Adams Gillian G W, McBain Hayley, MacKenzie Kelly, Hancox Joanne, Ezra Daniel G, Newman Stanton P
Moorfields Eye Hospital, London, United Kingdom.
City University, London, United Kingdom.
J AAPOS. 2016 Oct;20(5):383-386. doi: 10.1016/j.jaapos.2016.07.221. Epub 2016 Sep 17.
Strabismus, which has been estimated to occur in 4% of the adult population, can have a negative psychosocial effect on an individual's quality of life. While correction of strabismus may improve quality of life, this is not always the case, even if realignment surgery is clinically successful. Surgeons need to understand patients' expectations of postsurgical outcomes and the impact surgery has on their psychosocial well-being.
This was a prospective cross-sectional study of 220 adult patients undergoing strabismus surgery at Moorfields Eye Hospital NHS Foundation Trust. Clinical assessments were performed before surgery and again 2 weeks and 3 months after surgery. Standardized psychological questionnaires were completed preoperatively and 3 and 6 months postoperatively.
Of 220 patients included in the study (mean age, 45 years), 54% were female, 81% were white, and 58.6% had a concomitant deviation. Prior to surgery, 24% of study participants were experiencing clinical levels of anxiety; 11% were suffering clinical levels of depression. Quality of life improved and anxiety and depression were reduced after surgery. Approximately 6% of the sample regretted having undergone surgery either at 3 or 6 months after treatment.
It is important to identify patients who are experiencing significant psychosocial distress and to assess their postsurgical expectations in order to improve the outcomes of strabismus surgery. Presurgical psychosocial support should be considered for these patients.
据估计，斜视在4%的成年人口中出现，会对个人生活质量产生负面的心理社会影响。虽然斜视矫正可能会改善生活质量，但情况并非总是如此，即使斜视矫正手术在临床上取得成功。外科医生需要了解患者对手术结果的期望以及手术对其心理社会幸福感的影响。
这是一项对在摩尔菲尔兹眼科医院国民保健服务基金会信托接受斜视手术的220名成年患者进行的前瞻性横断面研究。在手术前、手术后2周和3个月分别进行临床评估。术前以及术后3个月和6个月完成标准化心理问卷。
在纳入研究的220名患者（平均年龄45岁）中，54%为女性，81%为白人，58.6%伴有斜视。手术前，24%的研究参与者存在临床水平的焦虑；11%患有临床水平的抑郁。手术后生活质量得到改善，焦虑和抑郁减轻。大约6%的样本在治疗后3个月或6个月后悔接受了手术。
识别出经历严重心理社会困扰的患者并评估他们的术后期望，对于改善斜视手术的效果很重要。对于这些患者应考虑术前心理社会支持。
