Changes in Health-Related Quality of Life 1 Year Following Strabismus Surgery

Abstract

Purpose To report changes in health-related quality of life (HRQOL) 1 year following strabismus surgery. Design Retrospective cohort study Methods 73 adults undergoing strabismus surgery in a single clinical practice completed the Adult Strabismus-20 (AS-20) HRQOL questionnaire pre-operatively and at 6 weeks and 1 year post-operatively. All included adults were successfully aligned at 6 weeks post-operatively. Success was defined based on clinical criteria. Change in AS-20 psychosocial and function scores was evaluated as: 1) difference in scores between 6 weeks and 1 year post-operatively and 2) proportions exceeding previously published limits of agreement at 6 weeks and 1 year. Results For patients successfully aligned at both 6 weeks and 1 year (n=51), further improvement in median scores was seen from 6 weeks to 1 year for both the psychosocial scale (83.8 vs 93.8; P<0.0001) and the function scale (72.5 vs 77.5; P=0.007). Also, a greater proportion exceeded limits of agreement at 1 year than at 6 weeks (psychosocial: 48% vs 30%; P=0.007, function: 67% vs 51%; P=0.01). For patients who became partial success (n=18) or failure (n=4) at 1 year there was a numerical decrease in scores at 1 year. Conclusions Adult strabismus patients who remain successfully aligned, show continued improvement in both psychosocial and function scores from 6 weeks to 1 year post-operatively, indicating that improvement in HRQOL is long-lasting. Evaluation of HRQOL should be considered when reporting strabismus surgery outcomes in clinical trials, and may prove helpful in assessing outcomes in clinical practice.

Improvement in patients' quality-of-life following strabismus surgery: evaluation of postoperative outcomes using the Adult Strabismus 20 (AS-20) score

“…Our postoperative AS-20 score of 73 compares favourably with other authors'. Hatt et al 13,14 analysed 73 consecutive adults in a cohort study and found an average postoperative score of 78 at 6 weeks, although this did improve to 86 at 1 year. Certainly, the sizeable and statistically significant improvement in scores would support existing evidence that the psychosocial implications of strabismus are improved by surgery.…”

We need to pay heed to the psychosocial aspects of strabismus

“…This showed that if the adult patient remained with a satisfactory strabismus alignment long term, then a continued improvement in AS20 scores occurred from the 6-week post-operative review to 1 year. 12 This indicated that the benefit of surgery improved over an extended period. The second study used the HAD, DAS, and WHOQoLBref measures.…”

Quality of life improves after strabismus surgery in patients with Graves' orbitopathy

“…Hatt et al (2012) (21) found no changes in the health-related QoL questionnaire 1 year after the surgery (HR-QoL) in both the diplopic and non-diplopic patients following a successful strabismus Correlation between the score of the field of BSV and the score for visual functioning of the GO-QoL after surgery (rZ0.417; surgery. A future study may reveal whether this is also applicable for the GO-patient group.…”