Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Am J Ophthalmol. 2012 Apr;153(4):614-9. doi: 10.1016/j.ajo.2011.10.001. Epub 2012 Jan 28.
To report changes in health-related quality of life (HRQOL) 1 year following strabismus surgery.
Retrospective cohort study.
Seventy-three adults undergoing strabismus surgery in a single clinical practice completed the Adult Strabismus-20 (AS-20) HRQOL questionnaire preoperatively and at 6 weeks and 1 year postoperatively. All included adults were successfully aligned at 6 weeks postoperatively. Success was defined based on clinical criteria. Change in AS-20 psychosocial and function scores was evaluated as: 1) difference in scores between 6 weeks and 1 year postoperatively and 2) proportions exceeding previously published limits of agreement at 6 weeks and 1 year.
For patients successfully aligned at both 6 weeks and 1 year (n=51), further improvement in median scores was seen from 6 weeks to 1 year for both the psychosocial scale (83.8 vs 93.8; P<.0001) and the function scale (72.5 vs 77.5; P=.007). Also, a greater proportion exceeded limits of agreement at 1 year than at 6 weeks (psychosocial: 48% vs 30%; P=.007, function: 67% vs 51%; P=.01). For patients who became partial success (n=18) or failure (n=4) at 1 year there was a numerical decrease in scores at 1 year.
Adult strabismus patients who remain successfully aligned show continued improvement in both psychosocial and function scores from 6 weeks to 1 year postoperatively, indicating that improvement in HRQOL is long-lasting. Evaluation of HRQOL should be considered when reporting strabismus surgery outcomes in clinical trials, and may prove helpful in assessing outcomes in clinical practice.
报告斜视手术后 1 年健康相关生活质量(HRQOL)的变化。
回顾性队列研究。
在单个临床实践中,73 名接受斜视手术的成年人在术前、术后 6 周和 1 年完成了成人斜视-20(AS-20)HRQOL 问卷。所有纳入的成年人在术后 6 周均成功对齐。成功基于临床标准定义。AS-20 心理社会和功能评分的变化评估为:1)6 周和 1 年术后评分之间的差异,2)6 周和 1 年时超过先前发表的一致性界限的比例。
对于在 6 周和 1 年均成功对齐的患者(n=51),心理社会量表(83.8 对 93.8;P<.0001)和功能量表(72.5 对 77.5;P=.007)的中位数评分从 6 周增加到 1 年。此外,超过 1 年一致性界限的比例高于 6 周(心理社会:48%比 30%;P=.007,功能:67%比 51%;P=.01)。对于在 1 年时成为部分成功(n=18)或失败(n=4)的患者,1 年时的评分下降。
在术后 6 周至 1 年期间,保持成功对齐的成年斜视患者在心理社会和功能评分方面均持续改善,表明 HRQOL 的改善是持久的。在临床试验中报告斜视手术结果时应考虑 HRQOL 的评估,并且在评估临床实践中的结果时可能会有所帮助。