Efficacy of spectacle lenses specifically designed for myopia control: systematic review and meta-analysis.

Abstract

To investigate the efficacy of spectacle lenses designed to control myopia progression in individuals under 18 years old, focusing on changes in spherical equivalent refraction (SER), axial length (AL) and relative peripheral refraction (RPR). A systematic review was conducted according to Prisma guidelines. Databases searched included PubMed, Embase, and Scopus, covering studies from the last six years without language restrictions. Studies were included based on specific criteria, and data were extracted and analysed using the metafor package in R. Separate meta-analyses were conducted for SER and AL at 12- and 24-month follow-ups, using random-effects models. RPR information was synthesized without meta-analysis. Out of the 796 studies screened, 21 were included in the review, with 17 selected for the meta-analysis, comprising a total of 6,175 patients. At 12 months, the intervention group showed a significant reduction in SER (d+ = -0.281, p < .0001) and AL (d+ = -0.155, p < .0001) compared to the control group, where d + is the pooled mean effect size estimate. However, at 24 months, no significant differences were observed in SER (d+ = -0.385, p = .067) or AL (d+ = -0.272, p = .137) between groups. Sensitivity analyses confirmed these findings, and publication bias was minimal. Regarding RPR, the results are limited and differ among model lenses. Spectacle lenses designed to control myopia progression show short-term benefits, significantly reducing SER and AL at 12 months. However, their long-term efficacy remains uncertain, with no significant differences observed at 24 months. Further research is needed to understand treatment response factors and evaluate the long-term efficacy and safety of these lenses in myopia management.