Defocus Incorporated Multiple Segments May Slow Pediatric Myopia Progression

Patients aged between 6 and 11 years may derive the greatest myopia control benefit from defocus incorporated multiple segments.

Defocus incorporated multiple segments (DIMS) may demonstrate better myopia control efficacy than single vision lenses, according to a study published in Ophthalmic and Physiological Optics. This finding is supported by a lower spherical equivalent (SE) progression among pediatric patients treated with DIMS compared with single vision lenses, the report shows. 

Researchers retrospectively reviewed data from 10,477 children with myopia (mean age; 11.02 years; mean SE, -2.78diopters [D]) who were treated with either DIMS (n=3639) or single vision spectacle lenses (n=6838) at 1 of 9 hospitals between July 2018 and November 2020. Patients underwent a cycloplegic refraction followed by a subjective refraction and were stratified according to age (younger: aged 6-11 years; older: 12-16 years). 

Study participants treated with DIMS experienced significantly less SE progression compared with children treated with single vision lenses (-0.50 vs -0.77 D; P <.001) at 1-year follow-up, the report shows. This slower progression among the DIMS group persisted into the second year of treatment as well compared with the single vision cohort (-0.88 vs -1.23 D; P <.001).

At 1 year, 40% of children treated with DIMS and 19% of children treated with single vision lenses experienced SE progression of 0.25 D or less (P <.01). A total of 9% of participants in the DIMS group and 22% of children in the single vision group experienced SE progression of 1.00 D or more (P <.001). 

From the greater efficacy point of view, it is suggested to apply DIMS in subjects with younger age and lower level of myopia.

During the second year, 33% of the DIMS group and 20% of single vision lens group had myopia progression of 0.50 D or less (P <.001), while 12% and 29% of the DIMS and single vision groups, respectively, had SE progression of 1.50 D or more (P <.001).

The 2-year subset data reveals that participants classified as younger derived a greater benefit from DIMS treatment compared with individuals classified as older (adjusted mean difference, younger: -0.35 vs older: -0.23 D).

“[T]he large-scale multi-center real-world study confirmed the myopia control effect of DIMS spectacle lens in Chinese subjects,” according to the researchers. “From the greater efficacy point of view, it is suggested to apply DIMS in subjects with younger age and lower level of myopia.”

Study limitations include a retrospective nature, a lack of axial length data, failure to account for confounders, and ethnic homogeneity, which may limit globalization of the findings.


Liu J, Lu Y, Huang D, et al. The efficacy of defocus incorporated multiple segments (DIMS) lenses in slowing myopia progression: a retrospective real-world study. Ophthalmology. Published online January 12, 2023. doi:10.1016/j.ophtha.2023.01.007