Efficacy of Diversified Segmental Defocus Optimization Lenses on Axial Length Growth in Children and Adolescents with...

To evaluate real-world efficacy of diversified segmental defocus optimization (DSDO) lenses in controlling axial length (AL) growth compared with defocus incorporated multiple segments (DIMS) lenses and no optical correction in children and adolescents with or without myopia.

Prospective, multicenter, clinical practice study.

Individuals aged 6 to 16 were recruited from 8 Aier Eye Hospital Group centers in China and wore DSDO lenses, DIMS lenses, or no optical correction.

Axial length was measured at baseline, 6 months, and 12 months after treatment initiation. Propensity score matching (PSM) was applied to balance baseline characteristics. Axial length changes were compared between DSDO and DIMS lenses in the myopia cohort and between DSDO lenses and untreated control participants in the nonmyopia cohort.

Change in AL over the 6-month and 12-month follow-up periods.

A total of 1541 participants were included (myopic group: 654 receiving DSDO lenses and 661 receiving DIMS lenses; nonmyopic group: 85 receiving DSDO lenses and 141 control participants). After PSM, baseline age, sex, spherical equivalent (SE), and AL were well balanced. In the myopic cohort, AL elongation was 0.07 ± 0.12 mm with DSDO lenses and 0.09 ± 0.10 mm with DIMS lenses at 6 months (P = 0.026) and 0.17 ± 0.18 mm versus 0.19 ± 0.16 mm, respectively, at 12 months (P = 0.019). In the nonmyopic cohort, AL growth was 0.18 ± 0.14 mm with DSDO lenses and 0.29 ± 0.14 mm in untreated control participants at 12 months (P = 0.01) and was greater in the hyperopic or emmetropic subgroup (0.00 < SE ≤ 1.50 diopters; P = 0.004). The most pronounced effect was observed within the first 6 months in the nonmyopic control participants. In the myopic cohort, subgroup analyses revealed greater efficacy in children 10 years of age or younger (P = 0.022) and in the low-myopia subgroup (P = 0.001). Age and intervention type independently predicted AL changes, whereas sex did not. Notably, baseline AL was significant determinant of subsequent AL changes in the myopia cohort.

Compared with DIMS lenses, DSDO lenses provide greater control of axial elongation in specific myopic subgroups and effectively suppress physiologic axial growth in nonmyopic children and adolescents. The greatest advantage occurs during the first 6 months and among younger children with low baseline refractive error, highlighting the importance of early, individualized optical intervention for effective myopia prevention and control.

The author(s) have no proprietary or commercial interest in any materials discussed in this article.