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Laura Liebermann, Sarah Hatt, David Leske, Jonathan Holmes; Specific Aspects of Function-Related Quality of Life Improvement in Non-Diplopic Patients After Strabismus Surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3643. doi: https://doi.org/.
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We have previously reported improvement in psychosocial score on the patient-derived, previously validated, health-related quality of life (HRQOL) Adult Strabismus 20 (AS-20) questionnaire in non-diplopic strabismic patients after strabismus surgery. Somewhat surprisingly, 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 improve postoperatively.
We retrospectively identified non-diplopic adult patients who underwent surgery presenting with a history of childhood onset strabismus who had a preoperative and one-year postoperative visit, with completed AS-20 questionnaires (scored from 0 - worst HRQOL to 100 - best HRQOL). Response options for each question were: Never, Rarely, Sometimes, Often or Always. Change in scores for each item were evaluated using signed rank tests.
A total of 20 patients met all inclusion criteria. 8 of the 10 function-related items showed improvement postoperatively (ordered from greatest to least improvement): “I feel stressed because of my eyes” (51.25 to 82.50, p<0.0001), “I worry about my eyes” (45.00 to 72.50, p=0.0002), “I need to take frequent breaks when reading because of my eyes”(62.50 to 87.50, p=0.0001), “I can’t enjoy my hobbies because of my eyes” (57.50 to 81.25, p<0.0001), “My eyes feel strained”(47.50 to 65.79, p=0.001), “I have problems with depth perception” (31.25 to 47.37, p<0.04), “I have problems reading because of my eye condition”(63.75 to 80.00, p=0.03) and “I stop doing things because my eyes make it difficult to concentrate” (73.75 to 86.25, p<0.04).
In addition to the previously reported psychosocial benefit of strabismus surgery in adult non-diplopic patients, we found function-related benefit in the specific areas of concentration, depth perception, hobbies, strain, reading, stress, and worry. These specific function-related quality of life concerns may have been previously overlooked in non-diplopic patients, particularly with childhood onset strabismus, but we now provide evidence that these concerns may be significantly improved with strabismus surgery.
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