Abstract
Purpose :
Lower lid involutional entropion is a common eyelid malposition. Few studies have analysed the quality of life (QOL) in patients after lower lid entropion surgery (LLES). We thus studied the effect of LLES on the QOL as well as factors associated with a poorer post-operative QOL.
Methods :
Consecutive patients from 2 centers who underwent LLES by a single surgeon in 2004 – 2007 were recruited. LLES was defined as lower eyelid retractor repair alone or with additional lateral tarsal strip (LTS). The EuroQol-5 Dimension (EQ-5D), EuroQol-Visual Analogue Scale (EQ-VAS) and Utility Value (UV) questionnaires were administered via a phone interview by a single interviewer after the patient underwent LLES. The UV score were derived using the time tradeoff (TTO) and standard gamble (SG). TTO was based on two hypothetical questions: how long they expected to live (x years) and how much time they would be willing to trade off (y years) in return for improvement in their pre-operative lower eyelid position and symptoms. The value was derived by 1-y/x. SG was based on the patient’s perception of the highest risk of blindness (z) they would be willing to accept if there was another technology that could possibly permanently improve pre-operative eyelid conditions and symptoms, but which success of the technology was not guaranteed. The value was derived by 1-z.
Results :
61 eyelids of 61 patients were evaluated. The mean age was 76.9 ±10.1 years old. The mean EQ-5D, EQ-VAS and TTO and SG scores are 90.8 ± 16.7, 74.8 ± 14.2, 0.8 ± 0.2 and 0.9 ± 0.07 respectively. There were no significant factors on univariate analysis of EQ-5D scores. Multivariate analysis showed the mean EQ-VAS score for patients who underwent additional LTS was 10.2 (95% CI=3.4-17.1, p=0.004) lower than patients who underwent isolated retractor repair. The mean EQ VAS score for patients with bilateral and recurrent entropion was 10.8 (95% CI=3.8-17.9, p=0.005) and 27.1 (95% CI=8.4-45.7, p=0.01) lower compared to those with unilateral entropion and no recurrence respectively. Patients with a positive family history had a 0.2 (95% CI=0.02-0.3, p=0.03) lower mean TTO score compared to those without. Male gender and higher education level were statistically associated with a lower SG mean score.
Conclusions :
Significant factors associated with poorer QOL include male gender, higher education level, positive family history, bilateral entropion, recurrent entropion and additional LTS.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.