Evaluation of digital binocular therapies for amblyopia after refractive adaptation in treatment-naive children aged 3-13 years: A systematic review and meta-analysis of randomised controlled trials

Patching has been the mainstay of unilateral amblyopia treatment, but adherence is challenging. Digital binocular therapies have emerged as a novel approach; however, evidence in treatment-naive children remains limited, as existing studies have predominantly included previously treated children.

To evaluate the effectiveness of digital binocular therapies versus patching for improving visual acuity in treatment-naive children aged 3-13 years with unilateral amblyopia following refractive adaptation.

A systematic review and meta-analysis of randomised controlled trials was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420261278100). Comprehensive literature searches were conducted from January 2000 to December 2025. Two independent reviewers screened and selected studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. The primary outcome was change in best-corrected visual acuity. Data were pooled using a random-effects model. The GRADE approach was used to rate the certainty of evidence.