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Jonathan M. Holmes, Sarah R. Hatt, David A. Leske; Improvement In Health-related Quality Of Life One Year Following Successful Adult Strabismus Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1602.
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The Adult Strabismus-20 (AS-20) health-related quality of life (HRQOL) questionnaire has been developed for the assessment of adult strabismus. We have previously reported improvement in HRQOL 6 weeks following successful strabismus surgery. We now report 1-year post-operative data on AS-20 psychosocial and function subscales in adults strabismus, with and without diplopia.
Adult strabismus patients completed the AS-20 pre-operatively, at 6 weeks post-operatively, and 1 year post-operatively. Forty-five patients (n=34 with pre-op diplopia, n=11 without diplopia) were classified as successfully aligned at one year, based on pre-defined motor and sensory criteria, and were included for analysis. We calculated mean change in score from pre-operatively to 6 weeks and 1 year post-operatively, for psychosocial and function subscales, by pre-operative diplopia status.
Compared to pre-op, at 1 year from surgery there was significant improvement in psychosocial subscale scores for both diplopic (14.6±16.5; P<0.0001) and non-diplopic (33.9±30.7; P=0.004) patients. There was a suggestion that the improvement in psychosocial subscale was greater for non-diplopic patients (P=0.07). For the function subscale, there was improvement from pre-op to 1-year post-op for diplopic patients (27.7±18.1; P<0.0001) and similar improvement (P=0.9) for non-diplopic patients (26.5±30.7; P=0.006). Comparing 6-week post-op to 1-year post-op, in the 40 patients who were successfully aligned at both, there was improvement in both psychosocial and function subscales for diplopic patients (6.5±11.5; P=0.004 and 6.1±12.2; P=0.009) and there was a suggestion of improvement in the psychosocial subscale for non-diplopic patients (8.6±16.0; P=0.1).
One year following adult strabismus surgery, successfully aligned patients have markedly improved HRQOL scores in both function and psychosocial domains. In patients who are successfully aligned at both 6 weeks and 1 year, continued improvement occurs beyond 6 weeks for both psychosocial and function scores in diplopic patients, and for psychosocial scores in non-diplopic patients. The AS-20 psychosocial and function subscales may respond differently in diplopic and non-diplopic patients and should be analyzed separately.
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