Age Modifies the Comparative Effectiveness of DIMS Versus HAL Spectacle Lenses for Myopia Control: A Real-World Study.

PURPOSE: To compare the real-world myopia control effectiveness of defocus incorporated multiple segments (DIMS) versus highly aspherical lenslets (HAL) spectacle lenses in children, and assess effect modification by age, baseline refraction, and axial length (AL).

METHODS

This retrospective cohort study included 180 children (aged 6 to 14) wearing DIMS or HAL lenses for ≥12 months. Participants were stratified by baseline spherical equivalent (SER) into pre-myopia, low myopia, and moderate myopia subgroups. Annual AL and SER changes were analyzed using analysis of covariance, with interaction terms tested for effect modification.

RESULTS

After adjustment, the HAL group showed significantly slower annual axial elongation (adjusted mean difference = 0.08 mm; 95% confidence interval [CI], 0.03 to 0.12; P < 0.001) and SER progression (-0.14 D; 95% CI, -0.25 to -0.03; P = 0.012) compared to DIMS. A significant treatment-by-age interaction was observed for AL change (P = 0.024). HAL's advantage was pronounced in younger children (≤10.5 years; AL difference = 0.13 mm; P < 0.001) but not significant in older children. Categorically, HAL yielded a higher proportion of "good" AL responders (64.4% vs. 41.1%; P = 0.004), most notably in pre-myopia. Axial shortening was observed exclusively in HAL wearers (8.9%).

CONCLUSIONS

Over one year, HAL lenses demonstrated superior myopia control efficacy versus DIMS in a real-world setting. Age was a key effect modifier, with greater benefit in younger children, supporting age-stratified clinical decision-making.

TRANSLATIONAL RELEVANCE: This study identifies patient age as a key biological modifier of the treatment response to different optical designs, bridging the mechanistic understanding of visual development with actionable, personalized clinical prescribing for childhood myopia control.

目的: (DIMS) (HAL) , 、 (AL) 。.

方法: 180 DIMS HAL ≥ 12 ( 6-14) 。 (SER) 、。 (ANCOVA) AL SER , 。.

结果: , DIMS , HAL (: 0.08 mm, 95% CI: 0.03 ∼ 0.12, P < 0.001), SER (-0.14 D, 95% CI: -0.25 ∼ -0.03, P = 0.012) 。 AL (P = 0.024) 。 HAL (≤10.5 ; AL : 0.13 mm, P < 0.001) , 。, HAL AL "" (64.4% vs. 41.1%, P = 0.004), 。 HAL (8.9%) 。.

结论: , HAL DIMS 。, , 。.

关键词: ; ; ;