Abstract
Purpose: :
The assessment of patient benefit or change in health status resulting from medical and surgical intervention is an important requirement of contemporary medicine. The measurement of patient-centered outcomes, are key in establishing which treatments are effective. Involutional lower eyelid entropion is an age-related inversion of the eyelid margin associated with significant morbidity resulting from ocular surface irritation and damage. The aim was to investigate the impact of entropion surgery (ES) on the patients' quality of life
Methods: :
A telephone survey was conducted of 66 patients following ES at one district general hospital in the United Kingdom. Surgery is performed as a day case procedure under local anaesthesia.Glasgow benefit inventory (GBI), a post-intervention questionnaire, was used to measure the change in health status produced by ES. GBI consists of 18 questions with responses on a five point Likert scale. The questions access the patient’s general perception of well-being with, psychological, social and physical subscales.The average GBI score was transposed onto a benefit scale from -100 (maximal negative benefit), to 0 (no benefit), to +100 (maximal benefit). The Mann-Whitney u test was used to compare the GBI scores
Results: :
The mean patient age was 78 years +/- 8.5, 62% were male and 86 % had unilateral ES. Mean follow up was 14 months +/-8. The general subscale score = +31 (range -33 to +87), physical health subscale score (relating to eye function) = +67 (range -50 to +100), Social support subscale score = +9 (range 0 to +50) and psychological subscale score (relating to eye appearance/cosmesis) = +5 (range -50 to +100). Patient undergoing unilateral ES scored the change in cosmesis lower than those undergoing bilateral surgery, -6 versus +72 (P = 0.05)
Conclusions: :
Patient’s general perception of well-being following ES was favorable and comparable to other previously reported oculoplastic procedures (ectropion repair 17.71, lacrimal surgery 32.25).The physical benefits of ES appear to be significantly better than social and psychological outcomes (P < 0.05). This suggests that recurring ocular irritation was relieved by surgery was of greater benefit to the patient than the relatively minor improvement in their appearance after surgery. However amongst patients undergoing bilateral ES there was no such difference suggesting that although all patients perceive ES as beneficial in terms of physical change, those undergoing bilateral surgery were more satisfied by the symmetrical surgery
Keywords: anatomy • clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: health care delivery/economics/manpower