Real-World Efficacy of Spectacle Lenses with Highly Aspherical Lenslets in Slowing Myopia Progression-A...

This study evaluated the efficacy of spectacle lenses with highly aspherical lenslets (HALs) for myopia control in clinical practice.

A retrospective cohort study with propensity score matching (PSM) was conducted using patients from the Eye Hospital, Wenzhou Medical University from July 1, 2020 to March 15, 2023. Participants wore either HALs or single-vision lenses (SVL). PSM was used to balance confounding factors between groups. Efficacy was assessed by comparing myopia progression (non-cycloplegic refractive error) and axial length (AL) elongation between the two groups.

A total of 3419 HALs and 10,846 SVL users aged 3-18 years were included (mean SER: -2.92 ± 1.82 D, range +0.50 to -9.00 D). After PSM, 2050, 1524, 807 and 433 pairs were retained in the 0.5, 1, 1.5 and 2 year sub-datasets, respectively. Additionally, a sub-dataset containing AL measurement from 406 pairs at 1 year was analysed. In the matched dataset without AL, the HAL group exhibited significantly slower myopia progression both at 1 year (-0.33 vs. -0.63 D) and 2 years (-0.68 vs. -1.10 D) compared with the SVL group. Furthermore, in the 1-year matched dataset that included AL, the HAL group showed significantly less AL elongation (0.19 mm) and myopia progression (-0.37 D) than the SVL group (0.37 mm, 0.69 D). Subgroup analysis indicated that the reduction in myopia progression was evident amongst children aged 3-14 years with low and moderate myopia. However, no significant difference was observed in the 15-18 year-old subgroup with low-to-moderate myopia or in the high myopia subgroup (all p > 0.05).

This real-world study found that wearing HALs effectively reduced myopia progression and axial elongation in children aged 3-14 years with low-to-moderate myopia. However, the efficacy of HALs was inconclusive in children aged 15-18 years and limited in those with high myopia.