Two-Year Efficacy of Cylindrical Annular Refractive Elements Spectacle Lenses for Myopia Control in European Children
In brief
CARE lenses cut rapid myopia progressors from 71% to 31% in European children
In a 2-year masked trial of 208 kids aged 6-13, cylindrical annular refractive element spectacles limited spherical equivalent shift to -0.32 D versus -0.69 D with single-vision glasses and reduced axial growth by half. The proportion becoming rapid progressors fell to about one-third, suggesting a durable, age-independent control option, though long-term outcomes remain to be seen.
- Journal
- Ophthalmology science (Q1)
- Published
- 1 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Cristina Alvarez-Peregrina, Miguel Angel Sanchez-Tena, Clara Martinez-Perez, Cesar Villa-Collar, Fernandez-Fernandez Victor Ignacio, Nicole Liu, et al.
- PMID
- 42571354
- DOI
- 10.1016/j.xops.2026.101309
Why clinicians should know about it
- Picked for Ophthalmology (top studies of the week, 16 August 2026): CARE lenses slow myopia progression in children
- Picked for Pediatrics and Child Health (top studies of the week, 16 August 2026): Myopia control spectacle lenses RCT in children
Abstract
PURPOSE: To evaluate the 2-year efficacy of cylindrical annular refractive elements (CARE) spectacle lenses in slowing myopia progression in European children. DESIGN: Multicenter, double-masked, randomized controlled trial. PARTICIPANTS: Children aged 6 to 13 years with documented myopia progression of at least < -0.50 diopters (D) in the preceding 12 months. METHODS: Participants were assigned to CARE or single-vision lenses (SVL). Cycloplegic spherical equivalent (SE) and axial length (AL) were measured at baseline, 12, and 24 months. MAIN OUTCOME MEASURES: Changes in SE and AL over 24 months, and the proportion of rapid progressors (defined as SE change ≤ -0.75 D and AL increase ≥ +0.30 mm over 24 months). RESULTS: Of the 234 enrolled children, 208 completed the 24-month follow-up. At baseline, mean age was 10.0 ± 1.9 years and mean SE was -2.20 ± 0.94 D. All participants met the inclusion criterion of documented myopia progression of at least -0.50 D in the preceding 12 months. At 12 months, CARE lenses slowed both SE and AL progression compared with SVL (both P < 0.001). At 24 months, myopia progression remains lower with CARE than SVL lenses in SE (-0.32 ± 0.20 D vs. -0.69 ± 0.18 D; P < 0.001) and AL (0.21 ± 0.11 mm vs. 0.43 ± 0.10 mm; P < 0.001). Moreover, the proportion of rapid progressors was lower in the CARE than in the SVL group (30.8% vs. 71.4%; P < 0.001). Younger children in the SVL group progressed faster, while CARE lenses mitigated age-related differences. CONCLUSION: Cylindrical annular refractive elements lenses effectively slowed myopia progression in European children, with sustained efficacy over 2 years. FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.