Which is better for myopia control in children: orthokeratology or DIMS spectacle lenses? A meta-analysis

OBJECTIVE: This study aims to systematically evaluate the effectiveness of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses compared with orthokeratology (Ortho-K) in controlling myopia. METHODS: Clinical studies related to DIMS and Ortho-K were searched for using PubMed, Medline, Embase, Ovid, CNKI, CBM, and Cochrane Library data up to August 2025. Following independent literature screening, data extraction, and risk of bias assessment by two researchers, analysis was conducted using RevMan 5.3 software. RESULTS: A total of nine studies were included in this analysis, all of which provided axial length (AL) changes at 1 year, while three studies reported spherical equivalent refraction (SER) changes. Pooled results indicated that the yearly increase of AL in the Ortho-K group was lower than that in the DIMS group (MD=-0.07, 95%CI (-0.11, -0.03), P < 0.001), with no statistically significant difference in SER changes between the two groups (MD = 0.05, 95%CI (-0.11, 0.22), P = 0.52). Subgroup analysis indicated that the comparative outcomes between Ortho-K and DIMS were influenced by ethnicity, sample size, and age (all P < 0.05). CONCLUSION: Ortho-K demonstrates superior efficacy in controlling axial elongation compared to DIMS. However, ethnic and age factors should be considered when selecting between these two myopia control interventions.