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Jonathan M Holmes, David A Leske, Sarah R Hatt; Improvement in health-related quality of life following successful strabismus surgery despite preoperative depressive symptoms. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2452. doi: https://doi.org/.
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We previously reported an association of depressive symptoms with poorer health-related quality of life (HRQOL) in adults with strabismus. We now evaluate whether patients with preoperative depressive symptoms on the CESDR questionnaire have lower levels of improvement in HRQOL after successful strabismus surgery.
We studied 131 adults (18 to 91 years old) who had undergone strabismus surgery classified as successful, based on a priori motor and diplopia criteria. All had completed the Adult Strabismus-20 (AS-20) and CESDR questionnaires pre-op and 6-weeks post-op. Pre-op CESDR scores were dichotomized as subnormal (depressive symptoms) or normal. The AS-20 was scored using Rasch look-up tables (0 to 100, worst to best), for each of 4 domains (Self Perception, Interactions, Reading Function, and General Function) and pre- to post-op change was calculated for each domain for each patient.
Pre-op, 16 (12%) of 131 patients had subnormal CESDR scores. Pre-op AS-20 scores were lower in those who had depressive symptoms versus those who did not; Self Perception (46.7±31.4 vs 62.9±30.2, P=0.05), Interactions (68.5±19.9 vs 78.7±23.0, P=0.03), Reading Function (41.1±24.3 vs 60.2±23.7, P=0.005), and General Function (42.7±20.4 vs 58.2±22.3, P=0.01). Nevertheless, there was similar improvement in AS-20 subscale scores between those with pre-op depressive symptoms and those without; Self Perception (27.0±27.0 vs 19.1±24.4, P=0.4), Interactions (11.7±16.6 vs 12.4±16.9, P=0.6), Reading Function (27.7±24.3 vs 20.9±23.9, P=0.5), and General Function (33.6±30.3 vs 26.7±21.3, P=0.4). These similar levels of improvement led to final HRQOL scores in patients with pre-op depressive symptoms that were still lower than those without; Self Perception (73.7±26.6 vs 82.0±21.5, P=0.08), Interactions (80.2±17.8 vs 91.1±13.7, P=0.01), Reading Function (68.8±20.1 vs 81.5±19.2, P=0.01), and General Function (76.3±19.6 vs 84.9±18.1, P=0.05).
Although HRQOL scores are lower in adult strabismus patients with preoperative depressive symptoms, successful strabismus surgery can still improve HRQOL.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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