Introducing Essilor® Stellest® 2.0 lenses - Q&A with Dr. Björn Drobe

The Essilor® Stellest® spectacle lens^† for myopia management has established a strong evidence base for slowing myopia progression and axial elongation, supported by longitudinal clinical data demonstrating sustained treatment effect over multiple years.¹  The introduction of the Essilor® Stellest® 2.0 lens^‡ reflects a shift towards refining treatment effect through modifications in optical design: specifically, enhancing the characteristics of the myopia control signal.²  In this Q&A, Dr Björn Drobe, Director of Applied Myopia Research at EssilorLuxottica, discusses the clinical rationale behind Essilor® Stellest® 2.0 lenses^‡, the significance of the latest trial data, and how this next-generation lens may be positioned within our current myopia management strategies.

Björn Drobe: The first generation of Essilor® Stellest® lenses^† launched in 2020 and, most recently, became the first and only spectacle lens to receive US FDA market authorisation for slowing myopia progression in children — something we’re enormously proud of. But science doesn’t stand still. Myopia management is an evolving field, and as our understanding continues to deepen, our research must continue to evolve to support different patient profiles and long-term outcomes. 

Our research showed there was an opportunity to optimise the optical design: specifically, to increase the mean power and asphericity of the lenslets in Essilor® Stellest® lenses^† (first generation). In doing so, this was hypothesized to generate a larger depth of volume of non-focused light positioned even further forward from the retina compared to Essilor® Stellest® lenses^†. The science predicted this would produce a stronger signal for slowing axial elongation. ^3-5  The Essilor® Stellest® 2.0 lens^‡ is built on this hypothesis, and the clinical trial results backed this.

Björn Drobe: Both generations of Essilor® Stellest® lenses^† share the same fundamental architecture: a single vision carrier lens with concentric rings of highly aspherical lenslets. The principle behind the design is that a volume of non-focused light (volume of myopic defocus) is more effective at controlling myopic axial elongation compared to a surface of signal created by a spherical defocus power. 

What H.A.L.T.* MAX does is amplify that volume. In Essilor® Stellest® 2.0 lenses^‡, each lenslet has a higher mean power and greater asphericity than in the first generation. This creates approximately twice the depth of the volume of non-focused light, positioned further in front of the retina compared to Essilor® Stellest® lenses. Think of it as a stronger, broader optical signal — and that is thought to translate into greater efficacy in slowing eye growth. Importantly, despite this enhanced design, the visual performance of Essilor® Stellest® 2.0^‡ remains comparable to the first-generation lens, so children can wear these lenses comfortably all day.^6,7  

Björn Drobe: The study enrolled 50 children aged 6 to 10 years in Singapore. Rather than assigning them to separate groups (one wearing Essilor® Stellest® 2.0 lenses^‡ and one wearing the first-generation lens) each child wore both lenses simultaneously: one in each eye. After six months, the eyes were switched, and the child wore them for another six months. What this means is that every child received an evidence-based myopia management lens in both eyes throughout the trial. No child was left wearing a standard single vision lens as a control. From an ethical standpoint, given what we know about the importance of early intervention, that matters enormously. 

From a scientific standpoint, allowing each child to serve as their own control is extremely powerful. It removes the variability you'd otherwise have between groups — differences in age, genetics, how much near work a child does, outdoor time, and so on. The result is a very clean, robust comparison between the two lens generations, achieved within just one year.

Björn Drobe: The headline finding is that Essilor® Stellest® 2.0 lenses^‡ significantly slowed axial elongation more than the first-generation Essilor® Stellest® lens^†. Cumulative 1-year axial elongation was 0.121 mm with H.A.L.T.* MAX lenses and 0.228 mm with H.A.L.T.* lenses - a difference of 0.107 mm. The results were consistent across both crossover phases, which tells us the effect is real and reproducible.

Furthermore, children younger than approximately 8.5 years showed an even greater relative response to Essilor® Stellest® 2.0 lenses.^‡ That aligns with what we know about younger children tending to have faster-progressing myopia and it reinforces the message that early intervention is critical. If we're going to make a real difference in a child's long-term visual outcome, we need to act as soon as myopia is detected.

 Compliance was also excellent: children wore the lenses for more than 13 hours a day on average. And there were no lens-related adverse events or discontinuations, which is important for a lens designed for daily, long-term wear in children and where compliance in myopia management is key for the best results.

Björn Drobe: The key question a clinician should ask is: is this child progressing with their current lens? For many children, the first-generation Essilor® Stellest® lens^† will continue to be an appropriate and effective choice. But for children who are still showing more refractive change and/or axial elongation that you would hope for (particularly younger children or those at higher risk) Essilor® Stellest® 2.0 lenses^‡ offer a meaningful step up in efficacy. The fact that both generations share the same scientific DNA — same lens architecture, same daily wear approach, comparable visual comfort — means the transition is straightforward for patients and families. There's no dramatic adjustment period or new modality to adapt to. 

 Importantly, for children newly starting myopia management, particularly younger children or those presenting with faster progression, clinicians may also consider Essilor® Stellest® 2.0 lenses^‡ as a first-line option. In our study, younger children showed an even greater relative response to Essilor® Stellest® 2.0 lenses^‡, reinforcing the importance of early intervention in children at risk of faster progression.

 Ultimately, myopia management is not a one-time decision but an ongoing process. Regular monitoring of refractive error and axial length remains essential to assess treatment response and guide clinical decision-making over time.

Björn Drobe: What excites me most about these results is the trajectory they demonstrate. The first-generation Essilor® Stellest® lens^† showed we could slow axial elongation significantly versus single vision lenses. Essilor® Stellest® 2.0^‡ shows we can slow it significantly more than the first generation. 

 These findings highlight the potential of continued innovation in optical design to further improve myopia management outcomes. They also reinforce the importance of a personalised approach to care, where treatment decisions are guided by factors such as a child's age, risk profile and progression pattern.

 More broadly, these results change how we can think about Essilor® Stellest® lenses^†: not just as a standalone product, but as part of a broader myopia management ecosystem. Combined with diagnostic tools, digital support platforms, and a personalised approach to care, we are moving towards a model where practitioners can truly tailor management strategies to each individual child.

Björn Drobe: I think there are a few important points to consider. First, these results reinforce the importance of early intervention, particularly in younger children where myopia tends to progress more quickly and where a stronger optical signal may have greater impact.^8,9  

 Second, the findings highlight the value of closely monitoring myopia progression and axial elongation over time. Myopia management is not a one-time decision, but an ongoing process, and understanding how each child responds to treatment is key to guiding management decisions.

 Finally, these results support a more dynamic and personalised approach to myopia management. As the evidence base continues to evolve, practitioners have increasing opportunities to tailor treatment according to each child's age, risk profile and progression pattern. Combined with regular monitoring, this helps support more informed clinical decision-making over time. From a clinical perspective, spectacle lenses offer a non-invasive and well-tolerated option for myopia management in children¹⁰  supporting consistent daily wear in real-world settings.

You can access the full paper here and read our Myopia Profile Science Summary here.

* H.A.L.T. is an acronym for Highly Aspherical Lenslet Target and does not imply a “halt” or “stop” of myopia progression.  

† Essilor® Stellest® lens regulatory status and product availability may vary by country. U.S. FDA authorization and indications for use are based solely on clinical trial data from the U.S. 

‡ Essilor® Stellest® 2.0 lenses are not currently available in all countries, including the U.S. and have not been cleared by the U.S. FDA.