Real-world Evaluation of the Effectiveness of Highly Aspherical Lenslets and Orthokeratology In Anisomyopic Children.

PURPOSE: To investigate the effectiveness of spectacle lenses with highly aspherical lenslets (HAL) and orthokeratology (ortho-k) for myopia control and the change in the interocular axial length (AL) difference in binocular anisomyopic children over 1-year in a real-world setting. METHODS: Retrospective analysis of 74 bilateral anisomyopes (8-14 years; 39 HAL, 35 ortho-k). Axial elongation (AE) and interocular AL difference were compared in both groups; spherical equivalent refraction (SER), spherical refraction (SR), refractive astigmatism (RA) and corneal astigmatism (CA) were evaluated for the HAL group. RESULTS: AE in the more myopic eye (MME) of the HAL group was significantly greater than the ortho-k group (0.24 ± 0.17 vs. 0.15 ± 0.15 mm, p = 0.007). However, the opposite finding was observed in the less myopic eye (LME) (0.20 ± 0.14 vs. 0.29 ± 0.23 mm, p = 0.01). The interocular AL difference was reduced in the ortho-k group (0.69 ± 0.41 vs. 0.54 ± 0.32 mm, p = 0.007), whereas no significant change was found in the HAL group (p = 0.09). AE was associated with baseline SER (β = 0.08, p = 0.008) in the ortho-k group and age (β = -0.04, p = 0.001) in the HAL group. The MME in the HAL group showed larger changes in SER (-0.39 ± 0.31 vs. -0.27 ± 0.30 D) and CA (-0.21 ± 0.29 vs. -0.11 ± 0.25 D) than the LME (both p ≤ 0.03). The change in SER was positively associated with age and baseline SER (β = 0.08; β = 0.07, both p ≤ 0.02) in the HAL group. CONCLUSIONS: Ortho-k reduced AE, more so in the MME and reduced the interocular AL asymmetry. HAL slowed AE symmetrically, with greater control in older and less-myopic children.