Investigation into the Therapeutic Efficacy and Inflammatory Modulatory Effects of the Combined Use of 0.01% Atropine Eye Drops and Orthokeratology Lenses in the Management of Myopia Among Adolescent Patients

Objective: To evaluate the therapeutic efficacy and inflammatory modulatory effects of combined 0.01% atropine eye drops and orthokeratology (OK) lenses in controlling myopia progression among adolescent patients. Methods: This retrospective study analyzed clinical data from 90 adolescent patients (90 eyes) with myopia treated from April 2021 to June 2023. Patients were divided into two groups: control group (n=45, treated with OK lenses alone) and observation group (n=45, treated with OK lenses combined with 0.01% atropine). Baseline and 1-year post-treatment measurements included refractive status, axial length (AL), corneal parameters, ocular surface indices, tear film stability, endothelial cell morphology, inflammatory cytokine levels in tears, and incidence of adverse events. Results: After 1 year, both groups showed myopic progression, but the observation group exhibited significantly less axial elongation (0.12 ± 0.08 mm vs 0.21 ± 0.09 mm; p < 0.001) and smaller increases in refractive error (p < 0.001). Corneal curvature and central corneal thickness were also significantly lower in the observation group (p < 0.05). The pupil diameter increased more in the observation group (p = 0.002), consistent with atropine's pharmacologic effect. Ocular surface damage was less severe, with lower OSDI (p = 0.002) and staining scores (p < 0.001). Tear film stability was better preserved, as reflected by higher NIBUT and TBUT values (p < 0.05). No significant differences in endothelial cell density or hexagonality were observed (p > 0.6). Tear cytokine levels (IL-1β, IL-6, TNF-α) increased in both groups but were significantly lower in the observation group (all p < 0.01). The incidence of adverse reactions was low and comparable between groups (p = 0.235), with no severe events reported. Conclusion: The combination of 0.01% atropine eye drops with orthokeratology lenses is more effective than orthokeratology alone in controlling myopia progression and mitigating ocular surface inflammation in adolescents, without increasing adverse effects. Keywords: adolescents, myopia, orthokeratology lenses, 0.01% atropine eye drops, inflammatory response, effect