Real-World Comparison of the Effectiveness of Defocus Incorporated Multiple Segments and Myopi-X Spectacle Lenses for Myopia Control in Turkish Children: A Retrospective Study

Objectives This study compared the 12-month real-world effectiveness of defocus incorporated multiple segments (DIMS) spectacle lenses, Myopi-X progressive addition lenses, and single-vision (SV) lenses in slowing myopia progression in children. Materials and Methods This retrospective observational study included 385 eyes using one of the three spectacle types. Baseline age, spherical equivalent refraction (SER), and axial length (AL) were recorded. Twelve-month changes in SER and AL were analyzed using the Kruskal-Wallis test with Bonferroni-adjusted pairwise comparisons. Generalized estimating equations (GEE) were used to assess the effects of treatment group, age group, sex, and baseline AL group on SER and AL changes. Results The study population consisted of 118 Myopi-X eyes (32.4%), 107 SV eyes (29.4%), and 139 DIMS eyes (38.2%). Baseline demographic and ocular characteristics (including age, sex, SER, AL, age group, and baseline AL group) were comparable among the groups (all p>0.05). After 12 months, mean SER progression was -0.35±0.34 diopters (D) in the Myopi-X group, -0.46±0.37 D in the SV group, and -0.24±0.33 D in the DIMS group (p<0.001). Mean AL elongation was 0.21±0.12 mm, 0.24±0.17 mm, and 0.17±0.16 mm, respectively (p=0.004). GEE analyses demonstrated a significant treatment effect for both SER and AL change (p<0.001 for both). The least progression occurred in the DIMS group, followed by Myopi-X, while the SV group showed the highest progression. Baseline AL group was the only significant predictor of AL elongation (β=0.210, 95% confidence interval: 0.189-0.231, p<0.001), with greater elongation in eyes with high baseline AL. Age group and sex did not significantly influence SER or AL outcomes. Conclusion DIMS spectacle lenses were more effective than Myopi-X and SV lenses in reducing both refractive progression and axial elongation over 12 months. Baseline AL was a key determinant of axial growth, supporting the use of individualized risk assessment in pediatric myopia management.