Vault Decay Prediction Formula for Posterior Chamber Phakic Intraocular Lens With Central Hole Implantation: A 10-Year Follow-Up Study.

Childhood myopia is a global health concern with escalating prevalence and can lead to severe irreversible visual impairment. Early prediction of myopia progression is crucial for timely intervention to prevent high myopia and associated complications. To develop and validate a quantitative method, based on a deep learning method and using only fundus images and baseline refraction data, to predict both myopia progression trajectory and high myopia risk in schoolchildren. This longitudinal school-based cohort study (Anyang Childhood Eye Study) was conducted from February 2012 to May 2018, with annual follow-up examinations from February 2013 to May 2018. Grade 1 students, aged 6 to 9 years, were recruited from 11 randomly selected urban primary schools in Anyang, Henan Province, China. Children who received myopia control treatments, had amblyopia, or underwent strabismus surgery were excluded. Two independent external validation cohorts were used: the Lhasa cohort (predominantly consisting of Tibetan children) and the Beijing cohort (predominantly consisting of Han Chinese children). Data analysis was performed from July 2024 to July 2025. Performance of a novel deep learning model, created from combining convolutional neural network (34-layer residual network) and recurrent neural network (long short-term memory network). Area under the curve (AUC) was used to assess myopia and high myopia risk prediction, and mean absolute error (MAE) was used to assess spherical equivalent refraction (SER) prediction. Myopia was defined as SER of -0.5 D or less, and high myopia was defined as -6.0 D or less, using cycloplegic autorefraction. Among the 3048 children (mean [SD] age, 7.1 [0.4] years; 1716 females [56.3%]) included, the baseline prevalence rate of myopia was 5.71% (174) and high myopia was 0.5% (15). The deep learning model achieved AUC scores of 0.941 (95% CI, 0.936-0.946) for myopia risk prediction and 0.985 (95% CI, 0.982-0.988) for high myopia risk prediction, with an overall MAE of 0.322 D per year for SER prediction. External validation in the Beijing cohort (n = 130; mean [SD] age, 9.9 [3.7] years; 82 males [63.1%]; 128 Han Chinese [98.5%], 2 Man Chu [1.5%]) and the Lhasa cohort (n = 1039; mean [SD] age, 6.8 [0.5] years; 536 males [51.6%]; 29 Han Chinese [2.8%], 1007 Tibetan [96.9%], 3 [0.2%] from other ethnic minority groups) demonstrated maintained cross-ethnicity performance by the model, with an MAE of 0.355 D and 0.261 D per year, respectively. In this cohort study, a deep learning model, using minimal baseline data, provided highly accurate prediction of myopia and high myopia risk. This deep learning approach suggests the utility of large-scale screening and early-intervention efforts in resource-limited settings.

Effect of Eye-Transcutaneous Electrical Acupoint Stimulation on Myopia Incidence in Children: A Randomized Clinical Trial.

To quantify macular cone cell mosaic metrics in patients with varying degrees of myopia and explore its link to myopia severity using an adaptive optics (AO) fundus camera. A total of 76 age- and gender-matched patients with varying degrees of myopia (pre-myopia, low, moderate, and high) were recruited. Macular cone cell mosaic metrics (density, spacing, regularity, dispersion) were quantified via adaptive optics (AO) imaging, including correlations between AO-derived parameters and clinical indicators (spherical equivalent refraction, axial length) and predictive efficacy of AO metrics for myopia severity evaluated through receiver operating characteristic (ROC) curve analysis. As spherical equivalent refraction (SER) decreased, cone density (r = 0.65) and regularity (r = 0.38) significantly declined, while spacing (r = -0.65) and dispersion (r = -0.40) increased (all P < 0.001). Axial length (AL) was negatively correlated with density (r = -0.62) and regularity (r = -0.39), and positively correlated with spacing (r = 0.61) and dispersion (r = 0.38) (all P < 0.001). Predictive efficacy analysis based on AO-derived parameters revealed the highest AUROC value in the HM group (0.96), followed by Pre-M (0.86), LM (0.82), and MM (0.65) groups, indicating that AO metrics demonstrated superior early identification capability for HM severity. The AO fundus camera enables noninvasive evaluation of macular cone cell mosaic metrics, revealing strong correlations between density, regularity, spacing, dispersion, and myopia severity. These metrics demonstrate potential as biomarkers for evaluating myopic changes, with AO showing enhanced diagnostic efficacy in high myopia.

Purpose:To compare the preoperative clinical features in patients with basic unilateral exotropia who underwent single versus two and three or more strabismus surgeries.Design:retrospectiveMethod:Two thousand four hundred fifty-seven patients with unilateral basic exotropia were recruited over 10 years. Of these, 1886 (76.8%) had one surgery, 411 (16.7%) had two, and 160 (6.5%) had three or more surgical interventions. Preoperative data included the best corrected distance visual acuity (BCVA), refractive error, magnitude of exotropia, and amblyopia type and severity.Results:The mean age at first surgery was 26.3 ± 13.35 years (age range: 2–77) with no significant difference between groups with one, two, and three or more surgeries (p = 0.770). Mean BCVA in the strabismic eye was significantly worse in patients who underwent three or more surgeries (0.82 ± 0.076 logMAR) than those who had one (0.55 ± 0.018 logMAR; p < 0.001) or two surgeries (0.52 ± 0.038 logMAR; p < 0.001). Spherical equivalent refraction in the strabismic eye was significantly more hyperopic in patients who underwent three or more surgeries (0.79 ± 0.37 D), compared with those with one (−0.95 ± 0.094 D; p < 0.001) or two surgeries (−0.36 ± 0.16 D; p < 0.001). Relative to one surgery, undergoing two surgeries was independently associated with larger distance horizontal deviation (adjusted odds ratio (aOR) per prism diopter = 1.012; 95% CI, 1.003–1.022; p = 0.009). Undergoing three or more surgeries was independently associated with amblyopia severity (aOR = 2.368; 95% CI, 1.279–4.384; p = 0.006); in the strabismic eye, and higher spherical power markedly increased the odds (aOR = 13.553; 95% CI, 12.801–14.348; p < .001).Conclusion:Worse preoperative BCVA, greater hyperopia, and higher angle of deviation were associated with a greater likelihood of requiring more than one surgery. Surgeons should optimize preoperative refractive and amblyopia management and counsel high-risk patients about the increased likelihood of additional procedures.

The rising prevalence of mild myopia among kids needs very effective methods for preventing its progression. Recent research suggests that a combination of acupuncture and a small dose of atropine eye drops might be more effectively combined for myopia control. The trial will evaluate myopia control among kids aged 6-14 years old using buried needle acupuncture with low-dose atropine 0.01%. To evaluate if there is a synergistic effect from periocular acupuncture and low doses of atropine on mild myopia in children 6-14 years old. A total of 80 children with mild myopia and 160 eyes were included in the randomized controlled trial from March 2020 to June 2021. All participants were then randomly assigned equally into both the treatment group, which included acupuncture and low doses of atropine and routine eye care, and the control group, which included sham acupuncture and routine eye care. The main outcomes were uncorrected visual acuity, best-corrected visual acuity, spherical equivalent refraction, amplitude and facility of accommodation, and axial length. All these were measured at 0, 2, 6, and 12 months. Treatment compliance and attendance were monitored. The treatment group showed marked improvement in UCVA and BCVA, accommodation function, and rate of SER and axial length progression compared with the control group (P < 0.05). There were no serious side effects; two patients complained of mild transient pain. The combination regimen was generally tolerated without serious ocular or systemic side effects. Periocular acupuncture with low dose atropine solution (.01%) seems to be a safe and more effective method as compared with conventional treatment alone for controlling mild myopia in children. Large scale trials should be conducted for validating these findings.

Accuracy of self-refraction using a portable device based on badal optics, iREF, in children in southern China: A cross-sectional study.

PurposeThis study aimed to compare the visual outcomes, safety and efficacy of myopic keratorefractive lenticule extraction treatments using the newer Zeiss VisuMax 800 system over its precursor, the VisuMax 500 system.Patients and MethodsA retrospective review conducted at a private clinic in Western Australia of myopic keratorefractive lenticule extraction treatments with the VisuMax 500 and the VisuMax 800 systems between July 2021 and February 2023. Pre-operative and 1-month post-operative data were compared between the two cohorts. Demographics, best corrected visual acuity, uncorrected distance visual acuity, mean refractive spherical equivalent, total suction time and complications were recorded.ResultsFifty procedures for each system were identified. Eight eyes in the VisuMax 500 cohort (group 1) and five eyes in the VisuMax 800 cohort (group 2) were excluded due to non-attendance at the 1-month post-operative review. The average total suction time was 34 seconds vs 13 seconds respectively. A single case of suction loss occurred in group 1. The mean pre-operative mean refractive spherical equivalent of groups 1 and 2 were −6.02D (−3.63 to −9.00) and −5.56D (−2.75 to −8.88) (P = 0.20). The mean post-operative mean refractive spherical equivalent of the two groups were 0.08D (−1.00 to 1.25) and −0.03D (−2.25 to 1.00) (P = 0.31).ConclusionThe VisuMax 500 and 800 systems have similar visual outcomes and no significant difference in safety profiles. The main advantage of the newer VisuMax 800 femtosecond laser is its speed and potential for less cases of suction loss. Larger studies over longer terms are required.

To explore the association between smartwatch usage and annual changes in refraction and axial length in primary school students. A 1-year prospective, school-based, observational study. 661 students (Grade 5 at baseline, ages 11-13) were invited. The cycloplegic spherical equivalent refraction (SER), axial length (AL) and questionnaires were measured at baseline and 1-year visit. Five hundred twenty-six participants (mean age, 11.31 ± 0.47 years; 52.3% male) completed the 1-year study, and were divided into three groups based on smartwatch time (<0.5, 0.5-1, >1 h/day). Participants with more daily smartwatch usage (>1 h/day) showed more significantly myopic shift in refraction (-0.95 D) and axial elongation (0.47 mm) compared to those with moderate (0.5-1 h/day: -0.29 D and 0.25 mm) or low (<0.5 h/day: -0.33 D and 0.28 mm) usage (both p < 0.001). The weekday time of the smartwatch was strongly associated with changes in SER (r = -0.173, p < 0.001) and AL (r = 0.163, p < 0.001). The generalised linear mixed model (GLMM) revealed that total screen time (β = -0.07 for SER change, β = 0.03 for AL change, both p < 0.001) and weekday smartwatch usage (β = -0.58 for SER change, β = 0.16 for AL change, both p < 0.001) were significantly associated with myopic shifts in refraction and axial elongation. Observational data indicate an association between total screen time (including smartwatch) and myopic shifts in refraction or axial elongation. These findings suggest that reasonable management of screen time may be warranted.

To compare the 1-year myopia control effects of spectacle lenses with highly aspherical lenslets (HAL), HAL combined with 0.01% atropine (HALA), and single-vision spectacle lenses (SVL) in children with moderate to high myopia. This retrospective cohort study analyzed 175 myopic children treated at the Eye Hospital of Wenzhou Medical University between January 2020 and January 2024. Participants were divided into three groups based on treatment: HAL (n = 62), HALA (n = 55), and SVL (n = 58). Changes in axial length (AL) and spherical equivalent refraction (SER) under non-cycloplegic conditions were compared using one-way ANOVA. Post hoc pairwise comparisons were performed using the LSD method, and all pairwise p-values were subsequently adjusted for multiple comparisons using the false discovery rate (FDR) to control the risk of Type I error. After 12 months, mean AL elongation was 0.21 ± 0.15mm in the HAL group, 0.21 ± 0.13mm in the HALA group, and 0.28 ± 0.15mm in the SVL group. AL changes between HAL and HALA were not significantly different (P = 0.837). However, both HAL (P = 0.004) and HALA (P = 0.009) significantly slowed axial elongation compared to SVL. In subgroup analysis, children aged 8-10 years showed no significant differences among groups. In the 11-12-year subgroup, both HAL and HALA significantly reduced AL elongation compared to SVL, with no difference between HAL and HALA. HAL and HALA offer similar efficacy in controlling myopia progression in children with moderate-to-high myopia, both outperforming SVL. Their effects appear more pronounced in older children.

This study aimed to evaluate the short-term visual performance and subjective satisfaction of a dual-focus soft contact lens (DF-SCL) compared with a single-vision soft contact lens (SV-SCL) in myopic Chinese children over one month of daily wear. Myopic children aged 8 to 14 years first underwent baseline testing with SV-SCL (Proclear), followed by DF-SCL (MiSight). They then continued wearing DF-SCL for one month. Distance and near high-contrast visual acuity (d-HCVA, n-HCVA), contrast sensitivity function, the Subjective Acceptability Questionnaire, and visual performance questionnaire were assessed at four visits: SV-baseline, MiSight (MS)-baseline, MS-1 week, and MS-1 month. A total of 38 subjects (19 female, 19 male; mean age 10.75±1.13 years; mean spherical equivalent refraction, -1.81±0.69 D) completed the study. At baseline, d-HCVA was significantly better with SV-SCL (-0.05±0.06 logMAR) than with DF-SCL (-0.02±0.04 logMAR, P=0.03), while n-HCVA showed no significant difference (P=0.27) between with SV-SCL (-0.03±0.05 logMAR) and DF-SCL (-0.01±0.04 logMAR). After one week of DF-SCL wear, n-HCVA improved significantly (-0.04±0.06 logMAR, P=0.04) compared with MS-baseline. After one month of DF-SCL wear, d-HCVA (-0.03±0.06 logMAR, P=0.55) and n-HCVA (-0.05±0.07 logMAR, P=0.48) were comparable with SV-baseline. The contrast sensitivity with DF-SCL improved at 12 and 18cpd after one week of DF-SCL wear compared with MS-baseline. In the questionnaire, overall satisfaction significantly improved at the 1-month visit (P<0.001) compared with MS-baseline, and visual symptoms of paracentral and peripheral blurry vision alleviated after a week of wearing (P=0.009). Myopic Chinese children demonstrated good visual quality and high subjective satisfaction over one month of DF-SCL wear, despite a slight initial decline in visual performance compared with SV-SCL.

This study aimed to identify the loci of gene mutations associated with high myopia, analyse the genetic mutation spectrum characteristics for early onset high myopia (eo-HM) and explore the application of polygenic risk scores (PRSs) in predicting eo-HM. Whole-exome sequencing (WES) and ophthalmic measurements were performed on participants with high myopia, and the mutation results were further verified by copy number variation sequencing, long range PCR and Sanger sequencing. Participants were classified into eo-HM (onset age<7 years and binocular spherical equivalent refraction <-6.0 dioptres (D)) and late-onset high myopia (lo-HM). PRS was calculated and assessed for eo-HM prediction accuracy through receiver operating characteristic (ROC) curve metrics. The participants comprised 100 patients with high myopia. WES identified 36 variants across 35 of 100 patients (35.00%), with the eo-HM group exhibiting a significantly higher detection rate (56.52%) than the lo-HM group (16.67%) (p<0.001). COL2A1 c.1221+1G>A, ARR3 c.41T>C, GLRA2 c.1006G>A, ZEB1 c.1672C>T and HDAC8 c.466A>G were recognised as de novo mutation loci in eo-HM. TCF7L2, AIPL1, INPP5E and the promoter mutation of SALL4 were identified as novel potential pathogenic mutations for high myopia (HM). Genetic mutations related to retinal diseases were more frequently observed in the eo-HM group than in the lo-HM group (p<0.01). ROC curve analysis signified that PRS had acceptable predicting ability for eo-HM (area under the curve=0.70). This study expands the eo-HM mutational spectrum and proposes novel HM pathogenic genes. PRS demonstrates a certain ability to predict eo-HM.

Randomized contralateral eye study of myopia control between aspheric multifocal soft contact lens and orthokeratology in children.

Effects of yoga facial massage on computer vision syndrome and ocular motor function: A randomised controlled trial.

To evaluate visual outcomes in patients with myopia or compound myopic astigmatism in wavefront-guided laser in situ keratomileusis (WFG-LASIK) and photorefractive keratectomy (WFG-PRK) performed by cornea fellows in training. Academic eye institute in Palo Alto, California, USA. Prospective, nonrandomized clinical trial. Patients with no history of refractive surgery underwent WFG-LASIK or WFG-PRK. Patients had preoperative refractive errors with sphere up to -10.25 diopters (D), cylinder up to 4.50 D, with a maximum spherical equivalent (SE) of -10.00 D. All eyes were targeted for emmetropia. The primary outcome measure was UDVA at 3 months. Secondary outcome measures included safety and predictability. 66 eyes of 33 patients underwent WFG-LASIK, and 71 eyes of 36 patients underwent WFG-PRK from March 2017 to October 2024. At 3 months, 91.2% of eyes in the WFG-LASIK group achieved UDVA of 20/20 or better, 35.3% of eyes achieved 20/15 or better, 91.2% of eyes achieved manifest refraction SE (MRSE) within 0.50 D of target, mean SE was -0.04, and no eyes lost more than 2 lines of corrected distance visual acuity (CDVA). In patients who underwent WFG-PRK, 82.0% of eyes achieved UDVA of 20/20 or better, 10.0% of eyes achieved 20/15 or better, 98.0% of eyes achieved MRSE within 0.50 D of target, mean SE was -0.01, and no eyes lost more than 2 lines of CDVA. WFG-LASIK and WFG-PRK performed by cornea fellows in training achieved excellent safety, efficacy, and predictability for the correction of myopia and compound myopic astigmatism.

We lack knowledge on the potentially progressive nature of and the prevalence of complications to myopia as a characteristic trait of Stickler syndrome. This cross-sectional study combines ophthalmic examination and medical record data on Danish patients with genetically confirmed Stickler syndrome type 1 (COL2A1) and type 2 (COL11A1). The main outcomes are axial length, spherical equivalent refraction (SER), SER over time, and myopic maculopathy category by fundus photography. The study includes 71 patients with type 1 (age: median = 29 years, IQR = 15-49 years; 44% male) and 13 with type 2 Stickler syndrome (age: median = 27 years, IQR = 9-33 years; 69% male). For type 1, the median SER was -6.00 dioptres (D) (IQR = -8.88 to -2.19 D) and -6.75. (IQR = -10.88 to -1.94) for type 2, (p = 0.52). Mean axial length was 25.99 ± 1.99 and 26.55 ± 3.45 mm, respectively (p = 0.57). SER was nonprogressive in childhood in both subtypes. Myopic maculopathy was present in 28 (43%) type 1 and five (42%) type 2 patients. The odds for higher category myopic maculopathy increased by a factor of 2.15 with each mm of axial elongation (95% CI = 1.14 to 4.04, p = 0.02) but not with age (odds ratio = 1.02 per year, 95% CI = 0.97 to 1.09, p = 0.39) in type 1. We find myopia in our cohort is nonprogressive. We find no difference in axial length or refractive error between subtypes. Myopic maculopathy is common, its severity depending on axial length, not age. These findings are relevant for risk stratification of vision-threatening myopia.

This study aimed to investigate the correlation between myopia severity and the stress–strain index (SSI), measured with the Corneal Visualization Scheimpflug Technology (Corvis ST) device. The subjects were divided into two groups, based on both the axial length (AL) and spherical equivalent refraction (SER): 22–26.00 AL group (22 mm < AL < 26.00 mm) associated with SER of less than − 6.00D, and ≥ 26.00 AL group (AL ≥ 26.00 mm) associated with SER over − 6.00D. The differences in the Corvis ST-derived dynamic corneal response parameters and stiffness parameters between the two groups were investigated. The correlation between SSI and AL, SER, age, ratio of AL to radius of corneal curvature (CR) (AL/CR), and axial length minus anterior chamber depth (ACD) (AL-ACD) were analyzed. The SSI (0.95 ± 0.13 in the 22–26.00 AL group and 0.86 ± 0.15 in the ≥ 26.00 AL group) were significantly different between the two groups (P < 0.01). In the ≥ 26.00 AL group, there was evidence of a weak negative correlation between SSI and AL (r = − 0.265, P < 0.01), AL/CR (r = − 0.376, P < 0.01), and AL-ACD (r = − 0.224, P < 0.01); and a weak positive correlation between SSI and SER (r = 0.251, P < 0.01). However, in the 22–26.00 AL group, there was no correlation between SSI and AL, AL-ACD, AL/CR or SER (P > 0.05). SSI was significantly correlated with AL, which is the major determinant of SER, in the ≥ 26.00 AL group. This correlation was not affected with CR and ACD, as both AL/CR and AL-ACD also correlated with SSI at the same degree.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-23834-x.

Rationale: EDOF IOLs, while providing an extended depth of focus, are associated with fewer adverse optical phenomena, although they may limit near vision. Therefore, to expand visual capabilities, methods of mini-monovision and combined IOL implantation are used. Objective: To analyze the effectiveness of combined implantation of a non-diffractive EDOF IOL and a multifocal intraocular lens. Materials and Methods: This prospective study included 138 patients (276 eyes), comprising 77 women and 61 men, after bilateral or unilateral implantation of various IOL models. Group I included 40 patients (80 eyes) after combined implantation of the AcrySof IQ Vivity IOL (n = 40) in the dominant eye and the AcrySof IQ Panoptix IOL (n = 40) (Alcon, USA) in the non-dominant eye, with a mean follow-up period of 15.4±1.2 (range 12-22) months. Group II included 40 patients (80 eyes) who underwent bilateral implantation of the EDOF AcrySof IQ Vivity IOL. Group III consisted of 58 patients (116 eyes) with bilateral implantation of the trifocal AcrySof PanOptix IOL. All patients underwent a comprehensive standard and special ophthalmological examination. Phacoemulsification cataract surgery was performed using a standard technique. Results: A significant (p&lt;0.05) increase in UDVA, CDVA, and UNVA was observed at the maximum follow-up period compared to preoperative values in all groups. In Group III and Group I (combined implantation), a significantly greater increase in UDVA and CDVA was noted at the 3-month follow-up compared to Group II (up to 0.83±0.14; p&lt;0.05 and 0.82±0.09 (p = 0.048), respectively) with distance correction throughout the entire follow-up period (p&lt;0.05). Patients in Group II were characterized by an increase in UNVA from 0.29±0.09 preoperatively to 0.9±0.20 at the maximum follow-up period. A similar dynamic was noted in Group III (0.34±0.09 and 0.87±0.13, respectively). Over the same follow-up period, an increase in UNVA was observed in Group I from 0.31±0.06 to 0.86±0.14, respectively. The differences between the groups at all follow-up periods were not statistically significant (p&gt;0.05). In the combined implantation group, a reduction in the spherical equivalent of refraction was shown from -2.50±1.3 to -0.12±0.64 at the 3-month follow-up. In Group II, 10% of patients reported complaints of ‘glare’, 10% of ‘halos’, and there were no complaints of difficulties with night driving. In Group III patients, the frequency of unwanted optical phenomena was significantly higher: 32.8% of patients complained of glare, 27.6% of halos, and 24.1% of patients reported difficulties with night driving. In Group I (combined implantation), the frequency of complaints was comparable to Group II: glare (10%), halos (10%), and difficulties with driving at dusk (5%). Conclusion: Combined implantation of EDOF and trifocal IOLs demonstrated advantages compared to bilateral implantation of each of these lens types: it allows for achieving higher near visual acuity while simultaneously reducing the frequency of adverse optical phenomena.

ABSTRACTThis randomized crossover trial investigates the effects of blue light defocus display technology on refractive status, axial length (AL), retinal blood flow, and visual function in adults. Twenty‐one participants completed all four interventions: 0D, 1D, 2D defocus, and 1D defocus with 30 % blue light filtering (1D+BLF) in a randomized order during standardized visual tasks. Pre‐ and post‐task assessments include refraction, AL, choroidal thickness (ChT), retinal defocus, reading efficiency, and visual fatigue. Results demonstrate that 1D defocus reduces spherical equivalent refraction (SER) (−4.35 ± 2.66 D to −4.21 ± 2.66 D, P = 0.045) and increases ChT (P = 0.003), while 1D+BLF induces axial elongation (P = 0.026). Both 1D and 2D defocus are linked to increased ChT, whereas 0D and 1D+BLF groups exhibited hyperopic defocus trends. Reading speed and efficiency improve in the 1D group (p < 0.05), while visual fatigue and blink frequency increase significantly in the 0D group (p = 0.001). Linear regression identifies correlations between defocus and changes in choroidal volume, near convergence, and fusional reserves. These findings suggest blue light defocus technology may help mitigate hyperopic defocus, influence retinal perfusion, and alleviate visual fatigue, supporting its potential role in myopia prevention. Further validation in diverse populations and long‐term studies is warranted.

To report the 1-year efficacy of Myofix Defocus spectacles, designed to control the progression of myopia in childhood. A total of 47 children with myopia aged 7-15years were enrolled. Cycloplegic objective refraction (spherical equivalent refraction, SE) and axial length (AL) were measured at baseline, 6months, and 12months. Linear regression models were used to identify risk factors of 12-month changes in SE and AL. For comparison, two virtual control groups of children were included. Tolerance was assessed through a questionnaire at each follow-up visit. Of the initial cohort, 11 participants were lost to follow-up after 6months due to reasons unrelated to lens design (77.1% retention rate). Over 12months, the mean SE change in all eyes was -0.21 ± 0.30 D, and AL change was 0.19 ± 0.13mm. Progression was significantly different in participants who reported good compared to poor compliance (p < 0.001). At the 12-month follow-up, participants with good compliance had a mean SE progression of -0.12 ± 0.25 D and a mean AL change of 0.17 ± 0.11mm. In virtual controls, the mean annual SE progression was -0.47 ± 0.36 D, and AL change was 0.26 ± 0.17mm (both p < 0.001). In compliant participants, Myofix Defocus lens demonstrated a 75% reduction in SE and 37% reduction in AL compared to virtual controls. After 1year, Myofix Defocus spectacles slowed myopia progression in children, demonstrating comparable efficacy to other defocus-incorporated spectacle designs. Greater compliance resulted in better treatment effect. Further long-term studies are warranted to confirm these findings. ClinicalTrials.gov identifier: NCT07092072. Registered retrospectively on July 29, 2025.