title: Does strabismus surgery improve quality and mood, and what factors influence this?
abstract: AimsTo establish the impact of adult strabismus surgery on clinical and psychosocial well-being and determine who experiences the greatest benefit from surgery and how one could intervene to improve quality of life post-surgery.MethodsA longitudinal study, with measurements taken pre-surgery and at 3 and 6 months post-surgery. All participants completed the AS-20 a disease specific quality of life scale, along with measures of mood, strabismus and appearance-related beliefs and cognitions and perceived social support. Participants also underwent a full orthoptic assessment at their preoperative visit and again 3 months postoperatively. Clinical outcomes of surgery were classified as success, partial success or failure, using the largest angle of deviation, diplopia and requirement for further therapy.Results210 participants took part in the study. Strabismus surgery led to statistically significant improvements in psychosocial and functional quality of life. Those whose surgery was deemed a partial success did however experience a deterioration in quality of life. A combination of clinical variables, high expectations, and negative beliefs about the illness and appearance pre-surgery were significant predictors of change in quality of life from pre- to post-surgery.ConclusionsStrabismus surgery leads to significant improvements in quality of life up to 6 months postoperatively. There are however a group of patients who do not experience these benefits. A series of clinical and psychosocial factors have now been identified, which will enable clinicians to identify patients who may be vulnerable to poorer outcomes post-surgery and allow for the development of interventions to improve quality of life after surgery.
authors.affiliation: School of Health Sciences, City University London, London, UK.|Community Health Newham, East London Foundation Trust, London, UK.
authors.forename: H B
authors.initials: HB
authors.lastname: McBain
authors.affiliation: Moorfields Eye Hospital NHS Foundation Trust, London, UK.
authors.forename: K A
authors.initials: KA
authors.lastname: MacKenzie
authors.affiliation: Moorfields Eye Hospital NHS Foundation Trust, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Hancox
authors.affiliation: Moorfields Eye Hospital NHS Foundation Trust, London, UK.|UCL Institute of Ophthalmology NIHR Biomedical Research Centre for Ophthalmology, London, UK.
authors.forename: D G
authors.initials: DG
authors.lastname: Ezra
authors.affiliation: Moorfields Eye Hospital NHS Foundation Trust, London, UK.
authors.forename: G G W
authors.initials: GG
authors.lastname: Adams
authors.affiliation: School of Health Sciences, City University London, London, UK.
authors.forename: S P
authors.initials: SP
authors.lastname: Newman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000503:physiopathology / Q000523:psychology; D003866:Depressive Disorder / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000503:physiopathology / Q000523:psychology*; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D017060:Patient Satisfaction; D011788:Quality of Life / Q000523:psychology*; D018434:Sickness Impact Profile; D012944:Social Support; D013285:Strabismus / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D011795:Surveys and Questionnaires