Blepharoptosis repair improves patients' quality of life

Blepharoptosis causes substantial reduction in a patient's quality of life. The limitations resulting from this reduction may affect the patient's perceived general vision, peripheral vision and ability to drive.

A research team at Mayo Clinic in Rochester, Minn., examined the effects of blepharoptosis and its surgical repair on health-related quality of life using two validated response measures:

  • The 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25), a vision-specific instrument
  • The EuroQol Group's EQ-5D, a generic, health-related quality-of-life instrument

"We found that surgical blepharoptosis repair was associated with statistically and clinically significant improvement in patient quality of life comparable in magnitude to what other investigators have reported for exudative age-related macular degeneration treatment with anti-vascular endothelial growth factor therapy," says Elizabeth A. Bradley, M.D., an ophthalmic plastic and reconstructive surgeon in the Department of Ophthalmology.

The team conducted a prospective pre- and postsurgery survey analysis of 48 adults who underwent blepharoptosis surgery by Dr. Bradley between March 2008 and March 2009. The age of participants ranged from 43 to 87 years, and 32 women and 16 men constituted the study group. Of the participants, 37 had bilateral and 11 had unilateral blepharoptosis repair under local anesthesia with sedation. The time between pre- and postsurgery surveys ranged from 14 to 252 days.

Survey comparisons

The NEI VFQ-25 uses 25 subscale scores in 11 categories and generates an unweighted composite score that averages all visual activity scores. The EQ-5D assesses five domains of health-related quality of life to generate index scores that correspond to related health states. The team used t test for paired data to compare both the NEI VFQ-25 subscale scores and composite scores and the EQ-5D index and overall quality-of-life scores.

"Prior studies show that individual subscore changes of five or more points indicate clinically significant change," says Dr. Bradley. "Clinically significant change for this study was set at an even more conservative 10 or more points. The EQ-5D showed statistically significant change in individual scores for usual activities, with a reduction in deficits reported across all dimensions."

For more information

John P. Brach, M.D., resident in the Department of Ophthalmology at Mayo Clinic in Minnesota, and Dr. Bradley presented this research at The Association for Research in Vision and Ophthalmology 2012 annual meeting in May 2012.

Points to remember

  • In a prospective pre- and postsurgery analysis of 48 adults, surgical blepharoptosis repair was associated with statistically and clinically significant improvement in patient quality of life.
  • Clinically significant change for this study was set at a conservative 10 or more points.
  • The research team examined the effects of blepharoptosis and its surgical repair on quality of life using both vision-specific and generic health-related instruments.