The Essilor® Stellest® Spectacle Lens ARVO 2024 Showcase

Authors: Xue Li¹^,², Yingying Huang¹^,², Chenyao Liu¹, Ziang Yin¹, Zaifeng Cui¹, Ee Woon Lim²^,³, Bjorn Drobe²^,³, Hao Chen¹, Jinhua Bao¹^,² 

1. National Clinical Research Center for Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, China
2. Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, China
3. R&D Singapore, Essilor International, Singapore 

This study assessed the effectiveness of highly aspherical lenslets (HAL) spectacle lenses in controlling myopia progression over five years in Chinese children. Fifty-one children who had already worn HAL spectacle lenses for three years continued for an additional two years. The outcomes were compared with a control group model based on single vision lens (SVL) data obtained from the original two-year trial, with a 9.7% predicted annual decrease in spherical equivalent refraction (SER)¹ progression and 15% in axial length (AL)² progression to account for physiological slowing of eye growth with increasing age. The HAL group had a mean change in SER of -1.27D and in AL of 0.67mm over five years, compared to the control group model's progression of -3.03D and 1.40mm (see figure 1).

This indicates a myopia control efficacy of 1.75D (58%)^* for SER and (0.72mm) 52%^** for AL with HAL spectacle lenses over five years. The children who were enrolled in the clinical trial when it began in 2018 were aged between 8 and 13 years old and the children who completed the fifth year follow up were aged between 13-18 years by then, so the lenses remained effective in slowing myopia progression in older children, up to 18 years old. These findings underscore the robust efficacy of HAL spectacle lenses in significantly reducing myopia progression and axial elongation in children over an extended period, offering evidence for a promising intervention for long-term myopia management.

*Compared to the 60-month progression of the extrapolated control group (predicted average annual decrease in SER by 9.7% based on the initial 2-year control group,  Smotherman C, et al. IOVS 2023;64:ARVO E-Abstract 811).

** Compared to the 60-month progression of the extrapolated control group (predicted average annual decrease in AL by 15% based on the initial 2-year control group, Shamp W, et al. IOVS 2022;63:ARVO E-Abstract A0111

Purpose: To investigate the myopia control efficacy of wearing spectacle lenses with highly aspherical lenslets (HAL) continuously for 5 years in Chinese children.

Methods: Fifty-one children who had been wearing HAL for three years were invited to continue wearing them for two additional years. The change in spherical equivalent of cycloplegic autorefraction (SER) and axial length (AL) with HAL was compared to a single vision lens (SVL) control group model. This model was based on SVL data from the first two years of the same clinical trial (Bao, et al. JAMA Ophthalmology 2022; May 1;140(5):472-478), with a predicted average annual decrease in SER by 9.7% (Smotherman C, et al. IOVS 2023;64:ARVO E-Abstract 811) and in AL by 15% (Shamp W, et al. IOVS 2022;63:ARVO E-Abstract A0111).

Results: The control group model predicted a 5-year increase in SER (±SE) and AL (±SE) of -3.03±0.18 D and 1.40±0.07 mm in children wearing SVLs, respectively. The 43 participants from the HAL group who completed the five-year visit were aged (±SD) 14.7±1.1 years (13 to 18). Their mean (±SE) change in SER and AL over 5 years was -1.27±0.14 D and 0.67±0.06 mm, respectively. The 5-year estimated myopia control efficacy of HAL lenses compared to the modeled control group was 1.76 D (58%) and 0.73 mm (52%).

Conclusions: Spectacle lenses with highly aspherical lenslets (HAL) were effective in slowing down myopia progression and axial elongation over five years.

Authors: Yee Ling Wong¹^,², Yingying Huang²^,³, Xue Li²^,³, Ee Woon Lim¹^,², Adeline Yang¹^,², Bjorn Drobe¹^,², Hao Chen²^,³, Jinhua Bao²^,³

1. R&D Singapore, EssilorLuxottica, Singapore
2. Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
3. National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China

In clinical practice, practitioners sometimes offer single vision lenses as first-time correction to establish if progression will occur.³ This study looked at the impact of first-time correction (FTC) on myopia progression in children. Three different types of spectacle lenses were investigated: spectacle lenses with highly aspherical lenslets (HAL), slightly aspherical lenslets (SAL), and single-vision lenses (SVL). The trial involved 157 myopic children (baseline SER of -0.75 to -4.75D) in Wenzhou, China, aged 8-13 years, who wore one of the three types of lenses for two years, with 67 receiving FTC at the beginning of the study. They found that:

• In the first six months, the mean change in SER for children with FTC was not significantly different between the HAL (-0.13 D) and SAL (-0.21 D) groups compared to those without FTC (-0.10 D and -0.12 D, respectively). However, children in the SVL group with FTC experienced greater myopic progression (-0.46 D) than those without FTC (-0.22 D).
• Over the two-year period, the mean change in SER for the HAL (-0.68 D) and SAL (-1.01 D) groups with FTC was not significantly different from those without FTC (-0.74 D and -1.00 D, respectively), but the SVL group with FTC showed significantly greater SER progression (-1.58 D) and axial elongation (0.73 mm) than those without FTC (-1.33 D and 0.64 mm, respectively).

Clinically, these findings suggest that prescribing myopia control spectacle lenses with aspherical lenslets as a child's first optical correction can effectively slow myopia progression and axial elongation, but also highlights how prescribing SVL as FTC is detrimental. This underscores the importance of selecting appropriate lens types for first-time corrections in young myopes.

Purpose: To examine the influence of first-time correction (FTC) on changes in cycloplegic spherical equivalent (SER) and axial length (AL) in children wearing spectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) compared to that of single-vision lenses (SVL).

Methods: The randomized trial had 170 myopic children in Wenzhou, China (8-13 years; SE of -0.75 to -4.75D) randomly assigned to wear 1 of the 3 spectacle lenses: HAL, SAL, or SVL for 2 years. FTC was defined as the wearing of any optical correction for the first time. Generalized linear models, adjusting for covariates baseline age, gender, SER, AL, age of myopia onset, and parental myopia, was used to evaluate the influence of FTC on treatment effect.

Results: A total of 157 (54 HAL, 53 SAL, and 50 SVL) children completed the 2-year trial, and 67 (20 HAL, 24 SAL, and 23 SVL) received FTC at the beginning. Children with FTC were less myopic (-1.9 vs -2.9D; P<0.001), had a later age of myopia onset (9.9 vs 9.0y; P<0.001), and shorter AL (24.5 vs 24.8mm; P=0.003), compared to those without FTC. 
 In the first 6 months, mean adjusted SER change with FTC for HAL and SAL (-0.13 and -0.21D) was not significantly different from those without FTC (-0.10 and -0.12D), but was more myopic in SVL with FTC (-0.46D) compared to SVL without FTC (-0.22D; P<0.001). Similar results for AL change were seen, with mean adjusted AL change with FTC for HAL, SAL, and SVL (0.10, 0.14, and 0.22mm) and without FTC (0.08, 0.12, and 0.18mm).
 Over a longer 2-year period, mean adjusted SER change with FTC for HAL and SAL (-0.68 and -1.01D) was not significantly different from those without FTC (-0.74 and -1.00D), but was more myopic in SVL with FTC (-1.58D) compared to SVL without FTC (-1.33D; P<0.001). Similar results for AL change were seen, with mean adjusted AL change with FTC for HAL, SAL, and SVL (0.37, 0.47, and 0.73mm) and without FTC (0.36, 0.50, and 0.64mm).

Conclusions: FTC is significantly associated with greater myopia progression and axial elongation in the SVL group, but not in HAL and SAL groups for the first 6 months and up to 2 years. Therefore, myopia control spectacle lenses with aspherical lenslets should be prescribed as a child’s first pair of spectacle lenses.

Authors: Jinhua Bao¹^,², Yingying Huang¹^,², Xue Li¹^,², Ee Woon Lim³^,², Bjorn Drobe³^,², Hao Chen¹^,²

1. National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
2. Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
3. R&D Singapore, EssilorLuxottica, Singapore, Singapore

This study examined the effects of HAL spectacle lenses on cylinder power and corneal astigmatism in myopic children and compared these effects to those observed with SVL. Children aged 8 to 13 years with myopia between -0.75 D and -4.75 D were randomly assigned to wear either HAL (n = 52) or SVL (n = 49) for two years. SER, cylinder power, AL, and corneal curvature radius, were taken every six months. Results showed that the HAL group experienced significantly slower refractive myopia progression (mean change in SER: -0.69D vs. -1.38D) and less axial elongation (mean change in AL: 0.34mm vs. 0.67mm) compared to the SVL group. However, there were no significant differences between the two groups in terms of changes in cylinder power (-0.46D vs. -0.51D) or corneal astigmatism (-0.29D vs. -0.39D). These findings suggest that while HAL spectacle lenses are effective in slowing myopia progression and axial elongation, they do not influence change of cylinder power or corneal astigmatism in any way differently to single vision lenses.

Purpose: To explore the changes in cylinder power and corneal astigmatism in myopic children wearing spectacle lenses with highly aspherical lenslets (HAL) and to compare these findings with those observed in myopic children wearing single-vision spectacle lenses (SVL).

Methods: Children aged 8 to 13 years with myopia between -0.75 D and -4.75 D were randomly assigned to wear HAL or SVL for two years. Cycloplegic autorefraction, including spherical equivalent refraction (SER) and cylinder power, axial length (AL), and corneal curvature radius were obtained every 6 months. The two-year changes were compared between groups.

Results: A total of 103 eyes in 52 children from the HAL group and 98 eyes in 49 children from the SVL group completed all examinations and were included in the analysis. The HAL group exhibited significantly slower myopia progression (SER, -0.69D, 95% CI [-0.81, -0.57] vs. -1.38D, 95% CI [-1.50, -1.26], p < 0.001), and change in AL (0.34mm, 95% CI [0.29, 0.39] vs. 0.67mm, 95% CI [0.62, 0.72], p < 0.001) compared to the SVL group. No significant difference was observed between the SVL and HAL groups in terms of changes in cylinder power (-0.46D, 95%CI [-0.54, -0.38] vs. -0.51D, 95%CI [-0.61, -0.41], p=0.43) or corneal astigmatism (-0.29D, 95%CI [-0.38, -0.20] vs. -0.39D, 95%CI [-0.49, -0.27], p=0.14) after two years.

Conclusions: Wearing HAL for two years had no significant impact on cylinder power and corneal astigmatism compared to SVL.

Authors: Yingying Huang¹^,², Xue Li¹^,², Ee Woon Lim³^,², Bjorn Drobe³^,², Hao Chen¹^,², Jinhua Bao¹^,²

1. National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, China
2. Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, China
3. R&D Singapore, Essilor International, Singapore

Studies have noted a significant correlation between peripheral eye length (PEL) and central myopic shift, indicating that eyeball shape may influence axial length elongation.^4,5 This relationship is likely driven by growth stimuli produced by hyperopic defocus, which may contribute to the progression of myopia in children.⁵ This study evaluated the effects of HAL spectacle lenses on PEL in Chinese myopic children (n = 40) aged 8 to 13 years with myopia ranging from -0.75 D to -4.75 D. They wore SVL for two years, followed by HAL spectacle lenses for one year. Results showed that during the two years of wearing SVL, there was a significant increase in AL and all PEL measurements, with the most substantial elongation observed centrally. After switching to HAL spectacle lenses for one year, the rate of AL elongation decreased by 63% (from 0.34 mm/year to 0.13 mm/year). The elongation rates at 15° in the nasal and temporal retina were reduced by 49% and 71% respectively, while the elongation rates at 30° in the nasal and temporal retina decreased by 31% and 53% respectively. In the third year, there were no significant differences in elongation rates across different positions in the eye. These findings indicate that HAL spectacle lenses are effective in significantly slowing both central and peripheral eye elongation in myopic children, showing the largest effects in the central and near-peripheral zones, resulting in a more uniform eye shape, rather than growth towards a more oval-shaped eyeball.

Purpose: This study aimed to investigate the impact of spectacle lenses with highly aspherical lenslets (HAL) on the peripheral eye length (PEL) changes in Chinese myopic children.

Methods: Forty children aged 8 to 13 years with myopia between -0.75 D and -4.75 D were recruited to wear single-vision spectacle lenses (SVL) for two years and changed to wear HAL for one year. Axial length (AL) and PEL at 15° and 30° in the nasal (N) and temporal (T) retina were measured every six months for three years.

Results: Over 2 years, wearing SVL resulted in significant increase of AL and all PELs (all p<0.001), with AL exhibiting the most elongation and increasing more slowly towards the periphery. After switching to wearing HAL for one year, AL elongation was reduced by 63% (from 0.34mm/year to 0.13mm/year), PEL-N15 and PEL-T15 elongation was reduced by 49% and 71% (PEL-N15, from 0.29mm/year to 0.15mm/year; PEL-T15, from 0.33mm/year to 0.09mm/year), PEL-N30 and PEL-T30 elongation was reduced by 31% and 53% (PEL-N30, from 0.21mm/year to 0.15mm/year; PEL-T30, from 0.26mm/year to 0.12mm/year). There was no difference between changes in AL and PELs at different positions in the third year (p=0.62).

Conclusions: HAL has been shown to be effective in slowing down both central and peripheral eye elongation, with greater effectiveness in the central and paramacular region. Eye length at different eccentricities showed similar elongation rates while wearing HAL, thereby preventing the eyeball from growing towards a more oval shape.