Essilor® Stellest® is part of the newest generation of myopia controlling spectacle lens technologies and has become a robust choice for correcting and controlling myopia. There’s a lot we already know about the lenses – you can read about it in our article Understanding The New Essilor Stellest Spectacle Lens – but what are we still learning? This article will go through the newest research coming out regarding the Essilor® Stellest® lenses.
Essilor Stellest and Visual Fields
The Essilor® Stellest® lenses are made up of 11 rings of 1021 contiguous aspherical lenslets that surround a central clear zone of 9mm.1,2 While they do not appear to have any impact on visual acuity1 and accommodation3 and minimal impacts on contrast sensitivity and glare sensitivity,4 the potential impact on visual field sensitivity has only recently been studied.
In November 2022, Gao et al published findings regarding the impacts of spectacles with highly aspherical lenslets on visual sensitivity using automated static perimetry. The study included 21 adults aged 26 to 61 years old with spherical equivalent refractive error (SER) ranging from +0.88D to -8.75D. Participants were asked to complete visual fielding testing using a Goldmann perimeter, and targets were presented within 30°eccentricity. The visual field sensitivity was obtained through one lens with highly aspherical lenslets (HAL), and one single vision lens and compared.
It was found that there was no significant difference between visual field sensitivity as measured through single vision lenses and HAL lenses, indicating that there is no measurable impact on visual field sensitivity, after accounting for age and SER.5
Essilor Stellest BHVI Cross-over Trial
A cross-over clinical trial is a research method where individuals undergo a series of treatments, rather than being assigned into a control group or treatment group. This way, participants in a cross-over clinical trial act as their own comparison group. This trial design allows researchers to assess and compare the effects of different treatments within each participant and is valuable for studying long-lasting conditions or interventions with sustained impacts.6
The Brien Holden Vision Institute (BHVI) conducted a cross-over trial comparing HAL lenses and single vision lenses.7 Stage 1 of the trial involved 119 Vietnamese children aged 7 to 13 years old with SER range of -0.75 to -4.75D who were given HAL or single vision lenses to be worn for 6 months. In stage 2, these lenses were switched from HAL to single vision and vice versa and again worn for another 6 months. After stage 2, all children were switched to HAL lenses.
Figure 1 from open access paper Spectacle Lenses With Highly Aspherical Lenslets for Slowing Myopia: A Randomized, Double-Blind, Cross-Over Clinical Trial7 with the following caption: “Observed changes in spherical equivalent refractive error and axial length for participants who completed all stages.”
Results indicate that HAL lenses slowed myopia compared to single vision lenses, and that this was evident between groups wearing different lenses, and at the individual level when lenses were switched to HAL lenses. The research further indicates that there is no rebound effect when switching from HAL to single vision lenses.7
Essilor Stellest 3-year and 4-year data
The one-year and two-year randomized control trial data established the Essilor® Stellest® lenses as an efficacious myopia control treatment option on par with the current 'best' interventions of orthokeratology, dual-focus soft contact lenses and 0.05% atropine.1-2,8
The 3-year data is a continuation of the original randomized control trial.9 The study participants were separated into groups:
- HAL1 group: 52 children who have been wearing HAL lenses for 2 years continue to wear HAL lenses
- HAL2 and HAL3 groups: children who had been wearing single vision lenses (n=48) or slightly aspherical lenslets (SAL) lenses (n=51) are switched to HAL lenses.
- nSVL group: 56 children with no prior history of myopia control were newly recruited at the start of the 3 year trial extension date and were given single vision lenses only. These children were matched for age, sex, cycloplegic SER and axial length to the HAL3 group.
It was found that the HAL1 group benefited from less myopia progression and axial elongation compared to single vision over 3 years. In the HAL2 and HAL3 groups, they also benefited from slowed myopia progression and axial elongation after switching to HAL lenses after 2 years of wearing single vision lenses or SAL lenses. In fact, No differences among the three HAL treatment groups were found in this third extension year. The nSVL group was compared as a control against the third year changes of the HAL groups, and it was found that there was significantly more axial elongation and SER progression in the nSVL group compared to all 3 HAL groups.9
Early reports from the 4-year clinical trial data indicate positive results. 43 children completed the 4th year follow-up and were now 11- to 16-year-olds with an average SER of -3.70±1.22 D and AL of 25.28±0.84 mm. Data was compared to single vision lens models based on data from the first 2 years of the clinical trial: it was found that myopia progression and axial elongation was slower in children wearing HAL than in the modeled single vision control group even in the fourth year of wear.10
The current research further indicates that the Essilor® Stellest® lenses are not only highly effective in slowing the progression of myopia, but do not impact visual function even when it comes to visual field sensitivity. It remains a worthy weapon in the myopia management armory, as long as compliance to full-time wear is emphasized.
Jeanne Saw is a clinical optometrist based in Sydney, Australia. She has worked as a research assistant with leading vision scientists, and has a keen interest in myopia control and professional education.
This content is brought to you thanks to an unrestricted educational grant from
- Bao J, Yang A, Huang Y, Li X, Pan Y, Ding C, Lim EW, Zheng J, Spiegel DP, Drobe B, Lu F, Chen H. One-year myopia control efficacy of spectacle lenses with aspherical lenslets. Br J Ophthalmol. 2022 Aug;106(8):1171-1176. (link) [Link to Myopia Profile Science Summary]
- Bao J, Huang Y, Li X, Yang A, Zhou F, Wu J, Wang C, Li Y, Lim EW, Spiegel DP, Drobe B, Chen H. Spectacle Lenses With Aspherical Lenslets for Myopia Control vs Single-Vision Spectacle Lenses: A Randomized Clinical Trial. JAMA Ophthalmol. 2022 May 1;140(5):472-478. (link) [Link to Myopia Profile Science Summary]
- Huang Y, Li X, Wang C, Zhou F, Yang A, Chen H, Bao J. Visual acuity, near phoria and accommodation in myopic children using spectacle lenses with aspherical lenslets: results from a randomized clinical trial. Eye Vis (Lond). 2022 Sep 1;9(1):33. (link)
- Li X, Ding C, Li Y, Lim EW, Gao Y, Fermigier B, Yang A, Chen H, Bao J. Influence of Lenslet Configuration on Short-Term Visual Performance in Myopia Control Spectacle Lenses. Front Neurosci. 2021 May 25;15:667329. (link) [Link to Myopia Profile Science Review]
- Gao Y, Spiegel DP, Muzahid IAI, Lim EW, Drobe B. Spectacles with highly aspherical lenslets for myopia control do not change visual sensitivity in automated static perimetry. Front Neurosci. 2022 Nov 25;16:996908. (link)
- Sibbald B, Roberts C. Understanding controlled trials. Crossover trials. BMJ. 1998 Jun 6;316(7146):1719. doi: 10.1136/bmj.316.7146.1719.
- Sankaridurg P, Weng R, Tran H, Spiegel DP, Drobe B, Ha T, Tran YH, Naduvilath T. Spectacle Lenses With Highly Aspherical Lenslets for Slowing Myopia: A Randomized, Double-Blind, Cross-Over Clinical Trial: Parts of these data were presented as a poster at the Annual Research in Vision and Ophthalmology meeting, 2022. Am J Ophthalmol. 2023 Mar;247:18-24.(link)
- Brennan NA, Toubouti YM, Cheng X, Bullimore MA. Efficacy in myopia control. Prog Retin Eye Res. 2020 Nov 27:100923. (link) [Link to Myopia Profile paper review]
- Li X, Huang Y, Yin Z, Liu C, Zhang S, Yang A, Drobe B, Chen H, Bao J. Myopia Control Efficacy of Spectacle Lenses with Aspherical Lenslets: Results of a 3-year Follow-up Study. Am J Ophthalmol. 2023 Apr 9:S0002-9394(23)00147-2. doi: 10.1016/j.ajo.2023.03.030. (link)
- Drobe B, Xue L, Huang Y, Lim EW, Bao J. Spectacle lenses with highly aspherical lenslets for myopia control: 4-year clinical trial results. Parts of these data were presented as a poster at the Annual Research in Vision and Ophthalmology meeting, 2023.