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This is a literature review of published quality of life surveys in patients who have undergone a variety of oculoplastic procedures. The authors emphasise the importance of patient reported outcomes, noting that clinician and patient perceptions may differ, and that similar outcomes will result in varying levels of satisfaction amongst different patients. A PubMed search for quality of life studies following nine different oculoplastic procedures found 30 publications of which 20 were from prospective studies. Of the generic quality of life scales, the Glasgow benefit inventory was used most often, and there were condition specific tools used for thyroid eye disease, ptosis, brow ptosis, epiphora and eye removal. All except one examined a single procedure. The majority of studies covered dacryocystorhinostomy (DCR), ptosis, thyroid eye disease and eye removal surgery. Both endoscopic and external DCR surgery was found to improve quality of life in the majority of studies, but laser-assisted techniques were inferior. For ptosis surgery the strongest predictor of quality of life improvement was preoperative subjective functional impairment, not clinical measurements of the degree of ptosis or field loss. There were significant psycho-social benefits from ptosis surgery, with one author noting that the general public have a negative view of patients with ptosis. From four separate studies, 71-88% of thyroid patients reported satisfaction following orbital decompression surgery, but again change in the subjective evaluation by the patient was the only predictor of the improvement in appearance-related quality of life scores and not the actual clinical objective parameters. The eye removal studies found the successful fitting of a prosthesis to be critical to improvement in quality of life. The authors note that outside the four main conditions, there is a paucity of research into patient reported outcomes in oculoplastics.

Postoperative quality of life in oculoplastic patients.
Seo ST, Sundar G, Young SM.
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James Hsuan

Aintree University Hospital, Liverpool, UK.

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