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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

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