的平均轴向长度变化值约为0.3毫米，而对照患者的平均轴向长度变化值为0.6毫米，这对应于约0.5屈光度（D）的典型屈光差异。较年轻的年龄组和个体大于平均瞳孔大小的人可能对Ortho-K产生更大的影响。停药或改用其他屈光治疗后可发生反弹。结论角膜塑形术可有效减缓儿童和青少年的近视进展，并在早期（6-8岁）开始可能具有更大的作用。由于隐形眼镜的佩戴可能会使微生物角膜炎致盲，因此安全仍然是个问题。