In Reply We appreciate the opportunity to address the comments by Dr Tsuda and colleagues about our article.1 First, we acknowledge that the participant dropout rate in our study was higher than anticipated. However, there were no significant differences in terms of demographics and baseline parameters between participants who attended follow-up and those who dropped out (eTable 2 in Supplement 1 of the article). The overall dropout rates were also similar among the 3 groups (eTable 3). Importantly, the association between the baseline characteristics of the participants and the dropouts was evaluated and the results showed that dropouts were not associated with treatment groups (eTable 4). In addition, we conducted sensitivity analyses on myopia incidence to include those who had myopia before discontinuing treatment and to include the missing data for those who missed the follow-up or dropped out with assumptions of them having different myopic statuses (eTables 7-9). All of these analyses were consistent with our main results at 2 years, suggesting that dropouts did not affect the main results.
