Essilor Stellest lenses: what the clinical trial evidence shows

Essilor Stellest is a spectacle lens for slowing myopia in children. Its front surface carries rings of highly aspherical lenslets (HAL) around a clear central zone. This review sets out what the published trials show, with the numbers.

How Stellest works

The central zone corrects distance vision. The surrounding lenslets create a volume of light in front of the retina rather than a single focal plane, which is intended to act as a signal that slows eye growth while the child sees normally through the lens.

What the evidence shows

Two years. In a double-masked randomised trial in Wenzhou, China, 157 children aged 8 to 13 completed two years. Myopia progressed by 1.46 D in the single-vision group. Progression was 0.80 D less with HAL lenses, and axial elongation was 0.35 mm less than the 0.69 mm seen with single-vision lenses. Children who wore HAL lenses at least 12 hours a day did better: 0.99 D less progression and 0.41 mm less elongation (Bao et al., 2022).

Three years. In the one-year extension, children who stayed in HAL lenses progressed by 0.38 D against 0.56 D in a newly recruited, matched single-vision group, and children switched to HAL in year three slowed as well (Li et al., 2023).

Five years. Forty-three of the original HAL group completed five years. Progression was 1.27 D against 3.03 D in an extrapolated single-vision control, and axial elongation 0.67 mm against 1.40 mm (Li et al., 2025).

Choroid. In the same trial, macular choroidal thickness thinned over two years with single-vision lenses, and HAL lenses reduced or abolished that thinning (Huang et al., 2023).

An honest read of the evidence

• The pivotal trial was run at one centre in Chinese children, and its authors include researchers from a joint Wenzhou Medical University and Essilor research centre. Results in other populations rely on smaller and real-world studies.
• The five-year comparison uses an extrapolated control group rather than children randomised to single-vision lenses for five years. That is understandable, but it is weaker than a randomised comparison.
• Wearing time matters. The best results came from children wearing the lenses 12 hours or more a day.

Myopia device research at NZERC

The open questions for spectacle-based myopia control are head-to-head comparisons, combination treatment, and outcomes in New Zealand children. The New Zealand Eye Research Centre (NZERC) measures axial length and choroidal thickness and vascularity and is set up to contribute that data. Lens manufacturers and sponsors assessing a New Zealand site are invited to read our information for sponsors and CROs. Families who would like to hear about myopia studies can register their interest. For assessment and treatment, contact our affiliated clinical practice, Rose Optometry.

References

• Bao J, et al. Spectacle lenses with aspherical lenslets for myopia control vs single-vision spectacle lenses: a randomized clinical trial. JAMA Ophthalmol 2022;140(5):472-478. doi:10.1001/jamaophthalmol.2022.0401
• Li X, et al. Myopia control efficacy of spectacle lenses with aspherical lenslets: results of a 3-year follow-up study. Am J Ophthalmol 2023;253:160-168. doi:10.1016/j.ajo.2023.03.030
• Li X, et al. Myopia control efficacy of spectacle lenses with highly aspherical lenslets: results of a 5-year follow-up study. Eye Vis (Lond) 2025;12(1):10. doi:10.1186/s40662-025-00427-3
• Huang Y, et al. Effect of spectacle lenses with aspherical lenslets on choroidal thickness in myopic children. Br J Ophthalmol 2023;107(12):1806-1811. doi:10.1136/bjo-2022-321815