To compare the effect of different training methods on strabismus and binocular visual function for postoperative patients with intermittent exotropia.

Prospective randomized controlled study. 312 patients with intermittent exotropia who underwent strabismus surgery from January to September 2017 in Beijing Tongren Hospital were recruited, including 162 males and 150 females, age (3 to 36) with an average age of (11.3±7.3) years-old. According to the table of Random Numbers, patients were divided into three groups, including observation group (102), traditional binocular vision training group (105) and visual perception training group (105). The patients were followed up at before and 1, 3 and 6 months after training. Generalized Linear Mixed Effect Linear Model was used to the strabismus and binocular visual function before and 1, 3, and 6 months after training.

The near strabismus before training, after training in 1, 3, and 6 months was (0.68±2.08)△, (1.45±3.19)△, (1.74±3.69)△ and (2.36±4.48)△, respectively. The comparison between 1, 3 and 6 months after training and before training was statistically significant (t=2.57, 2.98, 3.54; P<0.05). The far strabismus before training, after training in 1, 3, and 6 months were (0.70±2.15) △, (1.45±3.19)△, (1.78±3.72) △ and (2.42±4.51) △, respectively. The comparisons between 1, 3 and 6 months after training and before training were statistically significant (t=2.35, 2.75, 3.67; P<0.05). The recovery rate of grade Ⅰ binocular function after operation was more than 95%; there were no significant differences in groups(F=0.92, P>0.05). The recovery rate of grade Ⅱ binocular function from 16 cases accouting for 9.25% was higher at 3 months after training than at before training, and their comparisons were statistically significant(F=4.32, P<0.05). The recovery rates of grade Ⅱ binocular function from 23 cases accouting for 13.29% and 20 cases accouting for 11.56% were higher at 6 months after training than at 1 month after training, and their comparisons were statistically significant (F=6.15, 5.17; P<0.05). The recovery rates of grade Ⅲ binocular function from 17 cases accouting for 31.48% and 21 cases accouting for 38.89% were higher at 3 months and 6 months after training compared with that before training in visual perception training group, and their comparisons were statistically significant(F=10.80, 16.34; P<0.05). The recovery rates of grade Ⅲ binocular function from 13 cases accouting for 20.64% and 14 cases accouting for 22.20% were higher at 3 and 6 months after the training compared with that before the training in traditional binocular vision training group, and their comparisons were statistically significant (F=5.36, 6.22; P<0.05). The recovery rates of near stereopsis from 122 cases accouting for 12.87% were higher at 3 months after training compared with that before training, and their comparisons were statistically significant(F=6.28, P<0.05). The recovery rates of near stereopsis from 46 cases accouting for 26.90%, 40 cases accouting for 23.39% and 24 cases accouting for 14.03% were higher at 6 months after the training compared with that before the training, 1 month and 3 months after training, and their comparisons were statistically significant (F=12.35, 9.54, 5.78; P<0.05).

After the training of patients with intermittent exotropia, the recovery rate of grade Ⅰ, grade Ⅱ binocular function and near stereoscopic vision of was improved compared with that before training. The recovery rate of grade Ⅲ binocular function was significantly improved in the traditional binocular vision training group and the visual perception training group at 3 and 6 months after training than before training; however the recovery rate was not improved in the observation group. Both further and near strabismus had increase with the time going on.