To investigate myopia control efficacy in children who continued wearing spectacle lenses with highly aspherical lenslets (HAL) or switched from spectacle lenses with slightly aspherical lenslets (SAL) and single-vision spectacle lenses (SVL) to HAL for 1 year after a 2-year myopia control trial. This was a 1-year extension of a randomized clinical trial. Of 54 children who had worn HAL for 2 years, 52 continued wearing HAL (HAL1 group), and of the 53 and 51 children who had originally worn SAL or SVL, 51 and 48 switched to wearing HAL (HAL2 and HAL3 groups) in year 3, respectively. A new SVL (nSVL) group of 56 children was recruited, matched for age, sex, cycloplegic spherical equivalent refraction (SER), and axial length (AL) of the HAL3 group at extension baseline, and used for a comparison of third-year changes. SER and AL were measured every 6 months in year 3. During year 3, the mean (SE) myopia progression in the nSVL group was -0.56 (0.05) diopters (D). Compared with nSVL, the changes in SER were less in HAL1 (-0.38 [0.05] D, P = .02), HAL2 (-0.36 [0.06] D, P = .01), and HAL3 (-0.33 [0.06] D, P = .005). The mean (SE) AL elongation in the nSVL group was 0.28 (0.02) mm. Compared with nSVL, the elongation in AL was less in the HAL1 (0.17 [0.02] mm, P < .001), HAL2 (0.18 [0.02] mm, P < .001), and HAL3 (0.14 [0.02] mm, P < .001) groups. Myopia progression and axial elongation were comparable in all 3 HAL groups (all P > .05) in year 3. Myopia control efficacy has remained in children who wore HAL in the previous 2 years. Children who switched from SAL or SVL to HAL in year 3 had slower myopia progression and axial elongation than that in the control group.

Purpose: To evaluate myopia control efficacy in myopic children wearing spectacle lenses with highly aspherical lenslets (HAL) for 5 years. Methods: This is a randomized, double-masked extended trial. Myopic children aged 8 to 13 years who were originally allocated to the HAL group in the 2-year clinical trial. The HAL group underwent a 5-year assessment for myopia progression using cycloplegic spherical equivalent refraction (SER) and axial length (AL). An extrapolated single-vision spectacle lenses (ESVL) group was used as a control group. The 5-year myopia progression and axial elongation of the ESVL group was calculated based on the 2-year data from the single-vision spectacle lenses group in the same clinical trial, and the data for the following 3 years was estimated by assuming an annual reduction in SER by 9.7% and in AL by 15%. A generalized linear model approach was used to evaluate the treatment efficacy. The validity of the ESVL group was evaluated by comparing myopia progression in the first year of the 3-year estimates with a single-vision spectacle lenses (SVL2) group from a 1-year extended study of the same clinical trial. Results: Forty-three participants from the original HAL group completed the 5-year visit (74%). Five-year myopia progression [mean ± standard error (SE)] in the HAL group was − 1.27 ± 0.14 D. Compared with the ESVL (− 3.03 ± 0.18 D), myopia progression was − 1.75 ± 0.24 D less for the HAL group (P < 0.001). The mean AL elongation over 5 years was 0.67 ± 0.06 mm for the HAL group compared with 1.40 mm in the ESVL group (P < 0.001), AL elongation was slower by 0.72 ± 0.10 mm for the HAL group (P < 0.001). No significant differences were found for myopia (− 0.58 ± 0.04 D vs. − 0.56 ± 0.05 D) or AL elongation (0.28 ± 0.02 mm vs. 0.28 ± 0.02 mm) between the ESVL group and SVL2 group (P _SER = 0.83; P _AL = 0.93) in year 3. Conclusions: In this 5-year study, HAL spectacles reduced the rate of myopia progression and axial elongation, preventing the equivalent of 3 years of myopia progression and axial elongation. Long-term use of HAL spectacles also decreased the incidence of high myopia. Extrapolated control groups are valid for evaluating myopia progression in long-term studies. Trial registration The study was registered at the Chinese Clinical Trial Registry (ChiCTR2100047262), https://www.chictr.org.cn/showproj.html?proj=127182.

Purpose: This study aimed to evaluate short-term visual performance and optical quality of three different lenslet configurations on myopia control spectacle lenses.Materials and Methods: This study utilized a cross-over design. Distance visual acuity (VA) was measured in 50 myopic children; contrast sensitivity (CS) was measured in 36 myopic children. For each test, four spectacle lenses were evaluated in a random order: single-vision lens (SVL), lens with concentric rings of highly aspherical lenslets (HAL), lens with concentric rings of slightly aspherical lenslets (SAL), and lens with honeycomb configuration of spherical lenslets (HC). The modulation transfer function (MTF) and MTF area (MTFa) were used to determine optical quality. All tests were performed monocularly on the right eye with full correction.Results: HAL and SAL had larger MTFa than HC. VA in lenses with lenslets was significantly reduced compared to SVL (all p < 0.01). The reduction in VA was worse with HC than with SAL (p = 0.02) and HAL (p = 0.03); no effect of lenslet asphericity was found (p > 0.05). VA changes induced by lenslets showed no correlation with spherical equivalent refraction (all p > 0.05) and were weakly positively associated with age for SAL (r = 0.36, p = 0.01) and HC (r = 0.31, p = 0.03), but not for HAL (p = 0.30). The area under the log contrast sensitivity function (AULCSF) decreased with HAL and HC (all p < 0.001) in all illumination levels, and AULCSF with HAL was higher than that with HC in a photopic condition (1.17 ± 0.10 vs. 1.10 ± 0.13, p = 0.0004). The presence of lenslets did not affect CS at 3 cycles per degree (cpd) (p = 0.80). At 6 to 18 cpd, CS was significantly reduced by HAL and HC (all p < 0.05), but not SAL (p > 0.05) compared to SVL. At high spatial frequencies (>12 cpd) both SAL and HAL reduced CS significantly less than HC (all p < 0.01).Conclusion: Short-term visual performance was minimally impaired by looking through the lenslet structure of myopia control spectacle lenses. Concentric rings with aspherical lenslets had a significantly lower impact on both VA and CS than honeycomb configuration with spherical lenslets.

This study shows accommodative accuracy and distance accommodation facility in myopic children do not play a role in myopia progression. In 144 subjects, the monocular distance accommodative facility (DAF) and continuous accommodative stimulus–response curves (ASRCs) were measured at the enrolment. Retrospective and prospective refraction with regard to the enrolment visit were obtained from the outpatient database system based on noncycloplegic subjective spherical equivalent refraction (SER). The rate of myopic progression at enrolment was the first derivative of the Gompertz function, which was fitted with each subject's longitudinal refractive error data, including at least four records of SER with an interval of more than 6 months between each visit. A mixed linear model for multilevel repeated-measures data was used to explore the associations between the rate of myopia progression and accommodative parameters. The mean rate of myopia progression at enrolment was -0.61 ± 0.31 D/y with a mean age of 12.27 ± 1.61 years. By adjusting for age and SER, it was shown that the myopic progression rate was not associated with the accommodative lag (F = 0.269, P = 0.604), accommodative lag area (F = 0.086, P = 0.354), slope of ASRC (F = 0.711, P = 0.399), and DAF (F = 0.619, P = 0.432).

Objective Spectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) showed effective myopia control. This study was to investigate their effects on macular choroidal thickness (ChT) in myopic children. Methods Exploratory analysis from a 2-year, double-masked, randomised trial. 170 children aged 8–13 years with myopia between −0.75D and −4.75D, astigmatism of 1.50D or less, and anisometropia of 1.00D or less were recruited. Participants were randomly assigned in a 1:1:1 ratio to receive HAL, SAL or single vision spectacle lenses (SVL). The subfoveal, parafoveal and perifoveal ChT were evaluated every 6 months. Results 154 participants completed all examinations. The ChT showed significant changes over time in all three groups in all regions (all p<0.05). The ChTs continuously decreased in the SVL group (ranging from −20.75 (SD 22.34) μm to −12.18 (22.57) μm after 2 years in different regions). Compared with the SVL group, ChT in the SAL group decreased less (ranging from −16.49 (21.27) μm to −5.29 (18.15) μm). In the HAL group, ChT increased in the first year and then decreased in the second year (ranging from −0.30 (27.54) μm to 8.92 (23.97) μm after two years). The perifoveal ChT decreased less than the parafoveal ChT, and the superior region decreased the least. Conclusions The ChT of the macula decreased after 2 years of myopia progression with SVL. Wearing spectacle lenses with aspherical lenslets reduced or abolished the ChT thinning and HAL had a more pronounced effect. Trial registration number ChiCTR1800017683.

This prospective study assessed the influence of wearing and then discontinuing orthokeratology (OK) lenses on retinal shape and peripheral refraction in myopic children. Fifty-eight myopic children (age 8-12 years) were equally divided into an OK group and a single vision spectacles (SVS) group. After 12 months of OK, it was discontinued for 1 month. Peripheral eye length (PEL), relative peripheral refraction (RPR), and corneal parameters were measured in the right eye on the nasal and temporal retinal sides at baseline, 6 months, and 12 months (13 months in OK group) visits. In the SVS group, faster elongation of the temporal side PEL made the eyes more asymmetric and prolate, developing a temporal pointed shape. In the OK group, the nasal retinal side PEL grew faster, the nasal RPR developed less hyperopic defocus, and the eye shape became more symmetric and less prolate. The central cornea became thinner and flattened, while the peripheral cornea became steeper. Changes in corneal thickness, relative peripheral corneal power, and K-values were no significant differences for the OK and SVS groups at 12 months. The cornea reverted to be no difference with myopic children with SVS after 1 month discontinuation of OK. The retinal shape of SVS eyes became more asymmetric and prolate with myopia progression. OK remodelled retinal shape to be less asymmetric and less prolate.