title: Quality of life and cost-utility assessment after strabismus surgery in adults.
abstract: OBJECTIVE
  To understand the functional and psychosocial aspects of strabismus surgery, an evaluation based on the patient's perspective is essential. In this study, we assessed quality of life and utility in adult patients who had undergone strabismus surgery, and we modeled the cost of providing this intervention in order to calculate the cost-utility of strabismus surgery in adults.
  
  
  METHODS
  The study population comprised 226 patients with strabismus aged 18 years or older who were scheduled for ocular alignment surgery at 12 facilities of the Strabismus Surgery Study Group in Japan. Survey questionnaires consisting of the Japanese versions of the Visual Function Questionnaire-25 (VFQ-25) and 8-Item Short-Form Health Survey (SF-8) and utility assessment by a time trade-off method were administrated preoperatively and 3 months postoperatively. On the basis of the cost model and measured utility data, the gains in quality-adjusted life years (QALYs) and $/QALY were estimated.
  
  
  RESULTS
  Postoperatively, the subscale scores of the VFQ-25 and the physical and mental component summary scores of the SF-8 showed a statistically significant improvement. A significant improvement of utility was also noted: 0.82 ± 0.28 postoperatively versus 0.76 ± 0.31 preoperatively. On the basis of the life expectancy of these patients and the cost model, the surgery resulted in a mean value gain of 0.99 QALYs and a cost-utility for strabismus surgery of 1,303 $/QALY.
  
  
  CONCLUSIONS
  By using standard tools to assess vision-associated and general health status, we confirmed the psychosocial benefits of corrective surgery for adults with strabismus. Our study concurrently demonstrated that strabismus surgery in adults is very cost-effective.
authors.affiliation: Division for Vision Research, National Institute of Sensory Organs, National Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Fujiike
authors.affiliation: Division for Vision Research, National Institute of Sensory Organs, National Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Mizuno
authors.affiliation: Department of Management Science, National Institute of Public Health, Wako, Japan.
authors.forename: Yoshimune
authors.initials: Y
authors.lastname: Hiratsuka
authors.affiliation: Division for Vision Research, National Institute of Sensory Organs, National Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan. yamadamasakazu@kankakuki.go.jp.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000191:economics*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D018434:Sickness Impact Profile; D013285:Strabismus / Q000191:economics* / Q000601:surgery*; D011795:Surveys and Questionnaires; D055815:Young Adult