Comparative Efficacy of Optical Correction Methods Combined with 0.01% Atropine in Myopia Control

Purpose : To evaluate axial length changes in myopic children treated with different optical correction methods combined with 0.01% atropine eye drops. Methods : This retrospective study included 366 myopic children (366 eyes) from the Eye Hospital of Wenzhou Medical University (January 2021-December 2024). Participants were stratified into six groups: orthokeratology (OK, n=52), OK + atropine (OKA, n=50), highly aspherical lenslets (HAL, n=83), HAL + atropine (HALA, n=69), single-vision spectacles (SP, n=65), and SP + atropine (SPA, n=47). Axial length (AL) elongation after one year was compared using one-way ANOVA. Results : After one year, AL elongation differed significantly across groups (F=25.345 P<0.001). The OK (0.25±0.13 mm), OKA (0.18±0.14 mm), HAL (0.16±0.16 mm), HALA (0.08±0.19 mm), and SPA (0.23±0.18 mm) groups all showed significantly less AL elongation than the SP group (0.39±0.20 mm; all P<0.001). The HALA group demonstrated the strongest effect (P<0.01 vs. others), and both OKA and HALA outperformed OK (P=0.036) and HAL (P=0.004). Adjunctive 0.01% atropine therapy significantly attenuated AL elongation in older children with myopia, with the most pronounced reduction observed in the OKA group (0.03±0.14 mm). Among subjects with higher baseline refractive error, both OKA (0.12±0.13 mm) and SPA (0.16±0.19 mm) groups demonstrated significantly slower AL progression, whereas the HALA (0.12±0.21 mm) cohort exhibited comparatively less effective control of AL growth. Conclusion : Combining OK, HAL, or SP with 0.01% atropine demonstrated significant efficacy in retarding myopia progression. And OKA and SPA exhibited superior control efficacy in older children with higher myopia, while HALA achieved greater outcomes specifically in older myopic children across refractive strata.