BACKGROUND: With the gradual development of display technology, naked-eye 3D technology has gradually come into people's view, and its impact on binocular vision has also attracted attention. This study examines the efficacy of visual perceptual training utilizing naked-eye 3D technology in the prevention and control of myopia progression among children. METHODS: A total of 110 children (220 eyes), aged 6 to 12 years, who visited Shenzhen Eye Hospital between April 5, 2023 and June 1, 2024, and presented with a spherical equivalent (SE) of 0 to -1.50 diopters (D) following cycloplegic refraction, were included. Participants were non-randomly assigned to one of three groups: the 0.01% atropine group, the visual perceptual training group, and the control group. Changes in SE, axial length, and visual function across the three groups were assessed following a three-month treatment period. RESULTS: Among the 110 participants, 81 (73.6%) completed the 3-month follow-up, with 30 in the 0.01% atropine group, 28 in the visual perceptual training group, and 23 in the control group. Following baseline equalization through entropy rebalancing weighting, a significant difference in binocular SE progression was observed between the visual perceptual training group and the control group {right eye SE difference: 0.386 D [95% confidence interval (CI), 0.153-0.619], P<
0.002
left eye SE difference: 0.244 D (95% CI, 0.016-0.472), P=0.03}. No significant differences in axial length changes were observed among the three groups. Improvements in accommodation flexibility were recorded in the visual perceptual training group: 2.5 cycles per minute (cpm) for the right eye (95% CI, 1.318-3.682, P<
0.002), 1.75 cpm for the left eye (95% CI, 0.580-2.920, P=0.006), and 2.279 cpm for both eyes (95% CI, 0.807-3.755, P=0.005). All visual perceptual indices demonstrated statistically significant improvements after three months of training. CONCLUSIONS: Visual perceptual training employing naked-eye 3D technology is effective in decelerating myopia progression, improving binocular vision, and enhancing accommodation flexibility among children.