Comparative Effectiveness of Three Myopia Control Lenses: A Multicenter, Real-World Study of 5182 Adolescents and Children in Chongqing, China

Purpose: The purpose of this study was to assess the 1-year myopia control efficacy of 3 optical interventions-lenslet-based design (LD) spectacle lenses, peripheral defocus (PD) spectacle lenses, and orthokeratology (OK) contact lenses-in real-world clinical settings among children and adolescents in China. Methods: In this multicenter retrospective study, we analyzed the medical records of 5182 participants aged between 6 and 16 years old. The participants were divided into four groups according to the myopia control method. The axial length (AL) and spherical equivalent refraction (SER) of the right eye were used to assess myopia progression. Myopia progression was compared across the matched cohorts using propensity score matching and multiple linear regression. Subgroup analyses were used to assess the differential efficacy of lenses, stratified by age, sex, and baseline refractive status. Results: At the 1-year follow-up, the LD group demonstrated SER progression of -0.23 ± 0.09 diopter (D) and 0.12 ± 0.06 mm of axial elongation (AE) compared with the single vision (SV) group. The OK group demonstrated an AE reduction of 0.13 ± 0.06 mm compared with the SV group. Stratified analyses demonstrated consistent superiority of OK lenses over PD and SV lenses across all subgroups (P < 0.05 for AL), whereas LD and OK lenses showed comparable efficacy in AL control (P > 0.05). Conclusions: LD and OK lenses demonstrated superior efficacy in controlling myopia compared with PD and SV lenses, with comparable AL control between the two interventions. Translational Relevance: This large-scale, real-world evidence translates the efficacy of myopia-control lenses into actionable guidance for pediatric clinical practice.