Highly aspherical lenslet spectacles slowed myopia and eye growth in US children

Design

Double-masked randomised clinical trial, 9 US sites

Population

159 children aged 6–12 with −0.75 to −4.50 D myopia

Primary outcome

24-month change in cycloplegic refraction and axial length

Effect

Refraction difference 0.64 D (0.50–0.79); axial length −0.24 mm (−0.29 to −0.19)

Spectacle lenses with rings of highly aspherical lenslets had shown benefit in Asian children. This double-masked randomised trial at nine US sites enrolled 159 children aged 6 to 12 with −0.75 to −4.50 D of myopia and no prior myopia control, assigning them to lenslet or single-vision spectacles.

At 24 months, myopia progressed by −0.25 D with lenslet lenses against −0.90 D with single-vision lenses (difference 0.64 D, 95% CI 0.50–0.79), a 71% relative reduction. Axial elongation was 0.21 mm against 0.45 mm (difference −0.24 mm), a 53% reduction. Best-corrected acuity was equivalent, and adverse events were similar and none lens-related. The results supported FDA authorisation of the device.

With effects now replicated outside Asia, lenslet spectacles sit alongside low-dose atropine and myopia-control contact lenses as evidence-based options. Spectacles avoid the hygiene demands of contact lenses in younger children. Longer follow-up is needed to show the effect persists and to examine rebound after stopping.

• Offer myopia-control spectacles with aspherical lenslets as an option for progressing myopia in children aged 6 to 12.
• Expect slower axial growth: about half that with single-vision lenses over two years.
• Consider spectacles where contact lens hygiene or atropine adherence is a concern.
• Monitor axial length every 6 to 12 months to confirm response.
• Check local availability and cost before recommending; these lenses cost more than single-vision spectacles.

Why it matters

It confirms a non-drug, non-contact-lens option works beyond the populations where it was first tested.

Don't overread it

Two-year data; whether the effect persists or rebounds after stopping is not yet known.

The statistics, in plain English

A difference of 0.64 D over two years is clinically meaningful — more than a year's progression in the untreated group. The 53% reduction in axial growth is the more important figure, because eye length drives later complications.

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