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A multicenter clinical trial of orthokeratology in school-aged children and adolescents in Japan



This study investigated the safety and efficacy of orthokeratology in myopic children in Japan.

Study design

Prospective clinical trial.


This study enrolled myopic children aged 6–16 years with a spherical equivalent of −1.00 D to −4.00 D and astigmatism of −1.5 D or lower, whose parents could manage contact lens use and could provide written informed consent. The children were treated with orthokeratology lenses (BREATH-O CORRECT R, Universal View Co., Ltd.) for 3 years. Slit-lamp findings, visual acuity, intraocular pressure, subjective refraction, corneal topography, corneal endothelial cell density, corneal thickness, and axial length were regularly assessed.


This study included 96 eyes of 48 patients (average age, 10.7 ± 2.08 years). The average baseline spherical equivalent was −2.46 ± 0.97 D. The average baseline uncorrected visual acuity was 0.74 ± 0.32 logMAR, with significant improvement to −0.08 ± 0.18 logMAR at 4 weeks and 0.02 ± 0.21 logMAR at 3 years (both p < 0.001, Dunnett’s test). The average baseline corneal endothelial cell density was 3053 ± 181 cells/mm2 and 3028 ± 213 cells/mm2 at postoperative 3 years (p = 0.9933, Dunnett’s test). The average axial length was 24.70 ± 0.78 mm at baseline, 24.77 ± 0.80 mm at 12 weeks, and 25.32 ± 0.85 mm at 36 months. Although mild corneal epithelial disorders occurred in 18% of eyes, they were successfully treated with eye drops, enabling resumption of lens usage. No serious adverse events were observed.


Orthokeratology lens (BREATH-O CORRECT R) use in children demonstrated good efficacy and safety during 3 years of follow-up.

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The authors thank Xiaodong Zheng, MD, PhD (Ehime University School of Medicine) for his invaluable advice and assistance on this paper.

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Corresponding author

Correspondence to Tomoko Goto.

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Conflict of interest

T. Goto, None; A. Shiraishi, None; Y. Ohashi, None; K. Negishi, Grant, Financial support (RE Medical, Bausch + Lomb, Wakamoto, TORAY, Universal View, Fuji Xerox), Grant, Honorarium for Lecturing, Financial support (HOYA, AMO, Kowa, Senju, Santen, Alcon), Grant, Honorarium for Lecturing (M3, Chuo Sangio, Otsuka, Qualitas, NIDEK), Tsubota Laboratory and the author are applicant for the patent of potential products for myopia suppression; K. Tsubota, Executive (Tsubota Laboratory); Y. Nakamura, None; O. Hieda, None; C. Sotozono, Lecture fee (Otsuka, Santen, Senju, TOA); S. Kinoshita, Honorarium for Lecturing, Consulting (Santen, Senju, Otsuka), Honorarium for Lecturing (Kowa), Senju and the author own the patent for the use of ROCK inhibitor. CorneaGen and the author own the patent for the use of ROCK inhibitor. Santen and the author own the patent for glaucoma-related genes. Sysmex and the author are applicants for the patent for SJS-related genes.

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Corresponding Author: Tomoko Goto

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Goto, T., Shiraishi, A., Ohashi, Y. et al. A multicenter clinical trial of orthokeratology in school-aged children and adolescents in Japan. Jpn J Ophthalmol 65, 624–631 (2021).

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  • Orthokeratology
  • Minors
  • School-aged children
  • Safety
  • Axial length