Comparative effectiveness of defocus lenses, atropine, and their combined use for myopia control in children: A systematic review.
Abdulaziz Hassan, Abdullah Hasan, Hasan Ibrahim et al.
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In 30 seconds
This systematic review compared defocus incorporated multiple segments (DIMS) lenses, atropine, and their combination for myopia control in children. It included 1,460 participants across eight comparative studies, with outcomes assessed after at least 6 months. DIMS and atropine monotherapy generally showed similar effects on spherical equivalent refraction (SER), although findings for axial length (AL) varied. Combination therapy more often reduced SER and AL than either treatment alone; all studies comparing combination therapy with DIMS favored the combination for AL, with three reporting statistically significant differences. The review also judged DIMS to have fewer adverse effects.
Key findings
- Across three studies comparing monotherapies, SER reduction did not differ significantly except in one study favoring atropine.
- Two studies found significantly less axial elongation with DIMS than atropine; one found no significant difference.
- Three of four studies reported significantly greater SER reduction with combination therapy than with DIMS alone.
- All studies comparing combination therapy with DIMS favored the combination for axial length, with three reporting statistically significant results.
Why it matters
The review suggests that both DIMS lenses and atropine can be used to manage childhood myopia, while combining them may provide greater control of refractive change and axial elongation. Its comparison of efficacy and adverse effects can inform discussions of treatment options, although the findings come from a limited set of comparative studies and do not establish that one approach is best for every child.
What to keep in mind
The review included only eight studies, and results varied across comparisons; the abstract does not report pooled effect estimates.