Accommodation in myopic children wearing individualized ocular refraction customization spectacle lenses: Results from a randomized clinical trial.

Individualized ocular refraction customization (IORC) spectacle lenses represent a novel design to effectively control myopia progression. This study aimed to assess whether one year of wearing IORC lenses induces persistent changes in accommodative functions when measured under single-vision (SV) correction condition and to evaluate the association between initial accommodative response and myopia progression. A total of 171 myopic children were randomized to wear either IORC lenses with high (4.50 diopters (D)), medium (3.50 D), or low (2.50 D) myopic defocus or SV lenses for 1 year. Accommodative response under stimuli ranging from 1 to 5 D, accommodative amplitude and facility, spherical equivalent refraction (SER) and axial length were assessed at baseline, 6 months, and 12 months. All accommodation parameters were assessed with SV correction. No significant differences in the changes in accommodation were detected across the four groups. All four groups exhibited significant decreases in accommodative amplitude and improvements in accommodative facility over 12 months. Only the SV group demonstrated negative associations between 1-year change in SER and initial accommodative lag, and the subgroup with higher lags in the SV group presented faster myopia progression and axial elongation. In conclusion, one-year of wearing IORC lenses did not induce significant persistent changes in accommodation parameters. The previously observed association between higher baseline accommodative lags and faster myopia progression was confirmed in the SV group, but was not observed in children wearing IORC lenses. Trial registration: Chinese Clinical Trial Registry: ChiCTR2200063036. Registered on 29 August 2022.