Comparison of the effects of spectacle lenses with highly aspherical lenslets combined with atropine for moderate to high myopia control in children.

PURPOSE: To compare the 1-year myopia control effects of spectacle lenses with highly aspherical lenslets (HAL), HAL combined with 0.01% atropine (HALA), and single-vision spectacle lenses (SVL) in children with moderate to high myopia.

METHODS

This retrospective cohort study analyzed 175 myopic children treated at the Eye Hospital of Wenzhou Medical University between January 2020 and January 2024. Participants were divided into three groups based on treatment: HAL (n = 62), HALA (n = 55), and SVL (n = 58). Changes in axial length (AL) and spherical equivalent refraction (SER) under non-cycloplegic conditions were compared using one-way ANOVA. Post hoc pairwise comparisons were performed using the LSD method, and all pairwise p-values were subsequently adjusted for multiple comparisons using the false discovery rate (FDR) to control the risk of Type I error.

RESULTS

After 12 months, mean AL elongation was 0.21 ± 0.15 mm in the HAL group, 0.21 ± 0.13 mm in the HALA group, and 0.28 ± 0.15 mm in the SVL group. AL changes between HAL and HALA were not significantly different (P = 0.837). However, both HAL (P = 0.004) and HALA (P = 0.009) significantly slowed axial elongation compared to SVL. In subgroup analysis, children aged 8-10 years showed no significant differences among groups. In the 11-12-year subgroup, both HAL and HALA significantly reduced AL elongation compared to SVL, with no difference between HAL and HALA.

CONCLUSION

HAL and HALA offer similar efficacy in controlling myopia progression in children with moderate-to-high myopia, both outperforming SVL. Their effects appear more pronounced in older children.