[Definition of the success of the surgical treatment of palpebral tumours with respect to quality of life].
BACKGROUND
The NEI-VFQ-25 (National Eye Institute Visual Function Questionnaire) was extended by several questions taking account of aesthetic and cosmetic aspects in addition to the mere visual function aspects. This amended questionnaire, named NEI-VQF +, was used to evaluate the perceived overall success of various surgical - including reconstructive - measures taken in the case of palpebral tumours.


METHODS
The NEI-VFQ + was presented to a group of 73 patients (average age 71 years) after surgical treatment of malignant palpebral tumours (basal cell carcinoma, squamous cell carcinoma, melanoma). The surgical treatment included different types of surgical techniques for eyelid resection and reconstruction performed between 2005 and 2008. The questions were asked after at least three and at most 56 months of post-operative observation. They covered the perceived success of the surgical treatment with respect to general quality of life, in particular concerning personal problems relating to behavioural as well as social changes caused by functional or aesthetic deficiencies resulting from the treatment.


RESULTS
The ratings given by the vast majority of patients, when linked to particular treatment regimes, reflect the subjectively superior importance of the aesthetic outcome in comparison to probable health risks, such as, e. g., rate of relapse or metastasis.


CONCLUSIONS
The overall success of a particular surgical intervention to treat a malignant palpebral tumour depends not only on the expected minimisation of future health problems, including decreased visual function, but appears to depend strongly on the personal expectations of individual patients with respect to the aesthetic outcome. Therefore in the case of a malignant palpebral tumour, it should be envisaged to plan a treatment strategy not only on the basis of the objective needs and limitations as seen by the surgeon, but also involving the patient's concern with all his/her expectations and fears in order to build up more mutual trust and to get a result that is satisfactory for the surgeon as well as for the patient.
Merté
R-L
RL
Klinik für Augenheilkunde, Universitätsklinikum Münster. ralph-laurent.merte@lrz.tum.de
Pfrommer
S
S
D000368:Aged; D003228:Conjunctiva / Q000601:surgery*; D003316:Corneal Diseases / Q000601:surgery*; D005134:Eye Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011788:Quality of Life; D016896:Treatment Outcome