To compare the one-year clinical efficacy and cost-effectiveness of single vision lenses (SVL), Myopia-control spectacle lenses (MCSL), Orthokeratology (Ortho-K), and Repeated Low-Level Red-Light (RLRL) therapy in children within a real-world setting. This retrospective observational cohort study analyzed data from 206 myopic children aged 8–14 years, who had already received one of four myopia control interventions: SVL (n = 50), MCSL (n = 60), Ortho-K (n = 44), or RLRL (n = 52). The primary outcomes were the change in axial length (AL) and spherical equivalent refraction (SER) after one year of intervention. The secondary outcome was the Incremental Cost-Effectiveness Ratio (ICER), calculated as the additional cost per 0. 1 mm of AL elongation saved compared to the SVL group. All active interventions significantly outperformed SVL in controlling AL elongation (SVL mean: 0. 42 mm/year). RLRL exhibited the greatest efficacy (mean AL change: 0. 06 mm; 86. 0% relative to SVL), with 31% of participants showing axial shortening. Ortho-K (0. 18 mm; 57. 5% efficacy) and MCSL (0. 23 mm; 45. 2% efficacy) also demonstrated substantial benefits. Mean annual direct medical costs were 140. 93 (SVL), 429. 44 (MCSL), 1, 108. 08 (Ortho-K), and 806. 29 (RLRL). ICER analysis identified MCSL as the most cost-effective active intervention (151. 69 per 0. 1 mm AL saved), followed by RLRL (184. 13), while Ortho-K yielded the highest ICER (400. 42). In this one-year study, RLRL therapy was observed to have the highest efficacy. However, the finding of axial shortening warrants validation in long-term randomized controlled trials (RCTs) to elucidate its mechanism and long-term safety. MCSL spectacle lenses were identified as the most cost-effective option, representing a well-balanced profile of efficacy and economic feasibility. Ortho-K, while a highly effective intervention, was associated with a greater financial burden.
Kang et al. (Sat,) studied this question.