Improvement in health-related quality of life following strabismus surgery for children with intermittent exotropia
Jonathan M Holmes, Amra Hercinovic, B Michele Melia, David A Leske, Sarah R Hatt, Danielle L Chandler, Trevano W Dean, Raymond T Kraker, Laura B Enyedi, David K Wallace, Sean P Donahue, Susan A Cotter, Pediatric Eye Disease Investigator Group, Jonathan M Holmes, Amra Hercinovic, B Michele Melia, David A Leske, Sarah R Hatt, Danielle L Chandler, Trevano W Dean, Raymond T Kraker, Laura B Enyedi, David K Wallace, Sean P Donahue, Susan A Cotter, Pediatric Eye Disease Investigator Group
Abstract
Purpose: To investigate health-related quality of life (HRQOL) after strabismus surgery in children with intermittent exotropia (IXT) and relationships between HRQOL and surgical success.
Methods: A total of 197 children with IXT aged 3-11 years (and 1 parent of each child) were enrolled in a previously reported randomized clinical trial comparing two surgical procedures. The Intermittent Exotropia Questionnaire (IXTQ) was administered before surgery (baseline), and again at 6 and 36 months following surgery. The child version of the IXTQ was only completed by children 5-11 years of age (n = 123). Outcomes were classified as "resolved" (exodeviation of <10Δ, no decreased stereoacuity, and no other nonsurgical treatment for IXT or reoperation), "suboptimal" (exotropia ≥10Δ by simultaneous prism and cover test or constant esotropia ≥6Δ or loss of ≥2 octaves of stereoacuity), or "intermediate." Mean changes in Rasch-calibrated IXTQ domain scores (Child, Proxy, Parent-psychosocial, Parent-function, and Parent-surgery; converted to a 0-100 scale) were compared.
Results: Overall, mean IXTQ domain scores improved for all domains from baseline to 36 months after surgery, ranging from 10.7 points (Child IXTQ; P < 0.0001) to 34.5 points (Parent-surgery IXTQ; P < 0.0001). At 36 months after surgery, 62 (39%) children had resolved IXT, whereas 38 (24%) had suboptimal outcome. Greater improvement was found in all mean domain scores with resolved IXT (range, 19.8-46.0 points) compared with suboptimal outcome (all comparisons P < 0.05).
Conclusions: Successful surgery for childhood IXT results in measurable improvement in a child's quality of life, in parental assessment of the child's quality of life, and in quality of life for the parent.
Copyright © 2021 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.
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Source: PubMed