Preliminary application of virtual reality technology in binocular vision recovery of children with intermittent exotropia after surgery

Purpose: To investigate the clinical effects ofvirtual reality (VR) technology in children with intermittent exotropia (IXT) after surgery and analyze the factorsinfluencing binocular vision recovery. Methods: In this retrospective study, 142 childrenwith IXT were divided into two groups according to whether they underwent VR training or conventional training after surgery. Controlgroup: 66 cases underwent conventional training (lens sequencing training, flipper training, polarized stereogram, andcheiroscope training). VR group: 76 patients underwent regular VR visualtraining. We evaluated preoperative and postoperative binocular vision (simultaneousperception, fusion, and stereopsis) and compared the binocular vision recoveryrates between the two groups. Logistic regression analysis was used to analyzethe factors influencing recovery of distance stereopsis. Result: Among the 142 children with IXT, we could not detect any significant differences in the simultaneous perceptionand near stereopsis recovery rates between the two groups preoperativelyand postoperatively. The fusion recovery rate in the VR group (85.5%) washigher than that in the control group (69.7%) (χ² = 5.187; P  < 0.05). The distance stereopsis recovery rate in the VR group (65.2%) was higherthan that in the control group (40.9%) (χ² = 7.786; P  < 0.05). The simultaneous perception, fusion, and stereopsis recovery rates at 3 and 6 monthspostoperatively were greater than those preoperatively in both the groups. Logisticregression analysis showed that age at onset (odds ratio(OR)=1.826, p < .05), age at surgery (OR = 0.840, p < .05), preoperation deviation (OR = 1.067, p < .05) and 6 months postoperation deviation (OR = 0.750, p < .05) were riskfactors that affected distance stereopsis recovery in children with IXT. Conclusion: VR technology can be used as a new trainingtool to promote simultaneous perception, fusion, and stereopsis recovery in IXTafter surgery. The age at onset and deviation at 6 months postoperatively wererisk factors that affected the recovery of distant stereopsis.