Abstract
PURPOSE: To evaluate the effectiveness of flexible personalized occlusion therapy compared to standard personalized and fixed occlusion strategies in improving visual acuity in children with amblyopia. It also seeks to analyze the impact of treatment flexibility on patient adherence and total effective dose (TED). METHODS: A total of 90 children with amblyopia participated in this prospective study. Participants were divided into three groups: Flexible personalized occlusion, standard personalized occlusion, and standard fixed occlusion. Visual acuity was assessed at baseline and monitored monthly for 12 weeks. Treatment adherence was measured using TED. Statistical analyses included one-way analysis of variance (ANOVA) and repeated-measures ANOVA to compare visual acuity improvements among groups. RESULTS: Baseline visual acuity was comparable across groups (P > 0.05). By the final assessment, the Flexible Personalized Occlusion and Standard Personalized Occlusion groups achieved similar visual acuity improvements (0.2 ± 0.05 logMAR and 0.2 ± 0.04 logMAR, respectively), whereas the Standard Fixed Occlusion group had a slightly smaller improvement, reaching 0.25 ± 0.09 logMAR. The flexible group exhibited the lowest TED (295.4 ± 56 h), suggesting higher efficiency in treatment delivery. CONCLUSIONS: Flexible personalized occlusion therapy demonstrated comparable efficacy to standard occlusion strategies while offering greater flexibility and potentially enhancing patient engagement. These findings support the adoption of personalized and adaptable occlusion regimens in amblyopia management.