HAL, DIMS Lenses Demonstrate Significant Efficacy in Slowing Myopia

The rising global prevalence of myopia among children and adolescents has elevated its management to a significant public health priority. A range of optical interventions has been developed to slow the progression of myopia, with spectacle lenses standing out as a particularly appealing option due to their noninvasive nature, ease of use and broad accessibility. Over time, multiple spectacle lens modalities have been developed, each employing different optical principles. Though not yet available in the US, these products are likely to arrive here, making it prudent to remain informed on their performance to date.Comparative data based exclusively on randomized controlled trials (RCTs) remains limited, especially regarding long-term outcomes, comprehensive subgroup analyses and head-to-head comparisons across all major lens types. A team of researchers from Italy and the UK conducted a systemic review and meta-analysis of 23 RCTs that compared intervention groups with myopia control lenses and control groups with standard single vision lenses to determine the effects of advanced spectacle lens technologies on changes in spherical equivalent of refraction (SER) and axial length (AL) elongation in slowing down the progression of myopia in children and adolescents. While the heterogeneity of the findings found in this meta-analysis limits the ability to produce a single precise estimate of effect size, it does not undermine the overall conclusion that myopia control spectacle lenses are effective. Photo: Hoya; Essilor. Click image to enlarge. Among the different lens designs, both highly aspheric lenses (HAL) and defocus incorporated multiple segments (DIMS) spectacle lenses demonstrated statistically significant efficacy in slowing myopia progression. HAL lenses reduced axial elongation by -0.28mm and SER progression by -0.52D. DIMS lenses showed a statistically significant reduction in SER, with a mean difference of -0.45D, supporting their efficacy in slowing myopia progression in children.“While the effect of HAL lenses is supported by multiple well-powered trials, the number of high-quality RCTs evaluating DIMS lenses remains limited,” the study authors did emphasize. “Although the available evidence for DIMS is promising, further large-scale studies are needed to confirm and consolidate these findings.”This meta-analysis, which was published in British Journal of Ophthalmology, included 23 RCTs with a total of 13,315 children and adolescents diagnosed with myopia. The studies varied in duration, ranging from one to four years, and were conducted across different geographical regions. The sample sizes ranged from 82 to 10.48 participants per study.Bifocal lenses also demonstrated a statistically significant reduction in axial elongation (-0.19mm), though the effect on SER progression was not statistically significant. In contrast, progressive addition lenses (PALs) showed more limited or inconsistent effects in axial elongation, though the reduction in SER progression was statistically significant (-0.21D). The researchers believe that this finding supports the hypothesis that PALs may primarily act by reducing accommodative lag rather than slowing axial growth.“While spectacle lenses represent a valuable and low-risk option within the broader toolkit for myopia management, they should be considered as part of a tailored, multifaceted approach,” the researchers wrote. “This might include pharmacological treatment, behavioral strategies and regular monitoring to offer children the best protection against high myopia and its long-term ocular complications.”Click here for the journal source. D'Andrea L, Rinaldi M, Piscopo R, et al. Efficacy of spectacle lenses for myopia control: a meta-analysis of randomized controlled trials. Br J Ophthalmol. September 5, 2025. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.