Abstract：
BACKGROUND: Corrective squint surgery has a significant psychological impact, affecting both the quality of life and mental health of patients. This study highlights the quantitative and subjective assessment of both the psychological and functional outcomes of squint surgery in adults having horizontal strabismus with no preoperative diplopia using a Quality-Of-Life Adult Strabismus 20 (QOL AS-20) questionnaire.
METHODS: The study is a retrospective cohort study on patients with uncomplicated, horizontal squint; with no vertical deviation and was conducted as part of a departmental clinical audit. It also aimed to challenge local clinical commissioning group (CCG) funding restrictions for what they regarded as a \'cosmetic procedure\'. The QOL AS-20 questionnaires were completed before and 3 months after surgery and were analysed using the paired Wilcoxon signed rank t-test which showed significant improvement. A Freedom of Information Act request sought information on strabismus surgery funding restrictions from all CCGs to explore variations in perceptions throughout England.
RESULTS: 28 patients were included in the study. The overall success of squint surgery was 67.5%. The median QOL AS-20 questionnaire overall score increased from 28.125 to 88.75 (p value<0.00001), functional subscale from 46.25 to 87.5 (p value<0.00001) and psychological subscale from 15 to 90 (p value<0.00001).
CONCLUSIONS: Squint surgery in non-diplopic adults with horizontal squint surgery should be regarded as restorative of normal anatomy from a pathological state rather than a cosmetic procedure.Restrictions to accessing this surgery may increase, especially during post-COVID-19. This patient-focused service evaluation demonstrates the substantial psychosocial benefits of such surgery, as evidenced through quality-of-life assessments.
METHODS: The study is a retrospective cohort study on patients with uncomplicated, horizontal squint; with no vertical deviation and was conducted as part of a departmental clinical audit. It also aimed to challenge local clinical commissioning group (CCG) funding restrictions for what they regarded as a \'cosmetic procedure\'. The QOL AS-20 questionnaires were completed before and 3 months after surgery and were analysed using the paired Wilcoxon signed rank t-test which showed significant improvement. A Freedom of Information Act request sought information on strabismus surgery funding restrictions from all CCGs to explore variations in perceptions throughout England.
RESULTS: 28 patients were included in the study. The overall success of squint surgery was 67.5%. The median QOL AS-20 questionnaire overall score increased from 28.125 to 88.75 (p value<0.00001), functional subscale from 46.25 to 87.5 (p value<0.00001) and psychological subscale from 15 to 90 (p value<0.00001).
CONCLUSIONS: Squint surgery in non-diplopic adults with horizontal squint surgery should be regarded as restorative of normal anatomy from a pathological state rather than a cosmetic procedure.Restrictions to accessing this surgery may increase, especially during post-COVID-19. This patient-focused service evaluation demonstrates the substantial psychosocial benefits of such surgery, as evidenced through quality-of-life assessments.
摘要：
背景：矫正斜视手术具有重大的心理影响，影响患者的生活质量和心理健康。这项研究强调了使用生活质量成人斜视20（QOLAS-20）问卷对术前无复视的水平斜视成人斜视的斜视手术的心理和功能结果的定量和主观评估。
方法：本研究是一项回顾性队列研究，水平斜视；没有垂直偏差，作为部门临床审计的一部分进行。它还旨在挑战当地临床调试小组（CCG）对他们认为的“整容手术”的资金限制。QOLAS-20问卷在手术前和手术后3个月完成，并使用配对Wilcoxon符号秩t检验进行分析，显示显着改善。《信息自由法》的要求从所有CCG中寻求有关斜视手术资金限制的信息，以探索整个英格兰的观念差异。
结果：28例患者纳入研究。斜视手术的总体成功率为67.5%。QOLAS-20问卷总分中位数从28.125增加到88.75（p值<0.00001），功能分量表从46.25到87.5（p值<0.00001），心理分量表从15到90（p值<0.00001）。
结论：非复视成人斜视手术伴水平斜视手术应被视为从病理状态而不是整容手术恢复正常解剖结构。接受这种手术的限制可能会增加，特别是在后COVID-19期间。这项以病人为中心的服务评估证明了这种手术的重大心理社会益处，生活质量评估证明了这一点。
方法：本研究是一项回顾性队列研究，水平斜视；没有垂直偏差，作为部门临床审计的一部分进行。它还旨在挑战当地临床调试小组（CCG）对他们认为的“整容手术”的资金限制。QOLAS-20问卷在手术前和手术后3个月完成，并使用配对Wilcoxon符号秩t检验进行分析，显示显着改善。《信息自由法》的要求从所有CCG中寻求有关斜视手术资金限制的信息，以探索整个英格兰的观念差异。
结果：28例患者纳入研究。斜视手术的总体成功率为67.5%。QOLAS-20问卷总分中位数从28.125增加到88.75（p值<0.00001），功能分量表从46.25到87.5（p值<0.00001），心理分量表从15到90（p值<0.00001）。
结论：非复视成人斜视手术伴水平斜视手术应被视为从病理状态而不是整容手术恢复正常解剖结构。接受这种手术的限制可能会增加，特别是在后COVID-19期间。这项以病人为中心的服务评估证明了这种手术的重大心理社会益处，生活质量评估证明了这一点。
