Move over, orthokeratology, soft multifocal contact lenses, and low-dose atropine! We have some new players entering the myopia management game.
Below is an image of Hoya’s MiyoSmart lens. It is a “DIMS”, or Defocus Incorporated Multiple Segments, spectacle lens. The DIMS lens has a clear central zone for distance viewing, surrounded by around 400 multiple segments of plus powered lenslets (+3.50D), each about 1 mm in diameter. Similar to how a multifocal contact lens works to slow myopia progression, the segments of plus power cause images to focus in front of the retina at the periphery (called peripheral myopic defocus) while the clear central zone provides clear central vision. It is that myopic defocus that is believed to slow the elongation of the eye, and thus slow the progression of nearsightedness.
The DIMS lens was found to slow myopia (spherical equivalent) by 52% and eye elongation (axial length) by 62% compared to single vision (aka “regular”) lens over a 2-year period (1).
Essilor’s Stellest lens was launched in China in 2020. The Stellest lens uses “HALT,” or Highly Aspherical Lenslet Target, technology. It provides myopia correction and sharp distance vision through a single vision zone in the center, and features 11 rings of aspherical lenslets that create a volume of myopic defocus signal to slow the elongation of the eye.
In 2020, the interim results of an ongoing clinical trial at Wenzhou Medical University in China were announced. After one year, children wearing Stellest lenses saw more than 60% slowdown in myopia progression (spectacle ) and 28% slowdown in eye elongation when compared to the control group wearing single vision (aka “regular”) lenses (2).
SightGlass Vision’s DOT lens is a bit different from the others in that it controls myopia through contrast management. The theory is that artificially high contrast environments (can stimulate the eye to elongate. DOT, or Diffusion Optics Technology, involves thousands of light scattering dots to mimic more natural/less artificial contrast at all distances. DOT lenses have a central aperture about 5mm in diameter, surrounded by microscopic scattering centers throughout the treatment zone of the lens surface. The DOT lenses slightly reduce contrast on the retina, without a significant reduction in contrast sensitivity or visual acuity for the wearer. According to the CYPRESS study results at year 2 (of 3), 85% of the kids wearing the DOT lenses had less than 1D of myopia progression, compared to 65% of the control group. Forty-one percent of the kids wearing the DOT lenses showed no clinically meaningful progression in refractive error (ie: less than a 0.25D increase in myopia from baseline as measured by cycloplegic autorefraction) after two years, compared to 17% in the control group.(3). The CYPRESS study involved kids age 6 to 10 having myopia between -0.75D and -4.50D.
| CliffsNotes: We will soon have spectacle lens options that can slow the progression of nearsightedness in kids. Most essentially work by providing a clear central zone for myopia correction, while having multiple areas of plus power surrounding that central zone to create peripheral myopic defocus. That defocus is thought to slow eye elongation and myopia progression. SightGlass Vision’s DOT lens works a little differently, by reducing the contrast on the retina to simulate for natura |