[Evaluation by quality of life questionnaires in patients undergoing strabismus surgery in Graves' disease]

Purpose: To evaluate the improvement in quality of life of patients operated within 6 months for strabismus in Graves' disease using a questionnaire.

Materials and methods: A retrospective study was based on a cohort of patients undergoing strabismus surgery for Graves' disease at the Nancy university medical center between June 2015 and January 2017. A quality-of-life questionnaire composed of the functional GO QOL questionnaire plus 10 additional questions was given to patients. The questionnaires were completed by patients in consultation before surgery and then at six months postoperatively. A subgroup analysis was conducted to identify potential risk factors such as smoking, orbital decompression, duration of disease progression, number of surgeries, previous treatments or gender influences on the progression of the postoperative score.

Results: Thirty-three patients (15 men/18 women) underwent surgery, with mean age 56 years; 16 (48 %) were smokers, 24 (70 %) were operated for the first time for strabismus. 8 patients (24 %) had a history of surgical orbital decompression. The mean preoperative GO QOLf was 30 (±23.8), which increased to 72 (±29.6) postoperatively (P=0.004). All the answers to the questions proposed were improved by surgery. The most improved items were difficulty in extreme gaze+6.82 points (P=0.001) and going down stairs +6.81 (P=0.002). Smokers had a lower preoperative GO QOLf than non-smokers (25±22.84 vs. 34±24.55); the same was true for their postoperative improvement (35±34.5 points vs. 50±18.8, P=0.002). History of orbital decompression did not appear to influence quality of life (21±25.39 vs. 65±33.98); the same was true for previous corticosteroid or immunosuppressant treatment (28±23.52 vs. 67±28.24), respectively P=0.42; P=0.73. Gender did not appear to influence the results P=0.17. First-time strabismus surgery patients showed a tendency which was not significant toward better improvement after 2 or 3 surgeries (respectively 45 vs. 39 vs. 33) P=0.056. There was no correlation between the duration of the disease and the change in the GO QOLf (R=0.04).

Conclusion: This study confirms that strabismus surgery significantly improves the quality of life of patients with Graves' ophthalmopathy. The GO QOLf demonstrates its effectiveness in highlighting this progression. Our ten additional questions proved to be very good tools for assessing this condition.