Differences between patient expectations and actual strabismus surgery experience in adults

• Published in: Canadian journal of ophthalmology 2015-02, Vol.50 (1), p.61-67
• Main Authors: Ryu, Won Yeol, MD, Sohn, Eun Jung, MD, Ahn, Hee Bae, MD
• Format: Article
• Language: English
• Subjects: Activities of Daily Living - psychology; Adult; Aged; Cohort Studies; Eye Pain - psychology; Female; Humans; Internal Medicine; Male; Middle Aged; Oculomotor Muscles - surgery; Ophthalmologic Surgical Procedures - psychology; Ophthalmology; Pain, Postoperative - psychology; Patients - psychology; Prospective Studies; Strabismus - surgery; Surveys and Questionnaires; Vision Disorders - psychology; Vision, Binocular - physiology; Young Adult
• ISSN: 0008-4182; 1715-3360
• DOI: 10.1016/j.jcjo.2014.09.009

Abstract Objective To provide objective information on patient discomfort after strabismus surgery. Design Prospective cohort study. Participants Forty-nine consecutive adult patients undergoing strabismus surgery. Methods A questionnaire was used to evaluate the following on a scale of 0 (absent) to 10 (very severe): patients’ expectations of pain, blurred vision, daily life disruption, diplopia, conjunctival redness, foreign body sensation, eyelid swelling, postoperative nausea and vomiting (PONV), and preoperative cosmetic satisfaction. Patients answered the questionnaire at 6 hours, 1 day, 2 days, 3 days, 1 week, 2 weeks, 1 month, and 3 months after surgery, focusing on the actual experience. Patient was also investigated according to previous surgical history and the surgery type. Results In the 42 patients included in the analyses, postoperative pain ( p = 0.049) and PONV ( p = 0.039) occurred at significantly lower-than-anticipated levels. Blurred vision ( p = 0.019), daily life disruption ( p = 0.009), and conjunctival redness ( p < 0.001) occurred at significantly higher-than-expected levels, and patients felt that conjunctival redness was the most severe symptom occurring immediately after surgery. Patients who required vertical or oblique muscle procedures ( p = 0.046) or had undergone previous ophthalmic surgery ( p = 0.025) experienced higher levels of postoperative pain than they had preoperatively anticipated. Conclusions Preoperative anticipations were quite different from actual postoperative experiences in adults undergoing strabismus surgery. Our results will allow surgeons to objectively educate patients before the operation about the postoperative course and to explain the inconveniences and minor side effects expected during the recovery process.