Effects of Orthokeratology Combined with Acupuncture Treatment on Visual Quality,Corneal Transparency,and Endothelial Cells in Children Who Suffer from Mild to Moderate Myopia

Abstract

Objective

This study aimed to investigate the effects of orthokeratology combined with acupuncture on visual quality, corneal transparency, corneal endothelial cells, axial development, and ocular hemodynamics in children with mild to moderate myopia.

Methods

We adopted a prospective randomized controlled study design. A total of 92 children (184 eyes) with mild to moderate myopia admitted from December 2022 to January 2025 were the subjects of this study, and using a random number table method, we divided these subjects into a control group and an observation group randomly, and in each group, there were 46 cases (92 eyes). The control group was given orthokeratology lens fitting and routine wearing guidance; based on the control group, the observation group received acupuncture treatment (Sizhukong, Yuyao, Cuanzhu, Taiyang, Sibai, Fengchi, etc.), and both groups were treated and followed for 12 months. Visual function and refractive status indicators [uncorrected distance visual acuity (logMAR), diopter, axial length] and accommodative function indicators (accommodative amplitude, accommodative sensitivity) were measured before treatment (T₀), at 3 months (T₁), 6 months (T₂), and 12 months (T₃) after treatment. Ocular hemodynamic indicators [PSV (peak systolic velocity), EDV (end-diastolic velocity), RI (resistance index)], corneal morphological indicators [ECD (corneal endothelial cell density), AVG (average cell area), CV (coefficient of variation of cell area), HEX (percentage of hexagonal cells)], and corneal transparency were measured at T₀ and T₃, and safety was evaluated.

Results

This study included 92 cases (184 eyes), with 1 case lost to follow-up in the control group and 2 cases in the observation group. At T₁–T₃, compared with the control group, the axial length, axial growth, and uncorrected distance visual acuity in the observation group were lower (P < 0.05); the diopter, accommodative amplitude, and accommodative sensitivity were higher (P < 0.05). In comparison with the control group, at T₃, PSV and EDV were higher, and RI was lower (P < 0.05). In comparison with the control group, at T₃, ECD and HEX in the observation group were higher, and CV was lower (P < 0.05); no significant change was observed in endothelial parameters before and after treatment in the observation group (P > 0.05), while in the control group, ECD and HEX decreased compared with T₀ (P < 0.05). Between the two groups, no difference with any statistical significance was found in corneal transparency before and after treatment (P > 0.05), and no grade 2 or above opacity occurred in either group. In the two groups, the incidence of adverse events was 11.36% and 8.89%, respectively, with no statistically significant difference (P > 0.05).

Conclusion

Orthokeratology combined with acupuncture may improve visual and accommodative outcomes and help slow myopia progression in children with mild to moderate myopia. This combined approach also appeared to preserve corneal endothelial stability without adversely affecting corneal transparency during the study period.

Keywords

orthokeratology traditional Chinese acupuncture therapy children myopia visual quality

Get full access to this article

View all access options for this article.

References

Binxian

Chao

(2023). Analysis of the efficacy of orthokeratology lens wear in adolescents with myopia. Journal of Chongqing Medical University, 48(2), 201–204. https://doi.org/10.13406/j.cnki.cyxb.003053

Fengming

Lixin

(2014). Ophthalmology in China (3rd ed). People's Medical Publishing House.

Huixia

Xia

(2022). Effects of long-term orthokeratology lens wear on visual quality and bacterial infection in adolescents. Chinese Journal of School Health, 43(12), 1847–1850. https://doi.org/10.16835/j.cnki.1000-9817.2022.12.021

Jing

Hong

Mei

Ren

(2023). Study on the disease spectrum and indications of acupuncture for eye diseases based on data mining. Chinese Journal of Traditional Chinese Ophthalmology, 33(6), 519–524. https://doi.org/10.13444/j.cnki.zgzyykzz.2023.06.004

Jinhui

Yan

Hairong

Yuping

(2023). Effects of Shugan Liqi decoction combined with acupuncture on primary open-angle glaucoma of liver qi stagnation type and hemodynamics. Sichuan Traditional Chinese Medicine, 41(5), 174–177. https://doi.org/10.3969/j.issn.1000-3649.2023.5.sczy202305051

Naixin

Guoqiong

Biao

Yang

(2023). Evolution of the understanding of the etiology and pathogenesis of myopia in traditional Chinese medicine. Chinese Journal of Traditional Chinese Ophthalmology, 33(2), 196–200. https://doi.org/10.13444/j.cnki.zgzyykzz.2023.02.024

Ophthalmology Branch of China Association of Chinese Medicine. (2022). Clinical practice guideline for appropriate traditional Chinese medicine techniques in the prevention and control of myopia in children and adolescents (part I). Chinese Journal of Traditional Chinese Ophthalmology, 32(6), 421–428. https://doi.org/10.13444/j.cnki.zgzyykzz.2022.06.001

Qinghua

(2021). Traditional Chinese ophthalmology (5th ed). China Press of Chinese Medicine.

Renxiang

Xiaolu

Wei

Min

Bingqin

(2025). Research progress on the mechanism of orthokeratology in controlling myopia in adolescents. Recent Advances in Ophthalmology, 45(5), 415–420. https://doi.org/10.13389/j.cnki.rao.2025.0073

10.

State Administration of Traditional Chinese Medicine. (1994). Diagnostic and therapeutic criteria of diseases and syndromes in traditional Chinese medicine. Nanjing University Press. 31–32.

11.

Thumann

(2012). Prospectives for gene therapy of retinal degenerations. Current Genomics, 13(5), 350–362. https://doi.org/10.2174/138920212801619214

12.

Wanli

Caiyun

Gang

Xiaoying

Lulu

(2022). Analysis of the efficacy and safety of multifocal soft lenses and orthokeratology lenses in controlling myopia. Chinese Journal of School Health, 43(9), 1305–1308. https://doi.org/10.16835/j.cnki.1000-9817.2022.09.007

13.

Wenting

Jiaqian

Shibei

Yongjun

Dingpeng

(2022). Clinical observation of orthokeratology lenses with increased compression coefficient for correcting myopia. Chinese Journal of Ophthalmology, 58(11), 907–913. https://doi.org/10.3760/cma.j.cn112142-20220203-00047

14.

Liu

C. H.

K. K.

Chun

R. K. M.

J. F. J.

Lam

T. C.

(2014). Differential retinal protein expressions during form deprivation myopia in albino guinea pigs. Current Proteomics, 11(1). https://doi.org/10.2174/1570164610666140109002531

15.

Xiaolin

Kaiqi

Yuying

Tao

Xiaoguo

Zhenyu

Qian

Wenhua

(2022). Association between screen time and myopia among children aged 11–14 years in China. Chinese Journal of School Health, 43(3), 333–337. https://doi.org/10.16835/j.cnki.1000-9817.2022.03.004

16.

Fengming

(2024). Preliminary study on Li's pestle needle combined with Wuqinxi in the prevention and treatment of myopia in children and adolescents. Chinese Journal of Traditional Chinese Ophthalmology, 34(3), 253–256. https://doi.org/10.13444/j.cnki.zgzyykzz.2024.03.010

17.

Shichao

Yijing

Yuxia

Zhiwei

(2024). Research progress on integrated traditional Chinese and Western medicine in preventing and controlling mild to moderate myopia in children. Chinese Journal of Traditional Chinese Ophthalmology, 34(10), 985–988. https://doi.org/10.13444/j.cnki.zgzyykzz.2024.10.017

18.

Ying

Hui

Ziyang

Jinjing

Xuqing

Xiao

(2025). Survey of myopia among children and adolescents in Nanchang in 2022 and analysis of influencing factors. Chinese Journal of Health Education, 41(7), 590–594. https://doi.org/10.16168/j.cnki.issn.1002-9982.2025.07.003

19.

Yixiu

Xinquan

(2022). Research progress on acupuncture-based comprehensive therapies for the prevention and control of myopia in adolescents. Chinese Journal of Traditional Chinese Ophthalmology, 32(11), 897–899. https://doi.org/10.13444/j.cnki.zgzyykzz.2022.11.015

20.

Yue

Yanmei

Xiaolan

Xiaoying

Wenqiang

Ren

(2025). Academic characteristics of Zhang Ren’s acupuncture treatment for modern refractory eye diseases based on the principle of treating different diseases with the same method. Chinese Acupuncture & Moxibustion, 45(9), 1311–1317. https://doi.org/10.13703/j.0255-2930.20240812-k0002

21.

Yuqing

Hewei

Yanjie

Xuemei

Mengnan

Mengyan

(2023). Eye acupuncture intervention promotes angiogenesis by regulating angiogenic factor expression in rats with cerebral ischemia. Chinese Journal of Tissue Engineering Research, 27(23), 3674–3681. https://doi.org/10.12307/2023.581

22.

Ziyi

Xiangui

Chenwei

Jun

Hui

Jinliuxing

Linlin

Xun

Jingjing

(2022). Epidemiological survey of pre-myopia among children aged 6–8 years in Shanghai. Chinese Journal of School Health, 43(9), 1314–1318. https://doi.org/10.16835/j.cnki.1000-9817.2022.09.009