The aim of this study was to compare the effect of different training methods on eye position control and binocular visual function reconstruction for concomitant strabismus patients (≥9 years-old) after surgery.

133 patients with concomitant strabismus who underwent strabismus surgery in Beijing Tongren Eye Center, Beijing Tongren Hospital affiliated to Capital Medical University from January to September 2017 were collected. There were 67 males and 66 females with an average age of (15.6±7.8) years-old (ranged from 9 to 34 years-old). After operation for one week, the patients were randomly divided into observation group, traditional binocular vision training group and visual perception training group. All patients completed the examination of strabismus degree, eye movement, binocular visual function and visual perception after operation for 1 month, 3 months and 6 months. The age and strabismus degree of patients were described by (±s) . ANOVA was used to compare the age of three groups. GLM ANOVA of repeated measurement was used to compare the strabismus degree among different groups and time. The gender, strabismus types and the binocular visual function were described by the number and percentage. χ² testing was used to compare the gender and strabismus types of three groups. GEE model was used to compare the binocular visual function among different groups and time.

Both distant and near deviation degree of the observation group, traditional binocular vision training group and visual perception training group after operation for 3 and 6 months were significantly higher than the baseline values (after operation for 1 week ) (F_{far, near}=33.65, 36.84; P<0.05), but no significant difference was found among different groups at each time point (F_{far, near}=0.38, 0.63, 0.22, 0.55; P>0.05). The horizontal deviation degree of the visual perception training group at 1 month, 3 months and 6 months after operation was significantly lower than that of the baseline value(F=7.80, P<0.05). There was no significant difference among different groups (F_{horizontal, vertical}=1.01, 1.81, 0.59, 1.30; P>0.05). The vertical deviation was neither in each group and time point(F=0.95, P>0.05). In terms of binocular visual function, there was no significant difference among groups or time (F=4.38, 3.92, 3.19; P>0.05). In terms of fusion function, there was no significant difference among groups and interaction (F=1.01, 2.54; P>0.05). The fusion function of two training groups was significantly improved after operation for 6 months (F=19.13, P<0.05). In terms of stereopsis function, there was no significant difference in the distant and near stereopsis function among groups and interaction (F_{far, near}=0.16, 10.36, 0.24, 0.99; P>0.05). Compared with the baseline value, the far stereopsis function of the visual perception training group was significantly improved after operation for 3 months and 6 months(F=9.05, P<0.05), while non-significant difference in the near stereopsis function among different time(F=4.86, P>0.05).

The older children and adult patients after concomitant strabismus surgery could obtain more stable eye position control and reconstruct better the distant stereoacuity through visual perception training.