Social Media Interventions and Postoperative Follow-Up in Congenital Ectopia Lentis

Importance Congenital ectopia lentis (CEL), often associated with systemic diseases such as Marfan syndrome, requires rigorous postoperative follow-up to reduce the risk of severe complications. However, follow-up rates are frequently suboptimal, indicating an urgent need for effective interventions to improve adherence. Objective To assess the effect of WeChat (Tencent Holdings Ltd), a social media smartphone communication application, in delivering phone reminders and health education to improve postoperative follow-up adherence among families of children with CEL. Design, Setting, and Participants This randomized clinical trial was conducted from December 2022 to October 2024. The study was conducted at the Zhongshan Ophthalmic Center, a tertiary ophthalmic hospital in Guangzhou, China. Families with children scheduled for lens surgery due to CEL were enrolled and randomized into the social media intervention group and the standard-care group. Interventions Parents in the social media intervention group received phone reminders and health education via the smartphone application before scheduled appointments at 1 week, 1 month, and 3 months after surgery. Main Outcomes and Measures The primary outcome was follow-up attendance at 3 months after surgery. Results A total of 110 children were included in this study, 55 in the social media group (mean [SD] age, 6.9 [2.8] years; 32 male [58.2%]) and 55 in the standard-care group (mean [SD] age, 7.3 [3.4] years; 32 male [58.2%]). The intervention group exhibited higher attendance rates than the standard-care group across all 3 postoperative follow-ups (3 months: 83.6% [46 of 55] vs 41.8% [23 of 55]; 1 month: 81.8% [45 of 55] vs 58.2% [32 of 55]; 1 week: 92.7% [51 of 55] vs 87.3% [48 of 55]). Follow-up adherence at 3 months was significantly higher in the intervention group compared with the standard-care group (relative risk [RR], 2.05; 95% CI, 1.53-2.75; P < .001). In addition, the intervention group showed greater improvements in parental CEL knowledge accuracy (10.6%, 95% CI, 7.8%-13.5%) and higher rates of amblyopia treatments (RR, 2.40; 95% CI, 1.26-4.56). Conclusions and Relevance Results of this randomized clinical trial reveal that social media smartphone application–based interventions significantly improved follow-up adherence and increased parental knowledge among families of children with CEL. These findings suggest that integrating mobile health technologies into standard care can enhance the management of progressive pediatric conditions with systemic risks, ultimately improving clinical outcomes. Trial Registration ClinicalTrials.gov Identifier: NCT05628129