Impact of orthokeratology lens decentration on axial length growth in Chinese myopic children: A meta-analysis.

Background: Orthokeratology (OK) lenses have become a prevalent intervention for myopia control. However, lens decentration, a frequent complication, may influence the efficacy of myopia control. The aim of this study was to systematically assess the impact of OK lens decentration on axial length growth (ALG) in Chinese myopic children through a meta-analysis.

Methods: We conducted a meta-analysis to evaluate the effect of OK lens decentration on ALG in myopic children. Relevant studies were identified through comprehensive searches in databases, including PubMed, Embase, and the Cochrane Library, for publications from 2000 to 2024. The primary outcome was the standardized mean difference (SMD) in ALG between the centered and decentered lens groups. Heterogeneity was assessed using the Cochrane Q test and I² statistics, while publication bias was examined using funnel plots and visual inspection.

Results: A total of nine retrospective studies, encompassing 1503 participants aged 8-15 years, met the inclusion criteria. Six studies with 12-month data were included in the primary analysis, showing a significant reduction in ALG in the decentered group (SMD = -0.45, 95 % CI: -0.66 to -0.24, p < 0.0001), with moderate heterogeneity (I² = 59.1 %). Subgroup analyses by publication year and sample size revealed temporal and methodological variations, with studies from earlier years showing more pronounced reductions in ALG. Sensitivity analysis confirmed the robustness of the results, with slight variations in the pooled effect size. At 24 months, three studies demonstrated a significant reduction in ALG (SMD = -0.46, 95 % CI: -0.68 to -0.24, p < 0.0001), with negligible heterogeneity (I² = 0 %). Potential publication bias was suggested by the funnel plot, particularly due to one outlier study.

Conclusion: OK lens decentration significantly reduces ALG in myopic children, indicating its potential efficacy in myopia control. However, moderate heterogeneity was observed, which may be attributed to variations in study designs and sample characteristics. Further research with larger sample sizes and extended follow-up periods is necessary to validate these findings.