Abstract
Purpose: :
Negative social perceptions, visual field limitation, and decreased functional capacity are well recognized sequelae of blepharoptosis. With increasing emphasis being placed on patient satisfaction and quality of life as an endpoint for surgical interventions, there is a need to quantify these outcomes. In this study we examined the effects of blepharoptosis and its surgical repair on quality of life using both a vision-specific assessment tool (NEI VFQ-25) and a generic health-related quality of life assessment tool (EQ-5D).
Methods: :
We conducted a prospective pre- and post-surgery survey. Adults who presented for unilateral or bilateral blepharoptosis repair under local anesthesia were recruited from March 2008 to March 2009. Eligible patients met Medicare criteria for visually significant ptosis. Prior to, and following a standardized surgery, each participant completed a self-administered NEI VFQ-25 and EQ-5D health-related quality of life questionnaire. Pre- and post- questionnaires were compared to assess for change. The NEI-VFQ-25 questionnaire and its 12 subscales were scored on a 0 (worst) to 100 (best) scale. The EQ-5D creates a 5 digit score to represent a unique health state and its Visual Analog Score represents overall health on a scale of 0 (worst) to 100 (best).
Results: :
Seventy-four subjects completed the pre-surgical questionnaires. Fifty-one subjects underwent surgery and completed post-surgical questionnaires. Prior to surgery, subjects scored lowest on the General Vision (70.7 ± 13.8, mean ± SD), Peripheral Vision (72.9 ± 20.7), and Near Activities (74.9 ±14.9) subscales. Highest baseline scores were measured for Color Vision (93.6 ± 14.4), Social Functioning (90.9 ± 13.5), and Dependency (90.9 ± 14.9). The overall composite score of the VFQ-25 increased following surgery (80.5 ±11.6 to 91.9 ±5.9). Average scores improved in all subscales after surgery, compared to pre-operative scores. The EQ-5D index increased from 0.78 ± 0.15 to 0.86 ± 0.11 and the VAS score increased from 83.9 ± 13.5 to 84.7 ± 12.4.
Conclusions: :
Surgical correction of blepharoptosis was associated with improved health-related quality of life, as measured by standardized assessment tools. The magnitude of the increase is comparable to that seen with cataract surgery.
Keywords: quality of life • eyelid • visual fields