Therapeutic efficacy of highly aspherical lenslets combined with low-concentration atropine: A retrospective study

The aim of this study is to evaluate the efficacy of 0.01 % atropine (AT), highly aspherical lenslets (HAL), and their combination in controlling myopia progression in children and adolescents.

A retrospective cohort study was conducted involving 144 children and adolescents aged 8 to 15 years who visited Shenzhen Eye Hospital between 2022 and 2024. Patients were categorized by refractive status into SE > -2.00 D (-2.00D < spherical equivalent [SE] ≤ -0.25D) and SE ≤ -2.00 D (SE ≤ -2.00D in at least one eye) groups. The SE > -2.00 D group was further divided into AT, HAL, and HAL+AT subgroups, while the SE ≤ -2.00 D group was divided into HAL and HAL+AT subgroups. Data collected included best-corrected visual acuity, cycloplegic SE, and axial length. The Shapiro-Wilk test was used to assess normality. Baseline differences were analyzed with parametric and non-parametric tests. Generalized estimating equations (GEE) were applied to evaluate longitudinal SE changes across groups, followed by post hoc comparisons.

In both the SE > -2.00 D and SE ≤ -2.00 D groups, the final GEE model identified statistically significant differences based on treatment group, time, baseline average spherical equivalent of both eyes (SE-mean), and age (p < 0.05). In the SE > -2.00 D group, the HAL+AT group significantly slowed myopia progression by 0.338D compared to the AT group. The HAL group also significantly slowed myopia progression by 0.235D compared to the AT group. In the SE ≤ -2.00 D group, after adjusting for potential covariates, the HAL+AT group significantly slowed myopia progression by 0.247D compared to the HAL group.

Over one year, combining HAL with 0.01 % atropine effectively controlled myopia progression in children and adolescents with varying refractive statuses.