Reliability and validity of pre- and post-operative health-related quality of life in strabismus patients using the Japanese version of the adult strabismus questionnaire (AS-20).

Abstract

Purpose: This study aimed to translate the Adult Strabismus-20 (AS-20) questionnaire into Japanese, creating the JAS-20, to assess health-related quality of life (HRQOL) in Japanese strabismus patients for the first time. The HRQOL was compared between patients with strabismus and those with non-strabismus mild eye diseases to evaluate HRQOL changes pre- and post-strabismus surgery.

Study design: Prospective cohort study.

Methods: The AS-20 was translated into Japanese according to international standards by bilingual health professionals. Participants were recruited from an ophthalmology hospital near Tokyo between May 2022 and August 2023. They included adults over 18 years with strabismus (strabismus group) and those with mild eye diseases without strabismus (control group). Patients with strabismus undergoing surgery were reassessed using the JAS-20 two months after operation. Analyses included comparisons between strabismus and control groups, the presence of diplopia within the strabismus group, and pre- versus post-surgery evaluations.

Results: The study included 239 patients: 168 in the strabismus group (114 with diplopia and 54 without diplopia) and 71 in the control group. The strabismus group showed significantly lower JAS-20 scores than the control group, indicating a reduced HRQOL. The patients without diplopia scored lower on the psychosocial scale, whereas those with diplopia scored lower on the functional scale. Despite significant post-surgery HRQOL improvements, strabismus patient scores remained below the control group levels.

Conclusions: Strabismus affects HRQOL in Japanese patients; it affects functional aspects in patients with diplopia and psychosocial aspects in those without diplopia. Although surgical intervention significantly enhanced HRQOL, it did not equalize with the control group's HRQOL.