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Quality of life and cost-utility assessment after strabismus surgery in adults

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To understand the functional and psychosocial aspects of strabismus surgery, an evaluation based on the patient’s perspective is essential. In this study, we assessed quality of life and utility in adult patients who had undergone strabismus surgery, and we modeled the cost of providing this intervention in order to calculate the cost-utility of strabismus surgery in adults.

Methods

The study population comprised 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. Survey questionnaires consisting of the Japanese versions of the Visual Function Questionnaire-25 (VFQ-25) and 8-Item Short-Form Health Survey (SF-8) and utility assessment by a time trade-off method were administrated preoperatively and 3 months postoperatively. On the basis of the cost model and measured utility data, the gains in quality-adjusted life years (QALYs) and $/QALY were estimated.

Results

Postoperatively, the subscale scores of the VFQ-25 and the physical and mental component summary scores of the SF-8 showed a statistically significant improvement. A significant improvement of utility was also noted: 0.82 ± 0.28 postoperatively versus 0.76 ± 0.31 preoperatively. On the basis of the life expectancy of these patients and the cost model, the surgery resulted in a mean value gain of 0.99 QALYs and a cost-utility for strabismus surgery of 1,303 $/QALY.

Conclusions

By using standard tools to assess vision-associated and general health status, we confirmed the psychosocial benefits of corrective surgery for adults with strabismus. Our study concurrently demonstrated that strabismus surgery in adults is very cost-effective.

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Acknowledgments

This study was supported in part by a grant from the Japanese Association of Strabismus and Amblyopia. Assistance was provided by Professor Shunichi Fukuhara of the Department of Epidemiology and Health Care Research, Kyoto University.

Author information

Authors and Affiliations

  1. Division for Vision Research, National Institute of Sensory Organs, National Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan

    Keiko Fujiike, Yoshinobu Mizuno & Masakazu Yamada

  2. Department of Management Science, National Institute of Public Health, Wako, Japan

    Yoshimune Hiratsuka

Authors
  1. Keiko Fujiike
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  2. Yoshinobu Mizuno
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  3. Yoshimune Hiratsuka
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  4. Masakazu Yamada
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Consortia

The Strabismus Surgery Study Group

Corresponding author

Correspondence to Masakazu Yamada.

Appendix

Appendix

The Strabismus Surgery Group in Japan. The following individuals participated in this study.

Central Unit and Writing Committee

National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo: Keiko Fujiike, Yoshinobu Mizuno, Masakazu Yamada.

National Institute of Public Health: Yoshimune Hiratsuka.

Clinical sites

Niigata University Medical and Dental Hospital, Niigata: Atsushi Miki, Rie Shirai.

Jichi Medical University, Shimotsuke: Shinji Makino, Kozue Hozawa.

National Hospital Organization Tokyo Medical Center, Tokyo: Tomoko Katsuta, Shin Hatou.

Hamamatsu University School of Medicine, Hamamatsu: Miho Sato, Akiko Hikoya, Yuka Maruyama-Koide, Yoko Tsuchiya, Risako Inagaki, Setsuko Masaki, Mitsuko Anma, Mai Asano, Megumi Washiyama.

Yagasaki Eye Clinic, Ichinomiya: Teiji Yagasaki, Hayako Matsuura, Yuko Ota, Noriko Ito, Kaori Muraguchi, Momoyo Oga.

Shohzankai Medical Foundation Miyake Eye Hospital, Nagoya: Sampei Miyake, Ken-ichiro Natsume, Kurumi Kawakami, Taeko Takada.

Nagoya University School of Medicine: Yoshiko Takai, Kiyoko Ukai.

Osaka University Medical School, Osaka: Takashi Fujikado, Kenji Matsushita, Hiroshi Shimojyo, Sanae Asonuma.

Hyogo College of Medicine, Nishinomiya: Akiko Kimura, Chigusa Aihara, Maki Tanaka.

Matsuyama Red Cross Hospital, Matsuyama: Ichiro Shimamura.

Social Insurance Chukyo Hospital, Nagoya: Yoshimi Oya, Mariko Maeda.

Tsukuba Memorial Hospital, Tsukuba: Yuka Sato, Kousuke Taki.

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Fujiike, K., Mizuno, Y., Hiratsuka, Y. et al. Quality of life and cost-utility assessment after strabismus surgery in adults. Jpn J Ophthalmol 55, 268–276 (2011). https://doi.org/10.1007/s10384-011-0022-6

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  • DOI: https://doi.org/10.1007/s10384-011-0022-6

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