Efficacy of Visual and Perceptual Training on Visual Function for Operative Congenital Ectopia Lentis Children

Overview

This is a single-centre, open-label, parallel-group randomized controlled trial with the following objectives: Firstly, the investigators aim to evaluate the efficacy of web-based visual and perceptual training therapy on visual function in children with postoperative congenital ectopia lentis. Secondly, the investigators target to investigate the proportion of patients achieving ≥2 lines improvement in best-corrected visual acuity (BCVA), changes in stereoacuity, quality of life scores, and treatment compliance following visual and perceptual training intervention. Thirdly, to explore the safety profile of visual and perceptual training therapy software in this specific patient population. Lastly, this study aims to provide evidence-based recommendations for visual rehabilitation training strategies in children with postoperative congenital ectopia lentis in the Chinese population.

Congenital ectopia lentis (CEL) is commonly observed in patients with Marfan syndrome. It is a rare genetic eye disorder caused by abnormal development of the lens zonules, leading to displacement of the lens from its normal anatomical position. In addition to abnormalities in the development of refractive media such as the cornea and lens, these patients may also exhibit abnormalities in the photoreceptive system, including the retina. Furthermore, since the patients receive abnormal visual input stimuli during the critical period of visual development, this often leads to the development of amblyopia in both eyes. Currently, for patients with severe visual impairment due to lens dislocation, the standard treatment involves lens extraction combined with primary intraocular lens implantation. However, for patients with bilateral amblyopia following CEL surgery, conventional treatment involves full-time refractive correction, which cannot prevent residual amblyopia. Additionally, patients who undergo extracapsular artificial lens implantation may experience astigmatism due to potential lens tilt post-surgery, which can impair visual function and mental health. Visual perception training therapy (HVT) is an emerging treatment modality for amblyopia. Studies have shown that compared to traditional refractive correction and occlusion therapy, visual perception training therapy offers faster visual acuity improvement, higher compliance, and the ability to enhance binocular visual function. Furthermore, existing research indicates that for patients with anisometropia or small-angle strabismic amblyopia, the efficacy of visual perception training therapy combined with refractive correction is superior to refractive correction alone. As a form of visual perception training therapy software, web-based visual perception training therapy enables patients to complete training at home through game-based activities. It can also adjust training plans based on patients' conditions and training progress, offering personalized treatment plans to enhance treatment compliance and patient experience while enabling remote management by hospitals. The meridian perception learning module is particularly effective in improving uncorrected visual function for patients with astigmatism undergoing CEL surgery. However, to date, no studies have focused on the efficacy of visual perception training therapy in improving visual function for this specific population of CEL postoperative patients.