One year results of a pilot study on stepwise defocus incorporated multiple segment spectacle wear for myopia prevention in preschool children with premyopia

Abstract

Abstract This study assessed the feasibility, acceptability, and preliminary efficacy of stepwise defocus incorporated multiple segment (DIMS) plano spectacle wear by preschoolers with premyopia and normal uncorrected visual acuity (UCVA). This single-arm, prospective pilot study included 23 children with premyopia (mean age 5.4 years) who were identified from a community screening program in Taiwan. A stepwise DIMS spectacle regimen was implemented: part-time wear during near work before school entry followed by full-time wear after starting school. The primary outcome was the change in the spherical equivalent (SE) and the secondary outcome was axial length (AXL) elongation after 1 year. The mean SE change after 1 year was + 0.08 dioptres (0.35), whereas the mean AXL elongation was + 0.22 mm (0.12). None of the participants developed myopia. During the preschool stage, 91.3% had good adherence to part-time wear. However, adherence dropped to 52.2% during full-time wear after school entry. The majority of the participants (73.9%) had physiological AXL growth. Visual symptoms were minimal and the caregivers reported high acceptance. Stepwise use of the DIMS plano spectacles was well-tolerated and associated with stable refractive outcomes and physiological AXL elongation among preschoolers with premyopia. Larger, controlled studies in future are warranted to validate these findings and optimise intervention strategies.