Assessment of the Abbreviated National Eye Institute Visual Function Questionnaire (NEI VFQ 9) in blepharoptosis and dermatochalasis.

César A Briceño,Molly L Fuller,Christine C Nelson,Elizabeth A Bradley

doi:10.5935/0004-2749.20160065

Abstract

To evaluate the Abbreviated National Eye Institute Visual Function Questionnaire (NEI VFQ 9), which is shorter than those previously published, as a tool for assessing vision-related quality of life in patients with ptosis and dermatochalasis. This is a cohort study of 46 patients who underwent blepharoptosis and/or upper eyelid blepharoplasty surgery by a single surgeon (CN) in 2013 in a public, academic, ambulatory care referral center. Patients included 29 who underwent blepharoplasty, 11 who underwent ptosis surgery, and 6 who underwent combined surgery. The NEI-VFQ 9 was administered pre- and postoperatively, and the composite scores were compared using Student's t-test. Survey duration was timed in a subset of patients. The hypothesis was that the NEI VFQ 9 could detect a statistically significant improvement in composite score after surgical intervention. The mean pre- and postoperative NEI VFQ 9 composite scores were 74.9 and 86.8, respectively, in the blepharoplasty-only group (P<0.0001), 72.07 and 86.41, respectively, in the ptosis-only group (P=0.004), and 75.8 and 87.2, respectively, in the combined group (P=0.022). There was no correlation between the gain in composite score and the change in upper eyelid margin to reflex distance. Twenty-five patients were timed filling out the survey, and the mean was 2.3 min. The NEI VFQ 9 consistently demonstrates a significant increase in visual function for blepharoptosis and dermatochalasis patients. Thus, it may be a useful tool for assessing vision-related quality of life in patients with ptosis and dermatochalasis.

Highlights

Quality of life (QoL) measurements in oculoplastic surgery are becoming increasingly relevant, given the evolving healthcare and payer systems in the United States
The previously employed instruments have ranged from published ophthalmic QoL instruments, such as the NEI-VFQ-25(1), to designed ptosis and dermatochalasis instruments adapted from other QoL instruments[2,3,4]
We sought to determine whether the NEI-VFQ 9 is a useful tool for detecting improvements in vision-related QoL in patients undergoing ptosis surgery and/or upper eyelid blepharoplasty, compared with published data on longer survey instruments

Summary

Introduction

Quality of life (QoL) measurements in oculoplastic surgery are becoming increasingly relevant, given the evolving healthcare and payer systems in the United States. Several instruments have been used to measure QoL outcomes in ptosis repair and upper blepharo plasty. They consistently demonstrate that these surgical interventions have a real and measureable positive impact on vision-related QoL[1,2,3,4]. The previously employed instruments have ranged from published ophthalmic QoL instruments, such as the NEI-VFQ-25(1), to designed ptosis and dermatochalasis instruments adapted from other QoL instruments[2,3,4]. The NEI-VFQ-25, which is one of the most commonly used ophthalmic QoL instruments, has been vetted in a number of conditions, including cataract, glaucoma, and age-related macular degeneration[5,6,7,8,9,10,11,12].

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Results

Conclusion