MiYOSMART iQ: The next evolution of D.I.M.S. Technology

Spectacle lenses based on Defocus Incorporated Multiple Segments (D.I.M.S.) Technology have become an established option for myopia control, supported by a robust body of evidence demonstrating their ability to slow myopia progression and axial elongation in children over multiple years. Building on this foundation, targeted refinements to D.I.M.S. Technology aim to further strengthen the myopic defocus signal and optimise treatment outcomes while maintaining good visual performance. 

This article introduces MiYOSMART iQ spectacle lens, HOYA's latest DIMS-based spectacle lens design, highlighting how it differs from MiYOSMART spectacle lens and reviewing the clinical evidence evaluating its biological effect – including tolerance and adaption, impact of MiYOSMART iQ on visual function and its efficacy in myopia control.

MiYOSMART iQ represents the next evolution of HOYA’s proprietary Defocus Incorporated Multiple Segments (D.I.M.S.) Technology with Triple Enhanced Design (TED) intended to improve myopia control performance compared with the original MiYOSMART design. The three enhancements are:

• Defocus segments closer to the geometric center of the spectacle lens: Defocus segments are positioned closer to the geometric center of the spectacle lens, decreasing the clear central zone from 9.4 to 6.9mm. This is intended to maintain more consistent stimulation of the near-peripheral retina, which is considered particularly responsive to myopic defocus and plays a role in eye growth regulation.¹ 
• Higher defocus power: The treatment segments now provide +4.5D of defocus compared with +3.5D previously, delivering a stronger myopic defocus stimulus.
• Expanded treatment coverage: Additional defocus segments extend the treatment zone across a wider zone of the spectacle lens, helping ensure consistent peripheral defocus even when children wear larger frames.² 

These enhancements modify the optical layout to strengthen the myopic defocus signal and increase treatment coverage across the child’s peripheral visual field. Together, they refine the original MiYOSMART design and aim to enhance the treatment effect of MiYOSMART iQ.

Research has evaluated MiYOSMART iQ over twelve months, evaluating the myopia control efficacy of a new-generation DIMS-based spectacle lens, the Defocus Incorporated Multiple Segments Spectacle Lenses with Triple Enhanced Design (DIMS TED).

The 12-month randomised controlled clinical trial results were released on the 5th of May at ARVO 2026 in Denver, USA. It compared MiYOSMART iQ, MiYOSMART and Single Vision (SV) spectacle lenses in 202 Chinese children aged 4 to 12 years with myopia of more than -0.75D. A unique inclusion criteria of this study was as follows:

• History of early-onset myopia: aged 4-5 with SER of ≥ -0.75D, aged 6 with SER of ≥ -1.25D
• Aged 7-12 years: documented history of myopia progression of -0.50D or more per year or axial elongation of 0.27mm or more per year.

 12-month progression outcomes are as follows:

Difference in changes in cycloplegic spherical equivalent refraction (cSER) and axial length (AL) of MiYOSMART iQ and MiYOSMART spectacle lenses compared to Single Vision spectacle lenses were as follows:

In children aged 4–6 years (n = 50), MiYOSMART iQ (n = 16) was the only spectacle lens among the three in the study to show a significant myopia control effect. Average myopia progression was -0.22 D with MiYOSMART iQ, compared with -0.67 D for MiYOSMART and -0.64 D for SV spectacle lenses. Axial elongation was also lower with MiYOSMART iQ (0.27 mm) than with MiYOSMART (0.44 mm) or SV spectacle lenses (0.48 mm).

The AMMC module evaluates myopia control by comparing a child's axial eye growth to the normal growth expected in age- and sex-matched emmetropic children, allowing treatment effectiveness to be expressed relative to a return to normal eye growth (you can read more about it here). Using the AMMC module, MiYOSMART iQ was evaluated on whether it slowed down axial elongation to levels expected for normal (emmetropic) eye growth. Over 12 months, 82% of children wearing MiYOSMART iQ spectacle lenses achieved physiological axial growth, compared with 57% wearing MiYOSMART spectacle lenses and 22% wearing SV spectacle lenses.

MiYOSMART and MiYOSMART iQ increased the proportion of children achieving physiological axial growth by 35% and 60% respectively, compared to SV spectacle lenses. The corresponding numbers needed to treat (NNT) were 2.9 for MiYOSMART and 1.7 for MiYOSMART iQ, meaning that approximately three children would need to be treated with MiYOSMART, or two children with MiYOSMART iQ, for one additional child to achieve age-matched physiological eye growth compared with single-vision spectacle lenses.

Choroidal thickness (ChT) is emerging as an important biomarker in myopia management, reflecting structural changes associated with eye growth, treatment response, and the risk of future myopia-related complications. To investigate the effects of MiYOSMART iQ spectacle lenses, choroidal thickness (ChT) and axial length were monitored in myopic children aged 6–13 years over 12 months. During the first two weeks, one eye was randomly fitted with a MiYOSMART iQ spectacle lens while the fellow eye wore a single vision spectacle lens, allowing each child to act as their own control. Choroidal thickening was observed within one week in MiYOSMART iQ-treated eyes (+12.41 μm), compared with a slight thinning in eyes wearing single vision spectacle lenses (-1.72 μm), and increased further after two weeks (+13.45 μm). Following a two-week recovery period, both eyes were fitted with MiYOSMART iQ spectacle lenses for 12 months. The increase in choroidal thickness was maintained at both 6 and 12 months, while axial elongation remained minimal (0.03 mm at 6 months and 0.08 mm at 12 months).

The design enhancements incorporated into MiYOSMART iQ spectacle lenses (defocus segments closer to the geometric center of the spectacle lens , higher defocus power, and an expanded treatment zone) appear to enhance myopia control efficacy compared with MiYOSMART spectacle lenses. However, an important question is whether these enhancements may affect visual performance.

To investigate this, visual field sensitivity and mid-peripheral near visual acuity were evaluated in myopic children (n=21) aged 9–14 years wearing MiYOSMART iQ spectacle lenses compared with single-vision spectacle lenses. Visual field testing assessed sensitivity across 76 locations within the central 30° visual field. Although average visual field sensitivity was slightly lower with MiYOSMART iQ than with SV spectacle lenses (28.05 dB vs 29.22 dB), no statistically significant differences were found at any test location after adjustment for multiple comparisons. This suggests that the enhanced lens design does not meaningfully impair a child's ability to detect visual stimuli across the central visual field.

A small reduction in mid-peripheral near visual acuity was observed with MiYOSMART iQ spectacle lenses, ranging from 0.05 to 0.08 logMAR (2.5 to 4 letters) compared with SV spectacle lenses. While this indicates a modest decrease in visual clarity when viewing through the peripheral treatment zones, the magnitude of the change was small and is unlikely to have a significant impact on everyday visual function.

The 12-month results suggest promising potential to further slow axial elongation and, in some cases, stabilize refractive changes in the short term. The three enhancements of MiYOSMART iQ spectacle lenses improve the myopia control treatment effect compared to MiYOSMART spectacle lenses, although longer-term evidence will be important to confirm this. 

 The MiYOSMART iQ lens design indicated efficacy in 4–6-year-old children, which is a significant development as this age group presents specific challenges. The randomised controlled clinical trial on MiYOSMART spectacle lens involved children of standard age group from 8 to 13 years which is usually involved in clinical studies on myopia management. Demonstrating the myopia control treatment effect in younger children directly addresses the gap, offering a promising treatment solution for young patients who are at the higher risk for fast myopia progression.

MiYOSMART iQ is currently available in China, Australia, New Zealand and several other countries, with plans for broader rollout throughout 2026. It will be offered alongside MiYOSMART.

Ultimately, the clinical value of any new design for myopia management is determined by its demonstrated efficacy in rigorous studies, its safety profile, and its visual performance for the wearer. These findings suggest that MiYOSMART iQ represents more than an incremental refinement of an established technology. By enhancing treatment efficacy while maintaining good visual performance, the MiYOSMART iQ has the potential to broaden the clinical impact of D.I.M.S. technology, particularly for younger children. 

MiYOSMART iQ highlights that spectacle lens-based myopia management remains a dynamic and rapidly advancing field, with ongoing innovation focused on helping more children achieve better long-term outcomes.