Comparative efficacy of three optical interventions for myopia control in adolescents

To compare the efficacy of single vision lenses (SVL), defocus incorporated multiple segments lenses (DIL), and diffusion optics technology lenses (DOTL) in controlling myopia progression among adolescents in real-world clinical settings. This observational comparative study enrolled 240 myopic children aged 7–16 years from July 2024 to June 2025. Participants were allocated into three groups based on clinical selection (n = 80 per group): SVL group (conventional single vision lenses), DIL group (HOYA DIL or ESSILOR Stellest), and DOTL group (Beijing Nikon DOT lenses). Primary outcomes included changes in spherical equivalent (SE) and axial length (AL) measured at baseline and 12 months. Age-stratified analyses were performed for younger (6–12 years) and older (13–16 years) groups to evaluate intervention effects across different developmental stages. All 240 participants completed the 12-month follow-up with complete data. Mean daily wearing time was 11.2 ± 0.8 h across all groups. After 12 months, the DOTL group demonstrated the smallest progression in SE (− 0.07 ± 0.34D) and AL (0.03 ± 0.18 mm), followed by DIL (− 0.26 ± 0.36D; 0.18 ± 0.07 mm) and SVL (− 0.68 ± 0.62D; 0.34 ± 0.27 mm) groups (all P < 0.05). Age-stratified analysis revealed that younger children had faster progression in SVL and DIL groups, while DOTL maintained consistent efficacy across age groups. Both DIL and DOTL demonstrated superior myopia control efficacy compared to SVL, with DOTL showing the most robust and age-independent effects. These findings provide real-world evidence for personalized myopia management strategies in clinical practice.