Next-Generation Spectacle Lenses for Myopia Control: Optical Designs, Mechanisms, and Clinical Efficacy

Myopia prevalence has risen dramatically worldwide, underscoring the critical need for effective interventions to slow its progression. Recent advancements in spectacle lens technology offer promising solutions, demonstrating significant efficacy in controlling myopia. This review critically examines next-generation spectacle lenses for myopia management, emphasizing their optical principles, mechanisms of action, clinical effectiveness, visual performance, compliance, and safety. Spectacle lenses incorporating technologies such as Defocus Incorporated Multiple Segments (DIMS), Highly Aspherical Lenslet Target (HALT), Diffusion Optics Technology (DOT), and Cylindrical Annular Refractive Element (CARE) lenses show a 40-60% reduction in refractive progression and axial elongation compared to traditional single-vision lenses. These lenses utilize optical strategies like simultaneous myopic defocus, peripheral contrast modulation, and controlled aberrations without compromising visual acuity, contrast sensitivity, accommodation, or binocular vision. High wearer compliance is attributed to excellent visual comfort, minimal adaptation issues, and favorable cosmetic appearance. Long-term studies further confirm sustained efficacy and safety profile. Ongoing research aimed at direct comparative trials, extended follow-up, and individualized lens designs will further define the role of these interventions. Collectively, the evidence positions next-generation spectacle lenses as a promising, evidence-based approach that may become an important component of global myopia management.