Does orthokeratology cure myopia?

Question

This 2013 study found:

Soft multifocal contact lens wear resulted in a 50% reduction in the progression of myopia and a 29% reduction in axial elongation during the 2-year treatment period compared to a historical control group. Results from this and other investigations indicate a need for a long-term randomized clinical trial to investigate the potential for soft multifocal contact lens myopia control.

Yet the website of the The American Academy of Ophthalmology appears to doubt this: (All bolds are mine)

You may have heard of a process called orthokeratology to treat myopia. It uses a series of hard contact lenses to gradually flatten the cornea and reduce the refractive error. Improvement of sight from orthokeratology is temporary.

Answer 1

Evidence:

1. Orthokeratology may slow myopia progression in children referring to a meta-analytic study by Si JK et.al. in 2015.

Conclusions: Our results suggest that orthokeratology may slow myopia progression in children. Further large-scale studies are needed to substantiate the current result and to investigate the long-term effects of orthokeratology in myopia control.

2. Orthokeratology has significantly greater efficacy in controlling axial elongation in children compared to spectacle correction referring to a meta-analytic study by Li SM et.al. in 2015.

Conclusions: The safety and acceptability results are good, and there appears to be a greater myopia control effect in Chinese children compared to Caucasians, and in those with higher initial myopia.

3. Orthokeratology was found to be effective and acceptable for slowing myopic progression in children with careful education and monitoring referring to a meta-analytic study by Daizong Wen et.al. in 2015

In conclusion, with careful education and observation, OK lens use is effective and acceptable for slowing myopic progression in children. Moreover, as the efficacy on myopic control by OK lenses reduces with increasing age, early intervention with OK in young children may be worth considering to reduce the prevalence of high myopia. Further well-organized, randomized, and prospective studies with larger sample size and longer follow-up periods are required to confirm the findings described herein.

4. Orthokeratology could slow myopia progression in school-aged children referring to a meta-analytic study by Yuan Sun et.al. in 2015.

In summary, ortho-k slows myopia progression in school-aged children. However, no studies had assessed a large number of participants. Further research should be conducted to assess the effects of ortho-k on myopic control compared with other interventions, such as atropine; RCTs would be especially informative in clarifying the effects of this treatment.

5. Per CRIMPS analysis of the effect of orthokeratology on childhood myopic refractive stability by Downie LE et.al. in 2013, orthokeratology might reduce the rate of progression of childhood myopia over the long term.

RESULTS: On the whole, OK eyes showed a significantly (P<0.05) more stable myopic refractive prescription than control eyes over all of the 2-year treatment intervals. A subpopulation (n=18; 64%) of OK eyes demonstrated an apparent total arrest of manifest myopic refractive change. Symmetry in the vertical meridian of baseline corneal topography was associated with a greater degree of refractive stability in OK eyes.

6. Per Jeffrey J Walline in 2011, highly nearsighted people are at greater risk of several vision-threatening problems such as retinal detachments, choroidal atrophy, cataracts and glaucoma in the future.

The most likely effective treatment to slow myopia progression thus far is anti-muscarinic topical medication. However, side effects of these medications include light sensitivity and near blur. Also, they are not yet commercially available, so their use is limited and not practical. Further information is required for other methods of myopia control, such as the use of corneal reshaping contact lenses or bifocal soft contact lenses (BSCLs) with a distance center are promising, but currently no published randomized clinical trials exist.

Meaning:

1. Nearsightedness a symptom of myopia causes blurry vision when looking at distant objects. The leading potential treatments are corneal reshaping contact lenses or bifocal soft contact lenses (BSCLs) with a distance center, but more evidence is needed by researchers in order to conclude their abilities to slow myopia progression.

2. Orthokeratology, using reverse geometry designed lenses, has been shown to be moderately effective in decreasing the progression of myopia by between 30 to 50% in a number of short-term, well-controlled studies, reducing myopia progression to between -0.25 and -0.35 D/year per Cooper J in 2012. Future large randomized studies are needed to substantiate small study results and to investigate the long-term effects of orthokeratology in myopia control.

Please note that this answer does not constitute medical advice. It is only meant to summarize published research related to the topic and limited to the cited sources. Consult your physician about what these results may mean for your health.