Age Modifies the Comparative Effectiveness of DIMS Versus HAL Spectacle Lenses for Myopia Control: A Real-World Study

Area of Science:

• Ophthalmology and optometry
• Pediatric vision science
• Biomedical engineering

Background:

• Childhood myopia is a growing public health concern.
• Effective myopia control strategies are crucial to prevent high myopia and associated ocular pathologies.
• Spectacle lenses with novel optical designs offer potential for myopia management.

Purpose of the Study:

• To compare the real-world myopia control effectiveness of defocus incorporated multiple segments (DIMS) versus highly aspherical lenslets (HAL) spectacle lenses in children.
• To assess the effect modification of age, baseline refraction, and axial length (AL) on myopia control efficacy.

Main Methods:

• Retrospective cohort study of 180 children (aged 6-14) wearing DIMS or HAL lenses for ≥12 months.
• Participants stratified by baseline spherical equivalent (SER) into pre-myopia, low myopia, and moderate myopia subgroups.
• Analysis of annual AL and SER changes using analysis of covariance, with interaction terms tested for effect modification.

Main Results:

• HAL lenses demonstrated significantly slower annual axial elongation (0.08 mm/year) and SER progression (-0.14 D/year) compared to DIMS lenses.
• A significant treatment-by-age interaction was observed; HAL's advantage was more pronounced in younger children (≤10.5 years).
• HAL lenses showed a higher proportion of "good" AL responders (64.4% vs. 41.1%) and induced axial shortening in 8.9% of wearers.

Conclusions:

• Highly aspherical lenslets (HAL) spectacle lenses are more effective for myopia control than defocus incorporated multiple segments (DIMS) lenses in a real-world setting.
• Patient age is a key biological modifier, with younger children benefiting more from HAL lenses.
• Findings support age-stratified clinical decision-making for personalized childhood myopia control.