Efficacy of Diversified Segmental Defocus Optimization Lenses on Axial Length Growth in Children and Adolescents with or without Myopia.

Abstract

To evaluate real-world efficacy of Diversified Segmental Defocus Optimization (DSDO) lenses in controlling axial length (AL) growth in children and adolescents with or without myopia, compared with Defocus Incorporated Multiple Segments (DIMS) lenses and no optical correction, respectively. Prospective, multicenter, real-world study. Individuals were recruited from eight Aier Eye Hospital Group centers in China and wore using DSDO lenses, DIMS lenses, or no optical correction. AL was measured at baseline, 6 months, and 12 months. Propensity score matching (PSM) was applied to balance baseline characteristics. AL changes were compared between DSDO and DIMS lenses in myopia cohort, and between DSDO lenses and untreated controls in non-myopia cohort. Change in AL over 6- and 12-month follow-up periods. A total of 1541 participants were included (myopic: 654 DSDO, 661 DIMS; non-myopic: 85 DSDO, 141 controls). After PSM, baseline age, sex, SE, and AL were well-balanced. In 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 at 12 months (P = 0.019). In non-myopic cohort, AL growth was 0.18 ± 0.14 mm with DSDO lenses and 0.29 ± 0.14 mm in untreated controls at 12 months (P = 0.01), greater in hyperopic/emmetropic subgroup (0.00 < SE ≤1.50 D; P = 0.004). The most pronounced effect was observed within the first 6 months. In myopic cohort, subgroup analyses revealed greater efficacy in children aged ≤ 10 years (P = 0.022) and in low-myopia subgroup (P = 0.001). Age and intervention type independently predicted AL changes, whereas sex was not. Notably, baseline AL was significant determinant of subsequent AL changes in myopia cohort. DSDO lenses provide greater control of axial elongation compared with DIMS lenses in specific myopic subgroups and effectively suppress physiological axial growth in non-myopic 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.