Axial Length Control Using Repeated Low-Level Red Light Combined with Orthokeratology Compared with Orthokeratology Alone in Rapidly Progressing Myopic Children

Purpose: To evaluate the efficacy and safety of combining repeated low-level red light (RLRL) therapy with orthokeratology (OK) in slowing axial elongation in children with rapid myopia progression. Patients and Methods: This retrospective cohort included 72 children aged 8-14 years (RLRL+OK, n=36; OK-only, n=36) meeting the rapid-progressor definition (>0.40 mm/year axial elongation. One eye per child was randomly selected. Axial length (AL) was measured at baseline and at 3, 6, and 12 months. Inverse probability of treatment weighting (IPTW) based on age, sex, and baseline AL achieved good balance between groups. The primary outcome was the 12-month AL change, assessed using IPTW-weighted linear mixed-effects models adjusted for covariates. Prespecified subgroup analyses were stratified by age (