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Sinthu Ranjan, Kimberly Estes, Rebecca Parrish, James Sinacore, Patricia Mumby, James F McDonnell; The Effect of Strabismus Surgery on Vision Related Quality of Life. Invest. Ophthalmol. Vis. Sci. 2019;60(9):239.
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© ARVO (1962-2015); The Authors (2016-present)
Strabismus plays an important role in patient daily functioning and psychosocial wellbeing. We utilized the Amblyopia and Strabismus Questionnaire (ASQ) to explore our hypothesis that strabismus surgery improves vision related quality of life. The questionnaire was created by Joost Felius et al., and has demonstrated good internal consistency reliability with reported Cronbach alpha values of 0.8 to 0.92.
We prospectively evaluated 95 adults with strabismus. Eligibility criteria included: age >18 years old, patients undergoing strabismus surgery, and the ability to complete a written questionnaire. Patients completed a demographics form and the ASQ pre-operatively and 6 months post-operatively. Questions focused on 5 domains: fear of losing the better eye, distance estimation, visual disorientation, double vision, and social contact and appearance. Responses were rated on a Likert-type rating scale, 0-100, with 0 corresponding to least favorable and 100 corresponding to most favorable score. Total scores were then subdivided by strabismus type, sex, and years of education. Because of a high degree of skewing, the total and subdivided ASQ scores were analyzed using the Wilcoxon Signed Rank Test.
There was a statistically significant improvement in overall ASQ scores. The pre-operative and post-operative medians were 75.00 and 89.13, respectively; an increase of 19% (z = 7.55, p < .0005). When subdivided by strabismus type, significant post-operative improvement was noted in all categories. However, the strongest change was noted with esotropic patients who showed an improvement in median scores of 30% (z = 4.49, p < .0005). The improvement in median ASQ scores was 20% for females (z = 5.99, p = < .0005) and 15% for males (z = 4.378, p < .0005). When subdivided by years of education, significant post-operative improvement was noted in all categories, with changes in median scores ranging from 18% to 23% (z’s = 3.13 to 5.50, p’s = .002 or less).
These data suggest there is significant improvement in vision-related quality of life following strabismus surgery. Further research is needed to identify why patients with esotropia, females, and college educated patients appeared to have the largest psychosocial gains from strabismus surgery.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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