[Multisegment spectacles for prevention of myopia progression]

The prevalence of myopia is postulated to be rising worldwide, along with the risk of secondary complications, such as maculopathy; however, the evidence for this remains inconclusive, particularly for Europe. The focus is on reducing the increased axial length growth in childhood. To this end, myopia control spectacles (MCS) with peripheral myopic defocus have been developed.

Review of randomized controlled trials (RCT, ≥ 12 months) reporting axial length (AL) and spherical equivalent refraction (SER) for the MCS technologies currently available in Germany (July 2026): DIMS, HALT, CARE, HAPD. Only absolute effect sizes were considered.

A meta-analysis (17 studies, n = 6175) confirmed significant effects at 12 months, which in some cases were no longer significant at 24 months. During the first 2 years of treatment RCTs for DIMS, HALT and CARE showed significant reductions in SER progression and axial elongation (0.2-0.5 D/year and 0.1-0.26 mm/year, respectively, versus single vision lenses). The longest evidence exists for DIMS and HALT. No RCT is available for HAPD. Combination treatment with low-dose atropine eye drops showed additive effects.

MCSs are an effective option for myopia control without relevant side effects, particularly in younger children, rapid progression or with genetic risk factors. The MCS generally remain an out-of-pocket expense. Regular axial length monitoring is recommended; combination treatment with atropine can be considered in cases of insufficient response.