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Purpose: This study aimed to examine the effect of Defocus Incorporated Multiple Segments (DIMS) lenses on myopia progression and axial elongation in a clinical population., Methods: A retrospective study was conducted using clinical data from 489 and 156 patients aged 3 to 17 years old who were prescribed DIMS and single vision (SV) lenses, respectively at the Optometry Clinic of The Hong Kong Polytechnic University between July 2018 and August 2019. The study included patients with previous myopia control interventions. The changes in spherical equivalent refraction (SER) and axial length (AL) were measured and normalized to annual changes. The correlation between age at baseline and annual change in AL was also examined., Results: The total change in SER and AL after DIMS were -0.94 ± 0.79D and 0.55 ± 0.40 mm, respectively with an average wearing period of 31.98 ± 9.97 months. The normalized annual changes in SER and AL in DIMS wearers were significantly smaller than those in SV wearers (DIMS; SER change vs. AL changes; -0.38 ± 0.32D vs. 0.22 ± 0.16 mm. SV; -0.45 ± 0.41D vs. 0.29 ± 0.20 mm, p  < 0.05). Patients with a history of myopia control had greater myopia progression after wearing DIMS lenses. There was a significant negative correlation between age at baseline and annual change in AL (correlation coefficient, r  = -0.61, p  < 0.001), suggesting that myopia progression was faster in children with a younger age of onset. A small proportion of patients (2.7%) experienced a clinically significant axial shortening (total change in AL:-0.13 ± 0.07 mm) after wearing DIMS lenses more than 2 years., Conclusion: The study demonstrated that DIMS lenses could retard axial elongation, with the effect sustained with increased duration of lens wear. However, patients with previous myopia control experienced greater myopia progression after wearing DIMS lenses. The study also highlighted the potential for axial length shortening in a small proportion of patients after the DIMS lens wear. These findings underscore the importance of adherence to intervention in achieving optimal treatment efficacy. Further research is needed to understand the mechanisms underlying these effects and to optimize the use of optical interventions in myopia control., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Chun, Wong, Lam, To, Liu, Wong, Tang, Chan, Kwok, Cheung, Yung and Lam.)

Background: Myopia, characterized by excessive axial elongation of the eyeball, increases risks of having sight-threatening diseases and impose a financial burden to healthcare system. Although myopic control interventions showed their effectiveness in slowing progression, the efficacy varies between individuals and does not completely halt progression. The study aims to investigate the efficacy of combining 0.01% atropine administered twice daily with optical defocus for myopia control in schoolchildren., Methods and Design: This is a prospective, parallel-group, single-blinded, randomized, active-control trial (ClinicalTrials.gov identifier: NCT06358755). Myopic schoolchildren with no previous myopic control interventions aged between 7 to 12 years will be recruited. They will be randomly allocated into two groups (n = 56 per group) after baseline measurement. Both groups will receive 0.01% atropine twice per day for 18 months (one drop in the morning and the other drop at night before bedtime). Defocus incorporated multiple segments (DIMS) spectacle lenses will be prescribed in atropine plus optical defocus (ATD) treatment group while single vision spectacle lenses will be given in atropine only (AT) group. Cycloplegic refraction and axial lengths will be monitored every 6 months over 18-month study period. The primary outcomes are changes in cycloplegic refraction and axial lengths relative to the baseline over the study period., Discussion: The result will examine the combination effect of low dose atropine and myopic defocus on myopia control in a randomized controlled study. The findings will also explore the potential benefits of applying 0.01% atropine twice per day on myopic control and its potential side effects., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Chun et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)