Improvement in specific function-related quality-of-life concerns after strabismus surgery in nondiplopic adults

Abstract

Background We have previously reported improvement in psychosocial scores after strabismus surgery on the patient-derived health-related quality of life (HRQOL) Adult Strabismus 20 (AS-20) questionnaire in adults with nondiplopic strabismus. Unexpectedly, we also found improvement in the function domain. The aim of the present study was to identify which specific aspects of function-related quality of life improved postoperatively. Methods We retrospectively identified non-diplopic adult patients with a history of childhood onset strabismus who underwent surgery and who had preoperative and 1-year postoperative AS-20 questionnaires (scored from 0 [worst] to 100 [best]). Change in scores for each item was evaluated using signed-rank tests. Results A total of 20 patients were included. Of the 10 function-related AS-20 items, 9 showed significant mean improvement postoperatively (improvement ranged from 12.5 to 32.5 points, all P < 0.05). Rasch-derived mean scores improved in both reading function and general function domains (71.0 to 86.5 and 66.4 to 87.5, respectively; both P < 0.0001). Specific areas of function-related benefit were concentration, depth perception, hobbies, strain, reading, stress, and worry. Conclusions We found specific function-related quality of life benefits after strabismus surgery in nondiplopic adult patients, particularly those with childhood onset strabismus.

Development of a Persian Version of the Adult Strabismus Questionnaire and Evaluating the Effect of Strabismus Surgery on Health-Related Quality of Life

“…These findings were compatible with the other studies, [9][10][11][12] including the recent study by Liebermann and colleagues that showed postoperative improvement in the functional scores in the non-diplopic patients. 12 In addition, there was relatively strong correlation between the amount of improvement in the angle of deviation and the amount of improvement in the total and psychosocial scores. These results showed the importance of strabismus surgery in improving HRQOL of the patients, especially in the psychosocial aspects, and may affect our decisions about indications and timing of the surgeries.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12] In some studies on the AS-20 that were done in Western societies, the median age of the patients was about twice our patients' median age. 1,4,9 This finding may reflect that strabismus cases in our country want surgical correction at a lower age.…”

“…4 Our study was one of the few studies that evaluated postoperative changes in the scores of the AS-20. [9][10][11][12] In 2010, Hatt and colleagues evaluated the responsiveness of the AS-20 (the ability of the test to assess HRQOL changes over time or after treatment). 9 They found that the AS-20 was responsive to the changes in ocular deviations, demonstrating higher postoperative score improvements in successfully aligned patients.…”

“…In addition, most studies on the AS-20 assessed preoperative cases, [1][2][3][4][5][6][7][8] and only few of them evaluated postsurgical HRQOL in the patients with strabismus. [9][10][11][12] In this study, we developed a Persian version of the AS-20 and used the new questionnaire to evaluate the effect of strabismus surgery on HRQOL.…”

Does strabismus surgery improve quality and mood, and what factors influence this?

“…1 Surgery to realign the eyes is associated with eliminating diplopia, expanding the visual field and reducing torticollis, as well as overall improvements in quality of life, patient satisfaction and confidence. [2][3][4][5][6][7] However, this is not the case for everyone. While 95% of patients achieve clinical success 6 weeks following surgery, only 60% of patients experience a meaningful improvement in quality of life.…”