Ophthalmology · Medical Literature
Visual Performance of Defocus Incorporated Multiple Segments With Triple Enhanced Design Spectacle Lenses Versus DIMS and Single Vision Lenses.
Abstract
To compare short-term visual functions changes in myopic children who had worn the defocus incorporated multiple segment (DIMS), DIMS with triple enhanced design (DIMS TED), and single-vision (SV) spectacle lenses. Thirty-eight Chinese children (six to 13 years) with spherical equivalent refractive error -1.00 D to -5.00 D were recruited. Participants wore DIMS, DIMS TED and SV spectacle lenses in random order. High- and low-contrast distance and near visual acuity (VA), mid-peripheral near VA, binocular functions, accommodation and visual symptoms were assessed before and after 1-week of lens wear, while mid-peripheral distance VA was assessed with and without glare in a second visit. Most visual functions showed no differences before and after lens wear. Central high- and low-contrast distance VA and central high-contrast near VA under room and dim lighting were unaffected by DIMS and DIMS TED spectacle lenses compared to SV lenses (all P > 0.05). Central low-contrast near VA was reduced by 0.06 ± 0.10 logMAR in DIMS TED lenses compared to DIMS lenses under room lighting (P < 0.01), and by 0.06 ± 0.11 logMAR compared with SV spectacle lenses under dim lighting (P < 0.01). Mid-peripheral distance VA and near VA were reduced by approximately 0.10 logMAR in DIMS TED and DIMS compared to SV lenses (P < 0.01), respectively. However, these reductions are unlikely to represent a clinically meaningful impairment in visual function. Most children adapted and accepted the DIMS TED spectacle lenses well. DIMS TED spectacle lenses demonstrated visual performance comparable to DIMS and SV spectacle lenses. The enhanced design of the DIMS TED spectacle lenses maintains visual performance comparable to DIMS and single vision spectacle lenses, and may potentially increase myopia control efficacy.
Clinical relevance
This study addresses a critical gap in pediatric myopia management by evaluating the short-term visual performance of the next-generation DIMS Triple Enhanced Design (DIMS TED) spectacle lens compared to standard DIMS and single-vision lenses in school-age myopic children. With myopia prevalence rising globally, particularly in East Asian pediatric populations, clinicians need robust safety and tolerability data before adopting newer optical interventions. Understanding whether enhanced defocus designs compromise visual function is essential for informed prescribing and patient counseling.
Key findings
1. Central high-contrast and low-contrast distance VA, and central high-contrast near VA under both room and dim lighting conditions were not significantly different between DIMS TED, DIMS, and SV lenses (all P > 0.05), confirming preservation of central visual acuity with the enhanced design. 2. Central low-contrast near VA was reduced by 0.06 ± 0.10 logMAR with DIMS TED compared to DIMS lenses under room lighting (P < 0.01), and by 0.06 ± 0.11 logMAR compared to SV lenses under dim lighting (P < 0.01), representing a statistically but not clinically meaningful difference. 3. Mid-peripheral distance VA and near VA were each reduced by approximately 0.10 logMAR with both DIMS TED and DIMS compared to SV lenses (P < 0.01), consistent with the optical design intent of peripheral defocus. 4. The authors concluded that the ~0.10 logMAR reductions in mid-peripheral VA are unlikely to represent clinically meaningful impairment in visual function in this pediatric cohort. 5. Binocular functions, accommodation, and visual symptoms showed no significant changes before and after 1 week of lens wear across all three lens types. 6. Most children adapted to and accepted DIMS TED spectacle lenses well, with overall visual performance deemed comparable to both DIMS and SV spectacle lenses.
Practice implications
DIMS TED spectacle lenses can be prescribed with confidence in myopic children aged 6–13 years with spherical equivalent refractive error between −1.00 D and −5.00 D, as the enhanced optical design does not meaningfully compromise central high- or low-contrast VA, binocular function, or accommodation relative to standard DIMS or SV lenses. Clinicians should counsel patients and caregivers that mild reductions in mid-peripheral VA (~0.10 logMAR) and central low-contrast near VA (~0.06 logMAR) are expected due to the defocus segment design but are within a range considered clinically non-significant. Given the favorable tolerability profile and the potential for greater myopia control efficacy with the triple-enhanced design, DIMS TED represents a viable upgrade from standard DIMS lenses, particularly for children requiring optimized myopia control without sacrificing functional vision.