Abstract
OBJECTIVES: This study compared the 12-month real-world effectiveness of defocus incorporated multiple segments (DIMS) spectacle lenses, Myopi-X progressive addition lenses, and single-vision (SV) lenses in slowing myopia progression in children. MATERIALS AND METHODS: This retrospective observational study included 385 eyes using one of the three spectacle types. Baseline age, spherical equivalent refraction (SER), and axial length (AL) were recorded. Twelve-month changes in SER and AL were analyzed using the Kruskal-Wallis test with Bonferroni-adjusted pairwise comparisons. Generalized estimating equations (GEE) were used to assess the effects of treatment group, age group, sex, and baseline AL group on SER and AL changes. RESULTS: The study population consisted of 118 Myopi-X eyes (32.4%), 107 SV eyes (29.4%), and 139 DIMS eyes (38.2%). Baseline demographic and ocular characteristics (including age, sex, SER, AL, age group, and baseline AL group) were comparable among the groups (all p>0.05). After 12 months, mean SER progression was -0.35±0.34 diopters (D) in the Myopi-X group, -0.46±0.37 D in the SV group, and -0.24±0.33 D in the DIMS group (p<0.001). Mean AL elongation was 0.21±0.12 mm, 0.24±0.17 mm, and 0.17±0.16 mm, respectively (p=0.004). GEE analyses demonstrated a significant treatment effect for both SER and AL change (p<0.001 for both). The least progression occurred in the DIMS group, followed by Myopi-X, while the SV group showed the highest progression. Baseline AL group was the only significant predictor of AL elongation (β=0.210, 95% confidence interval: 0.189-0.231, p<0.001), with greater elongation in eyes with high baseline AL. Age group and sex did not significantly influence SER or AL outcomes. CONCLUSION: DIMS spectacle lenses were more effective than Myopi-X and SV lenses in reducing both refractive progression and axial elongation over 12 months. Baseline AL was a key determinant of axial growth, supporting the use of individualized risk assessment in pediatric myopia management.