The effect of surgical methods and postoperative eye position on the quality of life in patients with intermittent exotropia

Abstract

Objective: To evaluate the effects of different surgical methods and postoperative eye positions on the quality of life of children with intermittent exotropia (IXT) and their parents 3 months following strabismus surgery. Methods: Clinical observation. One-hundred and eighty children aged 2 to 17 years with IXT who received surgical treatment were recruited. One parent of each child was investigated by using 2 kinds of the Chinese version of the Intermittent Exotropia Questionnaires (CIXTQ) within 1 weeks before and at 3 months after surgery: the parent proxy scale (for parents to assess children's health related quality of life (HRQoL)) and the parent scale (containing functional, psychosocial and surgery subscales; for parents to assess their HRQoL). One hundred and eighty children were divided into different groups according to the surgical. Methods Monocular surgery group, binocular surgery group and eye position after 3 months: undercorrection group, successful group, overcorrection group, to explore: (1) the change of scores before and after surgery. (2) the difference of score changes after surgery between monocular and binocular surgery groups. (3) the difference of score changes after surgery between different postoperative eye position groups. Results: Significant improvement in median scores was seen from pre-operation to 3months post-operatively for all the proxy scale (t=-9.585, P<0.001), the functional (t=-11.361, P<0.001), psychosocial (t=-10.856, P<0.001) and surgery subscale (t=-11.622, P< 0.001) of parent scale. The change values from pre-operation to 3months post-operatively were not significantly different between monocular and binocular surgery groups for all the proxy scale (t=0.242, P=0.330), the functional (t=0.462, P=0.050), psychosocial (t=0.781, P=0.582) and surgery subscale (t=0.009, P=0.355) of parent scale, but significantly different between undercorrection, successful and overcorrection groups for the proxy scale (F=21.527, P<0.001), the functional (F=54.236, P<0.001), psychosocial (F=41.784, P<0.001) and surgery subscale (F=31.943, P<0.001). The scores of proxy scale and 3 parent subscales were all significantly improved (t=-13.639 to -6.059, P<0.05) after operation in both the undercorrection and successful groups, while significantly decreased in the overcorrection group (t=1.350-4.391, P<0.05). Conclusions: HRQoL can be improved significantly in both the undercorrection and successful groups, while decreased in the overcorrection group. (Chin J Ophthalmol, 2017, 53: 924-930).