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Kimberly Estes, Rebecca Parrish, James Sinacore, Patricia Mumby, James F McDonnell; The Effect of Strabismus Surgery on Self-Esteem. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1032.
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Strabismus surgery as a modifier of psychosocial factors continues to be deliberated. Our hypothesis that corrective strabismus surgery improves self-esteem was examined by performing a questionnaire based prospective study evaluating the effect of strabismus surgery on the self-esteem rating scale developed by Nugent & Thomas in 1993. This survey had demonstrated excellent internal consistency and had yet to be utilized in the evaluation of strabismus surgery in the literature.
We prospectively evaluated 94 adults who met our eligibility criteria, which was defined as age >18 years old, patients undergoing surgical correction of strabismus and the ability to complete a written questionnaire. Patients completed a demographics form and the self-esteem rating scale pre-operatively and 6 months post-operatively. The self-esteem rating scale was rated on a Likert-type rating scale where positively and negatively scored items were summed to produce a total score ranging from -120 to 120 with more positive scores signifying greater levels of self-esteem. Total scores from the self-esteem rating scale were then subdivided by strabismus type, sex, years of education and marital status. The total and subdivided scores were analyzed using the two-tailed paired Student’s t-test.
There was statistically significant improvement in total survey scores (p=0.010) when compared pre-operatively (mean score 62.52 +/- 31.13) and post-operatively (mean score 69.31 +/- 26.11). When subdivided by strabismus type, significant post-operative improvement was noted in esotropic patients (pre-op mean score 55.50 +/- 29.02; post-op mean score 65.53 +/- 24.07; p=0.011), but not in patients with exotropia or hypertropia. Females showed significant improvement post-operatively (pre-op mean score 57.90 +/- 33.90; post-op mean score 68.98 +/- 25.56; p=0.006) while males did not. When subdivided by years of education, college graduates improved post-operatively (pre-op mean score 64.73 +/- 31.53; post-op mean score 73.25 +/- 25.52; p= 0.045), but not in those who completed high school and graduate school. No significant improvement was noted when subdivided by marital status.
This preliminary data suggests strabismus surgery can produce an improvement in self-esteem as measured by the self-esteem rating scale. In this study, females, college graduates and those with esotropia appeared to be the populations that benefit the most.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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