Orthokeratology (ortho-k) lenses appear to slow myopia progression in children and adolescents for at least three years, according to a systematic review and meta-analysis published in International Ophthalmology.
Researchers from the 967th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army analysed 15 prospective studies published between 2014 and 2025, including 1,065 children aged 9 to 13.4 years with baseline myopia ranging from -1.00 to -8.75 D.
The review found that overnight ortho-k lens treatment reduced axial elongation by 0.15 mm in the first year compared with single-vision spectacles or soft contact lenses. This effect persisted through 24 to 36 months, with axial length reduction ranging from 0.19 mm to 0.26 mm in longer-term analyses. The authors noted this reduction corresponds to an estimated 0.37–0.38 D per year, representing a clinically meaningful slowing of myopia progression.
Subgroup analyses showed the greatest benefits in randomised controlled trials and paired-eye studies, while modified ortho-k lens designs – particularly aspheric lenses – demonstrated additional reduction in axial elongation compared with conventional lenses.
“Overnight orthokeratology slows axial-length growth in myopic children by about 0.15 mm during the first year, and a measurable benefit of approximately 0.20 mm persists for at least two to three years,” the researchers said.
They highlighted the correlation between axial elongation and myopic progression, noting that even small reductions in axial length can have significant clinical relevance in paediatric myopia management.
The study authors cautioned that 13 of the 15 included trials were conducted in Asia, which may limit the generalisability of the findings to other populations.
Reference: Dong X, Li W, Liu H. Effectiveness of orthokeratology in controlling myopia in adolescents aged 6–18 years: a systematic review and meta‑analysis. Int Ophthalmol. Published online January 31, 2026. doi:10.1007/s10792-026-03976-1
