title: Objective and subjective outcomes of strabismus surgery in Graves' orbitopathy: a prospective multicentre study.
abstract: OBJECTIVE
  To assess the change and interrelationship of the field of binocular single vision (BSV) and the quality of life (QoL), tested with two different tools, after one or two strabismus surgeries in patients with Graves' orbitopathy (GO).
  
  
  METHODS
  Prospectively, consecutive patients with GO who were scheduled for their first strabismus surgery were recruited from five centres specialized in the treatment of GO. One week preoperatively and 3 months after the last operation, a full ophthalmic and orthoptic examination was performed. Change in field of BSV, GO-QoL and thyroid eye disease-QoL (TED-QoL) was recorded.
  
  
  RESULTS
  A total of 59 met all the eligibility criteria of whom 15 underwent two strabismus operations. The median (interquartile range) preoperative score of the field of BSV was 0 (0-0), which improved to 73 (53-85) after the correction(s) (p < 0.001). After the first surgery, a significant higher score of the field of BSV was found in the patients who underwent one operation (76; 60-86) compared with those who underwent two 0 (0-63) operations (p < 0.001). After the second surgery, this score increased to 62 (40-76; p = 0.05). A moderate correlation was found between the score of the field of BSV and the GO-QoL visual functioning (VF) questionnaires (r = 0.485; p < 0.001). Both the GO-QoL and TED-QoL for VF and appearance (AP) showed significantly higher scores after the treatment (p < 0.001).
  
  
  CONCLUSIONS
  After strabismus surgery in GO patients, both the field of BSV and quality of life questionnaires increase. In approximately 30% of the patients, an additional strabismus surgery is performed. This second surgery significantly expands the field of BSV and the quality of life.
authors.affiliation: Department of Ophthalmology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Hinke Marijke
authors.initials: HM
authors.lastname: Jellema
authors.affiliation: Department of Ophthalmology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Peerooz
authors.initials: P
authors.lastname: Saeed
authors.affiliation: Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Ilse
authors.initials: I
authors.lastname: Mombaerts
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Dolman
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, New York, USA.
authors.forename: Jim
authors.initials: J
authors.lastname: Garrity
authors.affiliation: Department of Ophthalmology, Columbia University, College of Physicians and Surgeons, New York, New York, USA.
authors.forename: Mike
authors.initials: M
authors.lastname: Kazim
authors.affiliation: Department of Ophthalmology, Columbia University, College of Physicians and Surgeons, New York, New York, USA.
authors.forename: Elona
authors.initials: E
authors.lastname: Dhrami-Gavazi
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Lyons
authors.affiliation: Department of Medical Psychology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Pythia
authors.initials: P
authors.lastname: Nieuwkerk
authors.affiliation: Department of Ophthalmology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Maarten P
authors.initials: MP
authors.lastname: Mourits
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D049970:Graves Ophthalmopathy / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D013285:Strabismus / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology*
keywords: Graves' orbitopathy; field of binocular single vision; quality of life; strabismus surgery