The rate of orthokeratology lens use and associated factors in 33,280 children and adolescents with myopia: a cross-sectional study from Shanghai

OBJECTIVES: To investigate the rate of orthokeratology lens (ortho-k lens) use and its associated factors in children and adolescents with myopia. METHODS: Cross-sectional study. Children from 104 primary and middle schools in Shanghai were enrolled by cluster sampling. Ophthalmic examinations were conducted and information was obtained using questionnaires for associated factors analysis. RESULTS: A total of 72,920 children and adolescents were included, among which 32,259 were the potential population for ortho-k lens use. A total of 1021 participants used ortho-k lenses, equating to a use rate of 1.4% in the total population and 3.1% in the potential population. Age (OR 0.91, 95% CI: 0.88–0.95, p < 0.001), BMI (≥95th percentile: OR 0.48, 95% CI: 0.35–0.66, p < 0.001), age at initiation of refractive correction (≤12 years: OR 1.75, 95% CI: 1.31–2.33, p < 0.001), and parental myopia (either: OR 2.09, 95% CI: 1.58–2.75, p < 0.001; both: OR 3.94, 95% CI: 3.04–5.11, p < 0.001) were independently associated with ortho-k lens use. Of the ortho-k lenses users, 12.4% had a logMAR CVA of ≥0.3. A correction target (SE) of ≤−3.0 D (OR 2.05, 95% CI: 1.38–3.05, p < 0.001) and a sleeping duration of ≤6 h (OR 4.19, 95% CI: 2.03–8.64, p < 0.001) were factors independently associated with CVA ≥ 0.3. CONCLUSIONS: A certain proportion of children and adolescents in Shanghai chose to wear ortho-k lenses, related to the situation of parents and children themselves. Health education and follow-ups should be strengthened to ensure orthokeratology application quality.