Efficacy of spectacle lenses for myopia control: a meta-analysis of randomised controlled trials

Purpose To determine the effects of advanced spectacle lens technologies on changes in spherical equivalent of refraction (SER) and axial length (AL) elongation in slowing down the progression of myopia in children and adolescents, by synthesising data from randomised controlled trials (RCTs). Methods A systematic review and meta-analysis was conducted to identify all RCTs up to 27 February 2025 that compared intervention groups with myopia control lenses and control groups with standard single vision lenses (SVLs). Data from eligible studies were extracted into specially-designed data collection forms without changing the original values. Means and SD for continuous outcomes were determined and imported into RevMan. Results This meta-analysis included 23 RCTs with a total of 13.315 subjects. Compared with SVLs, myopia control lenses significantly reduced AL (−0.15 mm; 95% CI −0.20 to −0.09; p<0.00001) and SER progression (−0.31 D; 95% CI −0.42 to −0.20; p<0.00001). Highly Aspherical Lenslet lenses significantly reduced AL (−0.28 mm; 95% CI −0.37 to −0.19) and SER progression (−0.52 D; 95% CI −0.84 to −0.20). Defocus Incorporated Multiple Segments lenses also significantly reduced SER (−0.45 D; 95% CI −0.65 to −0.26), although only one eligible RCT reported AL data. Other lens types had modest or variable effects. Conclusions This meta-analysis provides an up-to-date and detailed comparative evaluation of spectacle lens designs for myopia control, based exclusively on RCTs. These findings support the use of specialty lenses as an effective, non-invasive strategy to reduce the risks associated with high-myopia and guide optimal lens selection in clinical practice. PROSPERO registration number CRD420251009898 All data relevant to the study are included in the article or uploaded as supplementary information.