Compare the effect of Orthokeratology and Highly Aspherical Lenslets on slowing the progression of myopia

Abstract Purpose: To evaluate the efficacy of Highly Aspherical Lenslets (HAL) in slowing myopia progression among school children and compare it to Orthokeratology. Methods: This retrospective cohort study included 186 cases of myopic individuals aged between 7 to 15 years, with myopia ranging from -0.75 to -8.00D and astigmatism of ≤ 4.0D. Each group consisted of 62 subjects, and only the right eye was included in the analysis. The study involved six-monthly measurements of both cycloplegic refraction and axial length to track changes over time. Results: The baseline average age, gender, Spherical equivalent refraction (SER), and axial length (AL) in the SV group, HAL group, and Ortho-K group were no statistically significant differences (P>0.05). At six months, average (SER) myopia progression was -0.44±0.34 D in the single vision (SV) lenses group and -0.16±0.32 D in the HAL group. Average axial elongation was 0.22±0.13mm in the SV group, 0.08±0.14mm in the HAL group and 0.04±0.11mm in the orthokeratology group. As compared to the SV group, the HAL group reduced myopia progression (SER) to 65.9% (mean difference 0.29±0.46D, P＜0.001). Compared with the SV group, the HAL group axial elongation more slowly(63.6%, mean difference 0.14±0.19mm, P＜0.001). Likewise, axial elongation more slowly at 81.8% for orthokeratology group subjects than the SV group (mean difference 0.18±0.20mm， P＜0.001). In terms of individual issues, 35 of 62 children wearing HAL had no myopia progression after 6 months, higher than the SV group (15 of 62, 24.2%, P＜0 .001). In addition, 30.6% of children with HAL revealed no axial elongation, compared with 3.2% of those with SV lenses (2 of 62, P＜0 .001). The axial elongation of HAL and Ortho-K lenses (28 of 62, 45.2%) was similar (P> 0.05). Conclusions: Wearing the HAL daily slows myopia progression in myopic children and significantly reduces axial elongation. Additionally, both the daily employment of HAL and overnight Orthokeratology demonstrate comparable efficacy in slowing axial elongation in myopic children.