Health-related quality of life improves after surgical treatment of blepharoptosis

August 1, 2006

A modified and updated survey should also reflect societal changes such as increased use of computers.

In this study, the quality of life of patients with blepharoptosis was evaluated after surgery, using the visual function questionnaire (VFQ). Although the VFQ is not the best questionnaire for evaluating these patients, since it was designed to assess visual function problems among the elderly, it is the most suitable tool currently validated in Brazil, Osaki said.

"Our department is developing a questionnaire to evaluate patients with blepharoptosis better and one that is better adapted to the Brazilian style of life," Osaki explained.

The study was performed at the Vision Institute of the Federal University of São Paulo. Researchers evaluated 21 patients with an age range of 21 to 76. Two patients had congenital ptosis, and the remainder had acquired ptosis.

The VFQ was applied before and after surgery. It consisted of 25 questions that were divided into 12 groups. The possible scores range from 0 to 100, with higher scores indicating better quality of life and visual function. The average score before surgery was 74; postoperatively, the average was 81.

"Vision, mental health, daily activities, and dependence showed a statistically significant difference (p < 0.05)," Osaki said.

Other studies have also attempted to assess the effects of decreased visual field on daily activities and the psychosocial impact of abnormal eyelid position. Federici et al. used questions adapted from the Sickness Impact Profile, Duke-UNC Health Profile, and Comprehensive Assessment and Referral Evaluation Interview Schedule to evaluate blepharoptosis. Average preoperative and postoperative scores were 52 and 82, respectively.

Batu et al. also adapted questions from these surveys to develop a 24-item questionnaire. The activities that improved the most were ability to perform fine manual work, hanging or reaching objects above eye level, watching television, and reading.

An analysis of the quality of life of cataract patients revealed an average score of 76.5 before surgery and 93.2 afterward, Osaki continued. When compared with blepharoptosis, "the higher postoperative score observed after cataract treatment is probably due to its more disabling effect before treatment and results usually faster after surgery," she added.

"Further studies using a specific questionnaire for this particular pathology are needed," Osaki said.

In addition to being designed with the younger demographic of blepharoptosis in mind, a modified and updated survey should also reflect societal changes such as increased personal and workplace use of computers that has come about since the VFQ was developed in the early 1990s, she concluded.