Efficacy and safety of cylindrical annular refractive element spectacle lenses for myopia in children: A meta-analysis

BackgroundMyopia is an increasing global public health concern, particularly in East Asia. Cylindrical Annular Refractive Element (CARE) spectacle lenses aim to slow myopia progression by inducing peripheral myopic defocus. This meta-analysis evaluates the efficacy and safety of CARE lenses versus single-vision spectacle lenses in children.MethodsWe conducted a systematic search for randomized controlled trials comparing CARE spectacle lenses to single-vision lenses in children with myopia. Primary outcomes were mean change in spherical equivalent refraction and axial length. All analyses were performed using R software. Pooled mean differences and risk ratios with 95% confidence intervals were calculated using a random-effects model.ResultsAt 12 months, CARE lenses significantly reduced myopia progression compared to single-vision lenses. The treatment effect increased with longer follow-up, with one study reporting sustained benefit at 24 months. CARE lenses were associated with a significantly lower risk of fast progression. No significant differences were observed between groups in visual acuity change or discontinuation rates.ConclusionCARE spectacle lenses may be a well-tolerated, non-invasive option for slowing myopia progression in children, with modest benefits observed over one to two years. Larger, longer-term RCTs in diverse populations are needed to confirm these findings and establish sustained efficacy.