Effectiveness of DIMS combined with atropine and orthokeratology in a real-world setting in China.

Background and objectives: Myopia cases have markedly increased worldwide, particularly in younger individuals. This study evaluatestheeffectofdefocus incorporated multiple segments (DIMS) lens combined with atropine (DIMSA) in the control of myopia progression versus orthokeratology (ortho-k) lenses.

Methods: In this non-randomized controlled clinical study, 180 eyes in 180 myopic children treated at the Nanjing Children's Hospital between January 2022 and February 2023 were included. According to the preferences of patients and their guardians, the participants were divided into the DIMSA and ortho-k groups, with 90 cases (90 eyes) each. Totally 161 patients in both groups met the inclusion and exclusion criteria, including 88 and 73 in the DIMSA and ortho-k groups, respectively. Right eye parameters were analyzed. Both groups were compared in terms of change in axial length (AL), AL negative growth rate and AL elongation rate after a one-year visit.

Results: No significant differences were found in baseline features other than age between the DIMSA and ortho-k groups. After a one-year treatment, no statistically significant difference was found in axial elongation (AE) between the two groups. After adjustment for baseline age, axial elongations in the DIMSA and ortho-k groups were 0.14 ± 0.18 mm and 0.20 ± 0.18 mm (P = 0.025), respectively. Baseline age was the only factor impacting the axial control efficacy of DIMSA and ortho-k lenses, with a negative association between AE and age in both groups and a positive association between spherical equivalent refraction (SER) increase and baseline age in the DIMSA group. The DIMSA group exhibited higher AL negative growth and AL slow growth (≤0.15 mm) rates after one year compared with the ortho-k lens group (P = 0.008 and P = 0.004, respectively).

Conclusions: DIMSA demonstrated marginally superior myopia control efficacy compared to ortho-k lenses in children with mild to moderate myopia in a real-world setting in China.