| Objective To evaluated the clinical effect of extraocular muscle surgeryfor thyroid-associated ophthalmology(TAO) and to evaluate the Thyroid-associated ophthalmopathy patientsquality of life by using Graves'Ophthalmolopathy Quality of Life questionnaire(QO-QOL).Methods The operations are recession of the restricted extraocular muscles or combined with resection of the antagonistic muscles of 23 TAO patients. To collect the angles of strabismus , the scales of restricted ocular movement and binocular vision function before operation and after one day, one week, six weeks,six months, one year or more than one year of operation. To evaluat the Thyroid-associated ophthalmopathy patients' quality of life before and after six weeks of operation.Results Different degrees of realignments were gained, and restricted ocular movements were improved in 23 patients postoperatively. After a mean follow-up of 6 months (1.5 months to 52 months), 8 patients were cured, and 7 patients were nearly cured, 8 patients were improved. The scales of restricted ocular movement were significantly increased (z=-5.634, p=0.000). The vertical strabismus degrees change from -7? to 22? after one day of postoperation to 6 weeks of postoperation, and 3 cases >13? (20?, 20?, 22?) , and the vertical strabismus degrees of 20 cases change from -7? to 8?.The horizontal strabismus degrees change from -15 ? to 20? after one day of operation to 6 weeks of postoperation, and 2 cases >13? (-15?, 20?) , and the horizontal strabismus degrees of 21 cases change from -3 ? to ? . The vertical strabismus degrees change from -5 ? to 6 ? after 6 weeks of operation to 1 year or and more of postoperation(17 cases), and 4 cases >2? (-5??3??4??6?, and 1 cases >5? (6?) . The horizontal strabismus degrees change from -10? to 6? after 6 weeks of operation to 1 year or and more of postoperation(17 cases), and 5 cases >2?(-10??-3??4??5??6?),and 2 cases >5?(-10??6?). A significant improvement in quality of life after strabismus surgery was noted (GO-QOL scores before surgery 40.3±17.9, GO-QOL scores after surgery 71.5±15.2, t=-9.866, p=0.000).The GO-QOL score for visual functioning was 40.7±18.2 before surgery and 71.8±18.5 after surgery (t=-7.767, p=0.000). The GO-QOL score for psychosocial functioning changed from 39.9±22.2 to71.1±15.9 (t=-9.184, p=0.000). There were no significant different between the visual functioning scores and the psychosocial functioning scores before (t=0.123, p=0.903 ) and after surgery(t--0.139, p=0.890 ) . There were no significant different between the visual functioning scores in patients of different gender before surgery ( male vs female were 46.9±18.0vs35.0±17.1, t=-1.619, p=0.121 ) . There were no significant different between the psychosocial functioning scores in patients of different gender before surgery (male vs female were 43.22±19.5vs37.0±24.9, t=-0.668,p=0.511 ) . There were no significant different between the visual functioning scores in patients of different gender after surgery ( male vs female were 72.2±19.1vs71.5±18.7, t=-0.094, p=0.926) . There were no significant different between the psychosocial functioning scores in patients of different gender after surgery (male vs female were 70.9±15.7vs71.4±16.7, t=0.073, p=0.942) .There were no significant correlation between the oblique angles and visual functioning scores before (r=-0.310, p=0.150) and after surgery (r=-0.220,p=0.313) .There were significant correlation between the oblique angles and psychosocial functioning scores before ( r=-0.433 , p=0.039 ) ,but there were no significant correlation between the oblique angles and psychosocial functioning scores after surgery (r=-0.185, p=0.399).Conclusions Surgical treatment can achieve functional rehabilitation and improve appearance for TAO restricted strabismus. Postoperative drifts were common in 6 weeks after operation. Surgical treatment can improve the quality of life of those patients. |
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