Table of Contents - WOC 2012

PO-STR-23
Quality of Life and Cost-Utility Assessment of Strabismus Surgery in
Adults
Yamada Masakazu (1) , Fujiike Keiko (1) , Mizuno Yoshinobu (1) , Hiratuka Yoshimune
(2)
1. National Institute of Sensory Organs, National Tokyo Med Center
2. National Institute of Public Health
Purpose: We assessed quality of lives and utilities in adult patients who had
undergone strabismus surgery and modeled the cost to provide these
interventions to calculate the cost-utility of strabismus surgery in adults.
Methods: Study population consisted of 226 patients with strabismus aged 18
years or older who were scheduled for ocular alignment surgery at 12 facilities
of the Strabismus Surgery Study Group in Japan. The Japanese versions
of VFQ-25, SF-8, and utility assessment by a time trade-off method were
administrated preoperatively and three months after surgery. Based on the
cost model and measured utility data, the gains in quality-adjusted life years
(QALYs) and $/QALY were estimated.
Results: Postoperatively, subscale scores of VFQ-25 and physical and mental
component summary scores of SF-8 showed statistically significant
improvement. A significant improvement of utility was also noted; 0.82 ± 0.28
postoperatively versus 0.76 ± 0.31 preoperatively, which resulted in a mean
value gain of 0.99 QALYs and cost-utility for strabismus surgery of 1,303 $/
QALY.
Conclusions: Our results confirm the psychosocial benefits of corrective
surgery for adults with strabismus. Our study concurrently demonstrated that
strabismus surgery in adults is very cost effective.
PO-STR-24
Esotropia and exotropia surgery in adults.
Perez-Flores Ines (1) , Lorenzo-Carrero Jose (1)
1. Department of Ophthalmology. Hospital POVISA
Purpose: To analyze the effectiveness and safety of horizontal strabismus
surgery in adults.
Methods: Patients (?16 years-old) with a history of esotropia or exotropia
surgery between 1997 and 2010 were retrospectively studied. Ocular alignment
was measured at 3 and at 12 months after surgery. Successful outcome was
defined as a horizontal deviation of ? 10 prismatic diopters (PD), and ?4 PD
of vertical deviation if present. A multivariate study of clinical and surgical
characteristics was performed.
Results: Out of 262 patients, 199 were included (93 ET and 106 XT). Median
follow up was 13.9 months (3-144). At 3 months ocular alignment was achieved
in 144 (80.2%) patients, ET 59 (63.4%) vs XT 85 (72.4%) p=.008, and at 12
months in 38(60.3%); ET 13(46.4%) vs XT 25 (71.4%) p=.044. Esotropia
increased two-fold the risk of postoperative deviation >10PD at 3 and at 12
months. Vertical deviation increased five fold the risk of postoperative deviation
>10PD at 12 months.Temporary diplopia was described in 14(7%) patients and
unplanned reoperation in 26(13.1%).
Conclusion: Surgical treatment in adults with ET and XT improves ocular
alignment and it is safe. Our data show better motor results in XT than ET.
WOC2012 Abstract Book
PO-STR-25
Horizontal Strabismus Surgery Results in Over Ten Years Old
Patients with Low Visual Acuity and Amblyopia
Gurkan Sedat (1) , Dinc Dincer (1) , Eltutar Kadir (1)
1. Istanbul Education and Research Hospital, Department of Ophthalmology
Purpose: To evaluate the horizontal strabismus surgery (HSS) results over ten
years old patients with low visual acuity (LVA) and amblyopia.
Methods: Between January 2008- June 2010, patients with LVA who were
performed HSS were retrospectively reviewed. The surgical success criteria
was 10 and under 10 prism diopter (PD) deviation postoperatively.
Results: 41 patients whose ages between 11 and 77 years (mean 27.54+14.81)
were included in our study. The mean follow up time was 12+2.4 months. There
was monocular exotropia in 15 patients (36.58%), monocular ezotropia in 14
patients (34.15%), alternan exotropia in 8 patients (19.51%) and alternan
ezotropia in 4 patients (9.76%). LVA and strabismus were related to ocular
pathologies in 7 (17.07%) patients. The mean near deviation angle was
49.51+22.91 PD (between 30-90 PD) in preoperatively and 9.02+12.04 PD
(between 0-50 PD) in postoperatively. Single muscle surgery was performed
in 21 (51.22%) patients, double muscle surgery was performed in 20 (48.78%)
patients. In the postoperative last examinations, we obtained surgical success
in 31 (75.61%) patients.
Conclusions: Successful results were obtained by HSS in elder patients that
have LVA and horizontal deviation. All patients must be informed about that
single operation cannot be enough for patient satisfaction.
PO-STR-26
Congenital strabismus: prevalence and surgical outcomes in Yazd
Besharati Mohammad Reza (1) , Manaviat Masoud Reza (1) , Kiyan Mojgan (1) ,
Lotfi Mohammad Hassan (1)
1. Faculty of Medicine, Shahid Sadoughi University
Purpose: Strabismus or ocular misalignment is one of the most common ocular
problems in children. Strabismus can be managed with conservative approach
or extra ocular muscle surgery. The goal of strabismus surgery is to achieve
normal alignment and sensory improvement with a minimum number of
procedures. This study reviews the frequency of strabismus types and surgical
outcome in Yazd- Iran.
Methods: In this descriptive analytic study the medical files of all strabismus
patients less than 16 years with at least 6 months follow-up were reviewed.
Data of surgical outcome and complications were gathered by questionnaire
and analyzed by statistical tests.
Results: Six hundred eighty-five cases of childhood strabismus were identified
during the 11-year study period, including 308 (45%) with Exotropia,
294(42.9%) with Esotropia, 117(25.4%) with combined type strabismus. The
alignment of 280 cases (73.9%) was normal (range of horizontal deviation < 8
PD). The most frequent complication was under correction.
Conclusion: In this study the most common type of strabismus was Exotropia.
Although the outcomes of surgery were comparable with similar studies but
longer follow-up is needed to evaluate late results.
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