Comparative longitudinal evaluation of DIMS, progressive addition and single-vision lenses on myopia progression, binocular and visual performance in Spanish children

An 18-month prospective, non-randomized comparative observational study evaluated the effects of different optical corrections on myopia progression, binocular vision, and visual performance in Spanish children. Forty-five myopic participants aged 9-14 years were allocated to single-vision lenses (SV), low-addition progressive addition lenses (PALs), or defocus-incorporated multiple segments lenses (DIMS). Assessments included spherical equivalent (SE) and axial length (AL), comprehensive accommodative function evaluated by measuring amplitude of accommodation, positive and negative relative accommodation, accommodative facility, and accommodative response, and binocular function evaluated by measuring phorias, fusional vergences, and stereopsis. In addition, contrast sensitivity (CS), visual disturbance index (VDI), and subjective visual quality were assessed at baseline and at 6, 12, and 18 months. After 18 months, SE progression was -0.59 D for SV, -0.51 D for PALs, and -0.30 D for DIMS, corresponding to a 49% reduction with DIMS compared to SV. AL increased by 0.24, 0.27, and 0.23 millimeters, respectively, although inter-group differences were not significant for AL. Accommodative and binocular functions, visual acuity, CS, and VDI remained stable, while distance stereopsis improved in the DIMS group. These findings suggest an association between DIMS lens wear and reduced myopia progression compared with SV lenses in this cohort, without clinically relevant differences in accommodative or binocular function, visual acuity, or subjective visual quality.