The Impact of Congenital Strabismus Surgery on Quality of Life in Children

Purpose: To assess quality of life (QOL) in children undergoing strabismus surgery. Methods: This prospective cohort study included 87 children (including 41 boys, 47.1%) with mean age of 8.7 ± 4.1 years at three academic eye hospitals in Tehran. A modified version of the RAND Health Insurance Study QOL questionnaire was filled based on interviews with parents before and three months after surgery. The questionnaire consisted of 36 Likert scale items ranging in score from 0 to 100, with higher scores representing better function. Relevant items were averaged together and categorized into 11 distinct QOL dimensions. Results: The majority of QOL dimensions improved after strabismus surgery including functional limitation (92.36 ± 16.78 vs. 82.15 ± 20.92, P < 0.01), anxiety (68.61 ± 18.15 vs. 60.28 ± 19.19, P < 0.01), depression (82.31 ± 16.42 vs. 72.36 ± 17.72, P < 0.01), positive well‑being (73.33 ± 14.69 vs. 70.56 ± 15.96, 0.048), social relations (79.43 ± 11.52 vs. 68.69 ± 30.98, 0.002), general health perception (76.4 ± 16.48 vs. 67.36 ± 18.9, P < 0.01), resistance/susceptibility (79.72 ± 13.4 vs. 71.02 ± 14.58, P < 0.01), satisfaction with development (73.81 ± 16.07 vs. 70.07 ± 14.98, P = 0.006), and eye alignment concerns (75.44 ± 15.89 vs. 53.14 ± 26.61, P < 0.01). Only self‑reported prior health (71.73 ± 15.9 vs. 72.78 ± 15.29, P = 0.33) and parent‑child closeness (72.92 ± 15.82 vs. 72.5 ± 17.99, P = 0.73) did not significantly improve. The amount of ocular realignment (more vs. less than 20 prism diopters [PD]) had a direct correlation with improvement in subscales of satisfaction with development (0.019) and eye alignment concerns (0.028). Conclusion: Strabismus surgery positively impacts physical and psychosocial function in children. Children with a greater amount of correction experienced more QOL improvement after surgery.