Sim Peng Yong, Cleland Charles, Dominic Jonathan, Jain Saurabh
Royal Free Hospital, London, United Kingdom.
Royal Free Hospital, London, United Kingdom.
J AAPOS. 2018 Aug;22(4):266-271.e3. doi: 10.1016/j.jaapos.2018.03.006. Epub 2018 Jul 10.
To explore factors that influence the success of adult strabismus surgery based on health-related quality of life (HRQOL) criteria.
The HRQOL aspect of strabismus surgery was assessed using the Adult Strabismus 20 (AS-20) questionnaire. Adult patients (≥16 years of age) undergoing strabismus surgery between 2014 and 2016 were identified using a treatment register. Pre- and postoperative AS-20 scores were calculated. HRQOL surgical success was defined as a pre- to postoperative change in AS-20 score exceeding previously published 95% limits of agreement. Any relationship between demographic factors (sex, age, and socioeconomic status), presence or absence of diplopia, type and magnitude of deviation, and change in deviation size with HRQOL success was investigated.
A total of 87 patients were included (mean age, 47 years; 53% female). Nondiplopic patients showed significantly lower pre- and postoperative scores on the AS-20 psychosocial subscale compared to diplopic patients. Of 87 surgeries, 54 (62%) were classified as successful based on HRQOL criteria. Multiple logistic regression analysis showed only lower socioeconomic status to be significantly associated with a higher rate of HRQOL success (P = 0.04).
Strabismic patients with a lower socioeconomic status are more likely to achieve HRQOL success following surgery. We also show that nondiplopic patients have more psychosocial concerns than those with diplopia and that this disparity persists even after strabismus surgery.
基于健康相关生活质量（HRQOL）标准，探讨影响成人斜视手术成功的因素。
使用成人斜视20（AS - 20）问卷评估斜视手术的HRQOL方面。通过治疗登记册确定2014年至2016年间接受斜视手术的成年患者（≥16岁）。计算术前和术后的AS - 20评分。HRQOL手术成功定义为AS - 20评分的术前至术后变化超过先前公布的95%一致性界限。研究人口统计学因素（性别、年龄和社会经济地位）、复视的有无、斜视类型和度数以及斜视度数变化与HRQOL成功之间的任何关系。
共纳入87例患者（平均年龄47岁；53%为女性）。与有复视的患者相比，无复视的患者在AS - 20心理社会子量表上的术前和术后评分显著更低。在87例手术中，根据HRQOL标准，54例（62%）被归类为成功。多因素logistic回归分析显示，只有较低的社会经济地位与较高的HRQOL成功率显著相关（P = 0.04）。
社会经济地位较低的斜视患者术后更有可能在HRQOL方面取得成功。我们还表明，无复视的患者比有复视的患者有更多的心理社会问题，并且这种差异即使在斜视手术后仍然存在。
