Corrected Visual Acuity as the Foundation of Effective Myopia Control: A 1-Year Real-World Cohort Study in 9-Year-Old Children

To determine whether achieving normal corrected visual acuity independently influences myopia progression in school-aged children wearing single-vision spectacles. In a one-year real-world cohort study, 9-year-old myopic children were classified into three groups: uncorrected, adequately corrected (normal visual acuity), and under-corrected (subnormal visual acuity). One-to-one propensity score matching was used to balance baseline characteristics, and annual axial length growth was compared. The adequately corrected group showed the slowest axial elongation (0.23 {+/-} 0.14 mm/year), significantly less than both the under-corrected (0.35 &{+/-} 0.14 mm/year) and uncorrected groups (0.37 &{+/-} 0.16 mm/year) (all P < 0.001). Although the under-corrected group exhibited marginally slower progression than the uncorrected group, this minimal benefit was not sustained in semiannual analyses and lacked clinical relevance. Simply prescribing spectacles is insufficient for myopia control; achieving normal corrected visual acuity is essential to meaningfully slow axial elongation.