Japanese Journal of Ophthalmology

, Volume 62, Issue 5, pp 544–553 | Cite as

Additive effects of orthokeratology and atropine 0.01% ophthalmic solution in slowing axial elongation in children with myopia: first year results

  • Nozomi Kinoshita
  • Yasuhiro Konno
  • Naoki Hamada
  • Yoshinobu Kanda
  • Machiko Shimmura-Tomita
  • Akihiro Kakehashi
Clinical Investigation



To investigate the additive effects of orthokeratology (OK) and atropine 0.01% ophthalmic solution, both of which are effective procedures to slow axial elongation in children with myopia.

Study design

Prospective randomized clinical trial.


Japanese children aged 8–12 years with a spherical equivalent refractive error of − 1.00 to − 6.00 diopters were included. A total of 41 participants who had been wearing the OK lenses successfully for 3 months were randomly allocated into two groups to receive either the combination of OK and atropine 0.01% ophthalmic solution (combination group) or monotherapy with OK (monotherapy group). Subjects in the combination group started to use atropine 0.01% ophthalmic solution once nightly from 3 months after the start of OK. Axial length was measured every 3 months using non-contact laser interferometry (IOLMaster), and the axial length measurement at month 3 of OK therapy was used as the baseline value in both groups. The increase in axial length over 1 year was compared between the two groups.


A total of 40 consecutive subjects (20 subjects in the combination group and 20 in the monotherapy group) were followed for 1 year. The increase in axial length over 1 year was 0.09 ± 0.12 mm in the combination group and 0.19 ± 0.15 mm in the monotherapy group (P = 0.0356, unpaired t test).


During the 1-year follow-up, the combination of OK and atropine 0.01% ophthalmic solution was more effective in slowing axial elongation than OK monotherapy in children with myopia.


Orthokeratology Atropine 0.01% ophthalmic solution Additive effects Axial length Myopia 



The authors thank Shigeto Shimmura, MD (Keio University School of Medicine) for English editing, and J-SENSATION (Jichi Medical University) for their editing support. This study was supported by JSPS KAKENHI Grant Number JP26462646 from the Japan Society for the Promotion of Science.

Conflicts of interest

N. Kinoshita, None; Y. Konno, None; N. Hamada, None; Y. Kanda, None; M. S. -Tomita, None; A. Kakehashi, None.


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Copyright information

© Japanese Ophthalmological Society 2018

Authors and Affiliations

  1. 1.Department of Ophthalmology, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
  2. 2.Konno Eye ClinicSaitamaJapan
  3. 3.Omiya Hamada Eye ClinicSaitamaJapan
  4. 4.Department of Hematology, Saitama Medical CenterJichi Medical UniversitySaitamaJapan

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