Clinical Observation Of Visual Perception Training On Reconstruction Of Binocular Vision In Postoperative Children With Intermittent Exotropia

Objective To observe the recovery of visual function at all levels and the improvement of perceptual eye position in different treatment cycles of visual perception training in IXT children,and to explore the effectiveness of visual perception training on postoperative reconstruction of binocular visual function in IXT children.Methods From January to October 2022,60 patients with IXT who underwent strabismus correction surgery and completed 6-month follow-up in the Department of Ophthalmology,Lanzhou First People’s Hospital were collected.1 day after operation,the patients were randomly divided into control group（30 cases）and training group（30 cases）.Patients in the training group developed binocular visual perception training program according to the results of visual function examination for visual training,while patients in the control group did not conduct visual training.The changes of visual function and perceptual eye position at all levels in the two groups were observed 1,3 and 6 months after operation.Results1.There were significant differences in the time of near and far strabismus between the two groups at different time after operation（F=46.034,49.154;all P<0.01）.2.In the control group,there was no significant difference in the proportion of patients with visual function recovery at 1 month,3 months and 6 months after operation compared with 1 day after operation（P>0.05）;3.Training group 3 months after operation,the proportion of patients with fusion,far stereopsis,fine stereopsis and dynamic stereopsis function recovery increased compared with1 day after operation,and the difference was statistically significant（P<0.05）.6 months after operation,the proportion of patients with simultaneous vision,fusion,far stereopsis,fine stereopsis and dynamic stereopsis function recovery increased compared with 1 day after operation,and the differences were statistically significant（P<0.05）.There was no significant difference in the results of rough stereopsis function at different time after operation compared with 1 day after operation（P>0.05）;4.1 month after operation,there was no significant difference in visual function examination results between the two groups（P>0.05）.3 months after operation,the proportion of patients with fusion and far stereopsis recovery in the training group was higher than that in the control group,with statistical significance（χ²=4.444,5.455;all P<0.05）,the proportion of patients with fine stereopsis and dynamic stereopsis recovered in the training group was higher than that in the control group,and the differences were statistically significant（χ²=4.444,5.934;all P<0.01）;6 months after training,the proportion of patients with fusion and far stereopsis recovery in the training group was significantly higher than that in the control group,with statistical significance（χ²=6.903,8.531;all P<0.01）;The proportion of patients with fine stereopsis and dynamic stereopsis recovered was significantly higher than that of control group,and the differences were statistically significant（χ²=7.500,6.093;all P<0.01）;There was no significant difference in rough stereopsis function between the two groups at different time after operation（P>0.05）;5.There were statistically significant differences in the degree of horizontal perceptual eye position deviation between the two groups at different time after operation(F_group=4.968,P_group<0.05;F_time=2.419,P_time<0.01);the degree of horizontal perceptual eye position deviation in the training group was lower than that in the control group in 3 and 6 months after operation,and the differences were statistically significant（t=2.498,P<0.05;t=3.855,P<0.01）;There were significant differences in the horizontal perceptual eye position deviation between the two groups at 1 month,3 months and 6 months after operation and 1 day after operation（P<0.05）;There were statistically significant differences in the degree of vertical perceptual eye position deviation between the two groups at different time after operation(F_group=5.520,P_group<0.05;F_time=12.239,P_time<0.01);The degree of vertical perceptual eye position deviation in the training group was lower than that in the control group at 3 and 6 months after operation,and the differences were statistically significant.（t=3.191,3.981;all P<0.01）;In the training group,there were significant differences in vertical perceptual eye position deviation between1 month,3 months and 6 months after operation and 1 day after operation（P<0.05）.There was no significant difference between 1 month,3 months and 6 months after operation and 1day after operation in the control group（P>0.05）.Conclusions Postoperative visual perception training for IXT children can promote the recovery of visual function at all levels,improve the abnormal perceptual eye position,and improve the ability of brain perception to control eye position.The effect of training for 3 and6 months was significantly better than that of training for 1 month,With the extension of training time,the recovery effect of binocular visual function and the improvement of perceptual eye position were more obvious.