ARVO2026 Recap #3 – New and improved lens designs & combination therapy

Authors: Dennis Yan-yin Tse^1,2, Ying Hon1, Rachel Ka-man Chun^1,2, Tsz Wing Leung^1,2, Daisy Ka Yan Leung¹, Chi Ho To¹, Carly S Y Lam¹

1. Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
2. Centre for Eye and Vision Research, Hong Kong

This study evaluated the myopia control efficacy of an enhanced Defocus Incorporated Multiple Segments lens (DIMS TED) compared to standard DIMS and single-vision (SV) lenses over 12 months. In this double-masked, placebo-controlled, randomised controlled trial, 196 Chinese schoolchildren aged 4–12 years with documented myopia progression (≥0.50D per year) or fast axial elongation (≥0.27 mm per year) were randomly allocated to wear either DIMS TED, DIMS, or SV lenses. 

At 12 months, both DIMS TED (+0.05D/0.08mm) and DIMS groups (-0.26D/0.21mm) showed less SER progression and AL elongation compared with SV (-0.53D/0.35mm). Interestingly, DIMS TED (but not DIMS) showed myopia control efficacy in the 4–6 year age group. On average, the DIMS TED group showed no myopia progression over 12 months, with AL growth below or comparable to emmetropic growth. This represents the highest myopia control efficacy reported to date for DIMS technology-based lenses; and for the first time, demonstrated efficacy in children as young as 4 years.

[Link to abstract]

Authors: Jinhua Bao¹, Xue Li¹, Yingying Huang¹, Weilin Wu¹, Yuxin Chen¹, Qiushi Li¹

1. National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, China

This study investigated the effect of treatment initiation age on myopia control efficacy across spectacle lenses with different optical mechanisms over 1 year. In this randomised trial, 197 schoolchildren aged 7–13 years were assigned to diffuser lenslets (DL), myopic defocus lenslets (ML), dual-mechanism lenslets (DML), or single-vision lenses (SVL), All three lenslet configurations are based on a compound-eye-like grid array, with a consistent pattern and amount. 

In younger children, ML and DML significantly slowed progression versus SVL (0.18mm and 0.24mm vs 0.48mm AL; -0.41D and -0.37D vs -0.90D SER), while DL showed weaker efficacy. In older children, all three lens types were similarly effective. After 1 year, all three lenslet designs reduced myopia progression and axial elongation compared to the control, with the myopic defocus design showing superior efficacy in slowing axial elongation in younger children.

[Link to abstract]

Authors: Xingyi Guo¹, Mengdi Li¹, Kailang Zhang¹, Yujia Lu², Wenli Lu², Xiaoqin Chen¹, Lihua Li¹

1. Tianjin Eye Hospital, Tianjin, China
2. Tianjin Medical University Department of Epidemiology and Biostatistics, Tianjin, China

This study investigated the myopia control efficacy of high order aberration diffusion (HOAD) spectacle lenses compared to defocus incorporated multiple segment (DIMS) spectacle lenses over 1 year. In this prospective randomised non-inferiority trial, 138 myopic children aged 8–13 years were assigned to wear enhanced HOAD (EHOAD), HOAD, or DIMS lenses. 

12-month mean changes were −0.20D/0.10mm, −0.30D/0.12mm, and −0.45D/0.22mm in the EHOAD, HOAD, and DIMS groups, respectively. For myopia progression, the lower 95% confidence interval for both HOAD lenses were above the non-inferiority margin of −0.04D. For axial length growth, the upper 95% confidence interval for both HOAD lenses were above the non-inferiority margin of 0.05mm. After 12 months of wear, both HOAD spectacle lens designs demonstrated non-inferior myopia control efficacy compared to DIMS lenses.

[Link to abstract]

Authors: Bryan Sim¹

1. Myopia Service, Singapore National Eye Centre, Singapore

This study aimed to evaluate the 24-month efficacy of combining HALT spectacle lenses with low-dose atropine (LDA) in children showing rapid myopia progression on atropine monotherapy, and to assess whether adjusting atropine concentration affected outcomes. In this prospective interventional cohort study, 50 children aged 6–11 years with inadequate control on LDA received HALT lenses combined with LDA (0.01%–0.025%). At 12 months, atropine concentration was maintained, decreased, or increased based on clinical judgement. 

After 1 year of combination therapy, progression was substantially reduced compared to the 6 months prior to combination therapy (-0.07 D and 0.13mm vs -0.61 D and +0.24mm). Second-year progression was greater than the first, but remained markedly below pre-treatment levels. Combination HALT-atropine therapy demonstrated meaningful efficacy over 24 months, regardless of whether atropine was maintained, decreased, or increased after year 1. This suggests clinicians can titrate atropine while preserving treatment effect.

[Link to abstract]

Authors: Noemi Guemes-Villahoz¹, Paula Talavero-Gonzalez¹, Elena Hernandez Garcia¹, Paloma Porras-Angel^1,2, Rafael Bella-Gala², Blanca Alonso-Abad¹, Alicia Ruiz-Pomeda², Beatriz Martin-Garcia², Nunila Gomez de Liaño², Elena Montolio-Marzo¹, Julian Garcia-Feijoo^1,2, Rosario Gomez-de-Liano^1,2

1. Ophthalmology, Hospital Clinico San Carlos, Madrid, Community of Madrid, Spain
2. Universidad Complutense de Madrid, Madrid, Community of Madrid, Spain

This study evaluated the myopia control efficacy of combination treatment using 0.025% atropine with DIMS spectacle lenses versus 0.025% atropine with single-vision (SV) lenses in children over 24 months. In a randomized controlled trial, 101 myopic children aged 4–16 years were randomly allocated to one of two groups: atropine plus SV (n=48) or atropine plus DIMS (n=53). 

At 12 months, children allocated to atropine plus DIMS showed slower SER progression (−0.09D vs −0.20D) and AL change (0.07mm vs 0.18mm) compared atropine monotherapy. Similarly, at 24 months, combination therapy showed greater efficacy than monotherapy (−0.18D/0.22mm vs −0.39D/0.36mm). The 24-month ASPECT results show that combining 0.025% atropine with DIMS lenses provides sustained, superior myopia control compared to atropine alone with SV lenses – the first European RCT to evaluate this combined approach.

[Link to abstract]