Surgical Techniques and the Choice of Operative Approach for Cranioorbital Lesions

Abstract Objectives Cranioorbital lesions present a great challenge for neurosurgeons and ophthalmologists. There is no consensus on the choice of surgical approach. The aims of this study were to investigate 49 cases of cranioorbital lesions and evaluate surgical approaches and outcomes. Patients and Methods A retrospective study was done on 49 patients (51 operations) from 2009 to 2018. Information about the lesion was used to decide whether the supraorbital eyebrow approach (SEA) or pterional approach (PA) was performed. Results Twenty-eight patients had surgical resection using SEA, 21 patients received PA, each group included one case of recurrence, who underwent reoperation via the same approach. SEA provided better cosmetic satisfaction, and a shorter incision than PA (p < 0.05). There was no significant difference in total resection rates, visual outcomes, recovery of ptosis, and other new surgical-related complications between SEA group and PA group (p > 0.05). Forty-nine cases of proptosis (94.1%, 49/51) were improved. Thirty-three patients (33/37, 89.2%) who underwent follow-up for longer than 12 weeks had a modified Rankin Scale (mRS) score ≤ 3. Conclusion Surgery is the preferred treatment for cranioorbital lesions, but total resection is difficult. SEA may be a more minimally invasive option for some more limited lesions superior to optic nerve. PA may be more reasonable for the lesion with obvious hyperostosis and more extensive lesions.

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Use of endoscopic transorbital and endonasal approaches for 360° circumferential access to orbital tumors

Journal of Neurosurgery ◽

10.3171/2020.6.jns20890 ◽

2020 ◽

pp. 1-10

Author(s):

Chiman Jeon ◽

Sang Duk Hong ◽

Kyung In Woo ◽

Ho Jun Seol ◽

Do-Hyun Nam ◽

...

Keyword(s):

Optic Nerve ◽

Minimally Invasive ◽

Surgical Techniques ◽

Cystic Teratoma ◽

Subtotal Resection ◽

Zone Model ◽

Team Approach ◽

Orbital Tumors ◽

Total Resection ◽

Endoscopic Transorbital

OBJECTIVEOrbital tumors are often surgically challenging because they require an extensive fronto-temporo-orbital zygomatic approach (FTOZ) and a multidisciplinary team approach to provide the best outcomes. Recently, minimally invasive endoscopic techniques via a transorbital superior eyelid approach (ETOA) or endoscopic endonasal approach (EEA) have been proposed as viable alternatives to transcranial approaches for orbital tumors. In this study, the authors investigated the feasibility of 360° circumferential access to orbital tumors via both ETOA and EEA.METHODSBetween April 2014 and June 2019, 16 patients with orbital tumors underwent either ETOA or EEA at the authors’ institution. Based on the neuro-topographic “four-zone model” of the orbit with its tumor epicenter around the optic nerve in the coronal plane, ETOA (n = 10, 62.5%) was performed for tumors located predominantly superolateral to the nerve and EEA (n = 6, 37.5%) for those located predominantly inferomedial to the nerve. Eight patients (50%) presented with intraconal tumors and 8 (50%) with extraconal ones. The orbital tumors included orbital schwannoma (n = 6), cavernous hemangioma (n = 2), olfactory groove meningioma (n = 1), sphenoorbital meningioma (n = 1), chondrosarcoma (n = 1), trigeminal schwannoma (n = 1), metastatic osteosarcoma (n = 1), mature cystic teratoma (n = 1), sebaceous carcinoma (n = 1), and ethmoid sinus osteoma (n = 1). The clinical outcomes and details of surgical techniques were reviewed.RESULTSGross-total resection was achieved in 12 patients (75%), near-total resection in 3 (18.8%), and subtotal resection in 1 (6.2%). Eight (88.9%) of the 9 patients with preoperative proptosis showed improvement after surgery, and 4 (66.7%) of the 6 patients with visual symptoms demonstrated improvement. Four (40%) of the 10 patients treated with ETOA experienced partial third nerve palsy immediately after surgery (3 transient and 1 persistent). There have been no postoperative CSF leaks or infections in this series.CONCLUSIONSWithout transcranial approaches requiring temporalis muscle dissection and orbitozygomatic osteotomy, the selection of ETOA or EEA based on a concept of a four-zone model with its epicenter around the optic nerve successfully provides a minimally invasive 360° circumferential access to the entire orbit with acceptable morbidity.

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Treatment of lumbar synovial cysts using minimally invasive surgical techniques

Neurosurgical FOCUS ◽

10.3171/foc.2006.20.3.3 ◽

2006 ◽

Vol 20 (3) ◽

pp. 1-6 ◽

Cited By ~ 24

Author(s):

Nouzhan Sehati ◽

Larry T. Khoo ◽

Langston T. Holly

Keyword(s):

Back Pain ◽

Minimally Invasive ◽

Surgical Techniques ◽

Definitive Treatment ◽

Surgical Approaches ◽

Lower Extremity Weakness ◽

Minimally Invasive Surgical ◽

Synovial Cysts ◽

The Mean

Object Lumbar synovial cysts are a potential cause of radiculopathy and back pain, and the definitive treatment is the complete excision of the cyst. This report summarizes the authors' preliminary clinical experience with the minimally invasive resection of lumbar synovial cysts. Methods Nineteen patients (nine men and 10 women) with symptomatic synovial cysts underwent minimally invasive resection. The mean patient age was 64 years of age (range 43–80 years). The presenting symptom was radiculopathy in 16 patients, low-back pain in two, and lower-extremity weakness in one. There were 16 cases of a cyst located at the L4–5 level, two at L3–4, and one at L5–S1. The mean cyst diameter was 13.7 mm (range 3–30 mm). The mean follow-up time was 16 months (range 4–29 months). Clinical outcomes were graded, based on the Macnab modified criteria, as excellent, good, fair, or poor. Eighteen patients (95% of cases) reported either excellent (10 patients) or good (eight patients) results, and a fair result was reported by one patient (5% of cases). The mean operative time was 158 minutes (range 75–270 minutes), and the average intraoperative blood loss was 31 ml (range 10–100 ml). Two patients had intraoperative dural tears that resulted in cerebrospinal fluid leaks that resolved following primary closure. Conclusions Synovial cysts can be safely and effectively treated using minimally invasive surgical techniques. Long-term follow up is required to determine whether this approach results in less need for fusion than conventional surgical approaches.

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Complications in adult spinal deformity surgery: an analysis of minimally invasive, hybrid, and open surgical techniques

Neurosurgical FOCUS ◽

10.3171/2014.3.focus13534 ◽

2014 ◽

Vol 36 (5) ◽

pp. E15 ◽

Cited By ~ 75

Author(s):

Juan S. Uribe ◽

Armen R. Deukmedjian ◽

Praveen V. Mummaneni ◽

Kai-Ming G. Fu ◽

Gregory M. Mundis ◽

...

Keyword(s):

Minimally Invasive ◽

Spinal Deformity ◽

Open Surgery ◽

Adult Spinal Deformity ◽

Intraoperative Complications ◽

Surgical Techniques ◽

Open Group ◽

Inclusion Criteria ◽

Significant Difference

Object It is hypothesized that minimally invasive surgical techniques lead to fewer complications than open surgery for adult spinal deformity (ASD). The goal of this study was to analyze matched patient cohorts in an attempt to isolate the impact of approach on adverse events. Methods Two multicenter databases queried for patients with ASD treated via surgery and at least 1 year of follow-up revealed 280 patients who had undergone minimally invasive surgery (MIS) or a hybrid procedure (HYB; n = 85) or open surgery (OPEN; n = 195). These patients were divided into 3 separate groups based on the approach performed and were propensity matched for age, preoperative sagittal vertebral axis (SVA), number of levels fused posteriorly, and lumbar coronal Cobb angle (CCA) in an attempt to neutralize these patient variables and to make conclusions based on approach only. Inclusion criteria for both databases were similar, and inclusion criteria specific to this study consisted of an age > 45 years, CCA > 20°, 3 or more levels of fusion, and minimum of 1 year of follow-up. Patients in the OPEN group with a thoracic CCA > 75° were excluded to further ensure a more homogeneous patient population. Results In all, 60 matched patients were available for analysis (MIS = 20, HYB = 20, OPEN = 20). Blood loss was less in the MIS group than in the HYB and OPEN groups, but a significant difference was only found between the MIS and the OPEN group (669 vs 2322 ml, p = 0.001). The MIS and HYB groups had more fused interbody levels (4.5 and 4.1, respectively) than the OPEN group (1.6, p < 0.001). The OPEN group had less operative time than either the MIS or HYB group, but it was only statistically different from the HYB group (367 vs 665 minutes, p < 0.001). There was no significant difference in the duration of hospital stay among the groups. In patients with complete data, the overall complication rate was 45.5% (25 of 55). There was no significant difference in the total complication rate among the MIS, HYB, and OPEN groups (30%, 47%, and 63%, respectively; p = 0.147). No intraoperative complications were reported for the MIS group, 5.3% for the HYB group, and 25% for the OPEN group (p < 0.03). At least one postoperative complication occurred in 30%, 47%, and 50% (p = 0.40) of the MIS, HYB, and OPEN groups, respectively. One major complication occurred in 30%, 47%, and 63% (p = 0.147) of the MIS, HYB, and OPEN groups, respectively. All patients had significant improvement in both the Oswestry Disability Index (ODI) and visual analog scale scores after surgery (p < 0.001), although the MIS group did not have significant improvement in leg pain. The occurrence of complications had no impact on the ODI. Conclusions Results in this study suggest that the surgical approach may impact complications. The MIS group had significantly fewer intraoperative complications than did either the HYB or OPEN groups. If the goals of ASD surgery can be achieved, consideration should be given to less invasive techniques.

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Treatment of thoracolumbar trauma by short-segment percutaneous transpedicular screw instrumentation: prospective comparative study with a minimum 2-year follow-up

Journal of Neurosurgery Spine ◽

10.3171/2013.11.spine13479 ◽

2014 ◽

Vol 20 (2) ◽

pp. 150-156 ◽

Cited By ~ 52

Author(s):

Petr Vanek ◽

Ondrej Bradac ◽

Renata Konopkova ◽

Patricia de Lacy ◽

Jiri Lacman ◽

...

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Cobb Angle ◽

Control Group ◽

Working Ability ◽

Short Segment ◽

Transpedicular Screw ◽

Significant Difference ◽

Screw Group

Object The main aim of this study was to compare clinical and radiological outcomes after stabilization by a percutaneous transpedicular system and stabilization from the standard open approach for thoracolumbar spine injury. Methods Thirty-seven consecutive patients were enrolled in the study over a period of 16 months. Patients were included in the study if they experienced 1 thoracolumbar fracture (A3.1–A3.3, according to the AO/Magerl classification), had an absence of neurological deficits, had no other significant injuries, and were willing to participate. Eighteen patients were treated by short-segment, minimally invasive, percutaneous pedicle screw instrumentation. The control group was composed of 19 patients who were stabilized using a short-segment transpedicular construct, which was performed through a standard midline incision. The pain profile was assessed by a visual analog scale (VAS), and overall satisfaction by a simple 4-stage scale relating to performance of daily activities. Working ability and return to original occupation were also monitored. Radiographic follow-up was defined by the vertebral body index (VBI), vertebral body angle (VBA), and bisegmental Cobb angle. The accuracy of screw placement was examined using CT. Results The mean surgical duration in the percutaneous screw group was 53 ± 10 minutes, compared with 60 ± 9 minutes in the control group (p = 0.032). The percutaneous screw group had a significantly lower perioperative blood loss of 56 ± 17 ml, compared with 331 ± 149 ml in the control group (p < 0.001). Scores on the VAS in patients in the percutaneous screw group during the first 7 postoperative days were significantly lower than those in the control group (p < 0.001). There was no significant difference between groups in VBI, VBA, and Cobb angle values during follow-up. There was no significant difference in screw placement accuracy between the groups and no patients required surgical revision. There was no significant difference between groups in overall satisfaction at the 2-year follow-up (p = 0.402). Working ability was insignificantly better in the percutaneous screw group; previous working position was achieved in 17 patients in this group and in 12 cases in the control group (p = 0.088). Conclusions This study confirms that the percutaneous transpedicular screw technique represents a viable option in the treatment of preselected thoracolumbar fractures. A significant reduction in blood loss, postoperative pain, and surgical time were the main advantages associated with this minimally invasive technique. Clinical, functional, and radiological results were at least the same as those achieved using the open technique after a 2-year follow-up. The short-term benefits of the percutaneous transpedicular screw technique are apparent, and long-term results have to be studied in other well-designed studies evaluating the theoretical benefit of the percutaneous technique and assessing whether the results of the latter are as durable as the ones achieved by open surgery.

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Evolution of Surgical Approaches in the Treatment of Petroclival Meningiomas: A Retrospective Review

Operative Neurosurgery ◽

10.1227/01.neu.0000303218.61230.39 ◽

2007 ◽

Vol 61 (suppl_5) ◽

pp. ONS202-ONS211 ◽

Cited By ~ 36

Author(s):

Nicholas C. Bambakidis ◽

U. Kumar Kakarla ◽

Louis J. Kim ◽

Peter Nakaji ◽

Randall W. Porter ◽

...

Keyword(s):

Survival Rates ◽

Progression Free Survival ◽

Surgical Approaches ◽

Single Institution ◽

Short Term ◽

Total Resection ◽

Free Survival ◽

Petroclival Meningioma ◽

Petroclival Meningiomas

Abstract Objective: We examined the surgical approaches used at a single institution to treat petroclival meningioma and evaluated changes in method utilization over time. Methods: Craniotomies performed to treat petroclival meningioma between September of 1994 and July of 2005 were examined retrospectively. We reviewed 46 patients (mean follow-up, 3.6 yr). Techniques included combined petrosal or transcochlear approaches (15% of patients), retrosigmoid craniotomies with or without some degree of petrosectomy (59% of patients), orbitozygomatic craniotomies (7% of patients), and combined orbitozygomatic-retrosigmoid approaches (19% of patients). In 18 patients, the tumor extended supratentorially. Overall, the rate of gross total resection was 43%. Seven patients demonstrated progression over a mean of 5.9 years. No patients died. At 36 months, the progression-free survival rate for patients treated without petrosal approaches was 96%. Of 14 patients treated with stereotactic radiosurgery, none developed progression. Conclusion: Over the study period, a diminishing proportion of patients with petroclival meningioma were treated using petrosal approaches. Utilization of the orbitozygomatic and retrosigmoid approaches alone or in combination provided a viable alternative to petrosal approaches for treatment of petroclival meningioma. Regardless of approach, progression-free survival rates were excellent over short-term follow-up period.

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Analysis of saccular aneurysms in the Barrow Ruptured Aneurysm Trial

Journal of Neurosurgery ◽

10.3171/2016.9.jns161301 ◽

2018 ◽

Vol 128 (1) ◽

pp. 120-125 ◽

Cited By ~ 24

Author(s):

Robert F. Spetzler ◽

Joseph M. Zabramski ◽

Cameron G. McDougall ◽

Felipe C. Albuquerque ◽

Nancy K. Hills ◽

...

Keyword(s):

Ruptured Aneurysm ◽

Modified Rankin Scale ◽

Clinical Trial Registration ◽

Treatment Groups ◽

Significant Difference ◽

Initial Hospitalization ◽

Intent To Treat ◽

Post Hoc ◽

Saccular Aneurysms

OBJECTIVEThe Barrow Ruptured Aneurysm Trial (BRAT) is a prospective, randomized trial in which treatment with clipping was compared to treatment with coil embolization. Patients were randomized to treatment on presentation with any nontraumatic subarachnoid hemorrhage (SAH). Because all other randomized trials comparing these 2 types of treatments have been limited to saccular aneurysms, the authors analyzed the current BRAT data for this subgroup of lesions.METHODSThe primary BRAT analysis included all sources of SAH: nonaneurysmal lesions; saccular, blister, fusiform, and dissecting aneurysms; and SAHs from an aneurysm associated with either an arteriovenous malformation or a fistula. In this post hoc review, the outcomes for the subgroup of patients with saccular aneurysms were further analyzed by type of treatment. The extent of aneurysm obliteration was adjudicated by an independent neuroradiologist not involved in treatment.RESULTSOf the 471 patients enrolled in the BRAT, 362 (77%) had an SAH from a saccular aneurysm. Patients with saccular aneurysms were assigned equally to the clipping and the coiling cohorts (181 each). In each cohort, 3 patients died before treatment and 178 were treated. Of the 178 clip-assigned patients with saccular aneurysms, 1 (1%) was crossed over to coiling, and 64 (36%) of the 178 coil-assigned patients were crossed over to clipping. There was no statistically significant difference in poor outcome (modified Rankin Scale score > 2) between these 2 treatment arms at any recorded time point during 6 years of follow-up. After the initial hospitalization, 1 of 241 (0.4%) clipped saccular aneurysms and 21 of 115 (18%) coiled saccular aneurysms required retreatment (p < 0.001). At the 6-year follow-up, 95% (95/100) of the clipped aneurysms were completely obliterated, compared with 40% (16/40) of the coiled aneurysms (p < 0.001). There was no difference in morbidity between the 2 treatment groups (p = 0.10).CONCLUSIONSIn the subgroup of patients with saccular aneurysms enrolled in the BRAT, there was no significant difference between modified Rankin Scale outcomes at any follow-up time in patients with saccular aneurysms assigned to clipping compared with those assigned to coiling (intent-to-treat analysis). At the 6-year follow-up evaluation, rates of retreatment and complete aneurysm obliteration significantly favored patients who underwent clipping compared with those who underwent coiling.Clinical trial registration no.: NCT01593267 (clinicaltrials.gov)

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A comparison of screw versus drill and curettage epiphysiodesis to correct leg-length discrepancy

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.12.180030 ◽

2018 ◽

Vol 12 (5) ◽

pp. 509-514 ◽

Cited By ~ 1

Author(s):

M. Troy ◽

B. Shore ◽

P. Miller ◽

S. Mahan ◽

D. Hedequist ◽

...

Keyword(s):

Operative Time ◽

Surgical Techniques ◽

Leg Length Discrepancy ◽

Complication Rates ◽

Leg Length ◽

Treatment Groups ◽

Length Discrepancy ◽

Baseline Activity ◽

Significant Difference

Purpose To compare two common surgical techniques of epiphysiodesis: drill/curettage epiphysiodesis (PDED) versus cross screw epiphysiodesis (PETS). The hypothesis is that the two techniques have similar efficacy but demonstrate differences in length of hospital stay (LOS), time to return to activity and complication rates. Methods A retrospective review of growing children and adolescents less than 18 years old who required an epiphysiodesis with leg-length discrepancy (LLD) of 2 cm to 6 cm with minimum two years of follow-up was conducted. Characteristics including age at surgery, gender, epiphysiodesis location, side, operative time, LOS and hardware removal were compared across treatment groups. LLD, expected growth remaining (EGR) and bone age were determined preoperatively and at most-recent visit. The correction ratio (change in EGR) was calculated along with a 95% confidence interval (CI) to assess if correction in leg length was achieved. Results A total of 115 patients underwent epiphysiodesis in the femur (53%), tibia (24%) or a combination (24%). The cohort was 47% male, with a mean age of 12.6 years (7.7 to 17.7) at surgery. Median follow-up was 3.7 years (2.0 to 12.7). In all, 23 patients underwent PETS and 92 patients had PDED. Both treatment groups achieved expected LLD correction. There was no significant difference in median operative time, complication rates or LOS. PETS patients returned to activity at a mean 1.4 months (interquartile range (IQR) 0.7 to 2.1) while PDED patients returned at a mean 2.4 months (IQR 1.7 to 3) (p < 0.001). Conclusion Effectiveness in achieving expected correction, LOS and operative time are similar between screw and drill/curettage epiphysiodesis. Patients undergoing PETS demonstrated a faster return to baseline activity than patients with PDED. Level of Evidence: III

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Minimally invasive comprehensive treatment for granulomatous lobular mastitis

10.21203/rs.2.16905/v2 ◽

2020 ◽

Author(s):

Yaohuai Wang ◽

Junlong Song ◽

Yi Tu ◽

Chuang Chen ◽

Shengrong Sun

Keyword(s):

Retrospective Study ◽

Minimally Invasive ◽

Operative Technique ◽

Treatment Process ◽

Comprehensive Treatment ◽

The Past ◽

Image Characteristics ◽

Surgical History ◽

Hospital Stays

Abstract Objective: To describe a minimally invasive comprehensive treatment for granulomatous lobular mastitis (GLM) and compare its effect with the existing methods, particularly in terms of its recurrence rate and esthetic outcomes. Methods: This retrospective study reviewed 69 GLM patients receiving the minimally invasive comprehensive treatment. Patients’ information, including age, clinical features, image characteristics, histopathological findings, mastitis history, treatment process, operative technique, recurrence, and esthetic effect, was evaluated. Results: All patients were female with a median age of 32 (range 17 - 55) years. Hospital stays ranged from 2 to 34 days, with a median of 6 days. The shortest time for complete rehabilitation was 2 days and the longest time was 365 days, with a median of 30 days. After a median follow-up of 391 days (range 162 - 690), 7 patients (10.14%) relapsed. The average cosmetic score was 2.62 ± 0.57 points and was mainly related to the past treatment, especially the surgical history. Conclusion: Minimally invasive comprehensive treatment is a new method for the treatment of GLM, ensuring a therapeutic effect while maintaining breast beauty.

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Analysis of Approaches in the Microsurgical Treatment of 102 Cases of Petroclival Meningioma in a Single Center

Frontiers in Neurology ◽

10.3389/fneur.2021.627736 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yazhou Lin ◽

Qiang Gao ◽

Huiping Jin ◽

Nana Wang ◽

Dingkang Xu ◽

...

Keyword(s):

Attachment Site ◽

Petrous Apex ◽

Surgical Approaches ◽

Karnofsky Performance Scale ◽

Therapeutic Effects ◽

Single Center ◽

Petroclival Meningioma ◽

Tumor Subtypes ◽

Significant Difference

Objectives: We identified the optimal approaches for treating the diverse tumor subtypes of petroclival meningioma (PM) by analyzing the clinical benefits of various surgical approaches adopted for each subtype.Methods: Tumors in 102 PM patients from a single center who underwent surgical treatment were classified as upper clivus (UC), cavernous sinus (CS), tentorium (TE), or petrous apex (PA) types based on the attachment site of the tumor base and the displacement of the trigeminal nerve. The therapeutic effects of different surgical approaches among the subtypes were evaluated according to the patient outcomes.Results: The subtemporal (33.33%), retrosigmoid (16.67%), and Kawase approaches (50%) were used for the UC type. Simpson I/II resection was achieved in 46.66% of patients with the Kawase approach. Significant differences were found between the other two approaches (P = 0.044) and in the follow-up Karnofsky performance scale (KPS) scores (P = 0.008). The subtemporal (60%) and Kawase approaches (40%) were used for the CS type; neither approach achieved Simpson I/II resection. The retrosigmoid (25.81%) and Kawase approaches (74.19%) were used for the TE type. The Simpson I/II resection rates of the two approaches were 55.55 and 86.95%, respectively, and a significant difference was observed between them (P = 0.039). The retrosigmoid (43.75%) and Kawase approaches (56.25%) were used for the PA type. The Simpson I/II resection rates of the two approaches were 31.25 and 50%, respectively. The resection degrees of the two approaches and the KPS scores at follow-up were significantly different (P = 0.034).Conclusion: The individual microsurgical approaches adopted for the various PM tumor subtypes can provide maximal safe resection and good KPS scores. The Kawase approach is more suitable for PM, especially for UC- and PA-type PM tumors.

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Effects of Orthokeratology Lens On Axial Length Elongation in Myopia With Anisometropia Children

10.21203/rs.3.rs-741927/v1 ◽

2021 ◽

Author(s):

Ziyang Chen ◽

Kai-Ming Chen ◽

Ying Shi ◽

Zhao-Da Ye ◽

Sheng Chen ◽

...

Keyword(s):

Retrospective Study ◽

Axial Length ◽

Statistical Significance ◽

Spherical Equivalent ◽

Significant Difference ◽

The Mean ◽

The Difference ◽

Better Than ◽

Group 1

Abstract AimTo investigate the effect of orthokeratology (OK) lens on axial length (AL) elongation in myopia with anisometropia children.MethodsThirty-seven unilateral myopia (group 1) and fifty-nine bilateral myopia with anisometropia children were involved in this 1-year retrospective study. And bilateral myopia with anisometropia children were divided into group 2A (diopter of the lower SER eye under − 2.00D) and group 2B(diopter of the lower SER eye is equal or greater than − 2.00D). The change in AL were observed.The datas were analysed using SPSS 21.0.Results(1) In group 1, the mean baseline AL of the H eyes and L eye were 24.70 ± 0.89 mm and 23.55 ± 0.69 mm, respectively. In group 2A, the mean baseline AL of the H eyes and L eyes were 24.61 ± 0.84 mm and 24.00 ± 0.70 mm respectively. In group 2B, the mean baseline AL of the H eyes and L eyes were 25.28 ± 0.72 mm and 24.70 ± 0.74 mm. After 1 year, the change in AL of the L eyes was faster than the H eyes in group 1 and group 2A (all P<0.001).While the AL of the H eyes and L eyes had the same increased rate in group 2B. (2) The effect of controlling AL elongation of H eyes is consistent in three groups (P = 0.559).The effect of controlling AL elongation of L eyes in group 2B was better than that in group 1 and group 2A (P < 0.001). And the difference between group 1 and group 2A has no statistical significance. (3) The AL difference in H eyes and L eyes decreased from baseline 1.16 ± 0.55mm to 0.88 ± 0.68mm after 1 year in group 1.And in group 2A, the AL difference in H eyes and L eyes decreased from baseline 0.61 ± 0.34mm to 0.48 ± 0.28mm. There was statistically significant difference (all P<0.001). In group 2B, the baseline AL difference in H eyes and L eyes has no significant difference from that after 1 year (P = 0.069).ConclusionsMonocular OK lens is effective on suppression AL growth of the myopic eyes and reduce anisometropia value in unilateral myopic children. Binocular OK lenses only reduce anisometropia with the diopter of the low eye under − 2.00D. Binocular OK lenses cannot reduce anisometropia with the diopter of the low eye equal or greater than − 2.00D. Whether OK lens can reduce refractive anisometropia value is related to the spherical equivalent refractive of low refractive eye in bilateral myopia with anisometropia children after 1-year follow-up.

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