Holmes, Jonathan M.Hercinovic, AmraMelia, B. MicheleLeske, David A.Hatt, Sarah R.Chandler, Danielle L.Dean, Trevano W.Kraker, Raymond T.Enyedi, Laura B.Wallace, David K.Donahue, Sean P.Cotter, Susan A.2021-10-142021-10-142021-04-24Holmes, J. M., Hercinovic, A., Melia, B. M., Leske, D. A., Hatt, S. R., Chandler, D. L., Dean, T. W., Kraker, R. T., Enyedi, L. B., Wallace, D. K., Donahue, S. P., & Cotter, S. A. (2021). Improvement in health-related quality of life following strabismus surgery for children with intermittent exotropia. Journal of American Association for Pediatric Ophthalmology and Strabismus. https://doi.org/10.1016/j.jaapos.2020.11.0211091-8531https://hdl.handle.net/1805/26774Purpose: To investigate health-related quality of life (HRQOL) after strabismus surgery in children with intermittent exotropia (IXT) and relationships between HRQOL and surgical success. Methods: A total of 197 children with IXT aged 3-11 years (and 1 parent of each child) were enrolled in a previously reported randomized clinical trial comparing two surgical procedures. The Intermittent Exotropia Questionnaire (IXTQ) was administered before surgery (baseline), and again at 6 and 36 months following surgery. The child version of the IXTQ was only completed by children 5-11 years of age (n = 123). Outcomes were classified as “resolved” (exodeviation of <10Δ, no decreased stereoacuity, and no other nonsurgical treatment for IXT or reoperation), “suboptimal” (exotropia ≥10Δ by simultaneous prism and cover test or constant esotropia ≥6Δ or loss of ≥2 octaves of stereoacuity), or “intermediate.” Mean changes in Rasch-calibrated IXTQ domain scores (Child, Proxy, Parent-psychosocial, Parent-function, and Parent-surgery; converted to a 0-100 scale) were compared. Results: Overall, mean IXTQ domain scores improved for all domains from baseline to 36 months after surgery, ranging from 10.7 points (Child IXTQ; P < 0.0001) to 34.5 points (Parent-surgery IXTQ; P < 0.0001). At 36 months after surgery, 62 (39%) children had resolved IXT, whereas 38 (24%) had suboptimal outcome. Greater improvement was found in all mean domain scores with resolved IXT (range, 19.8-46.0 points) compared with suboptimal outcome (all comparisons P < 0.05). Conclusions: Successful surgery for childhood IXT results in measurable improvement in a child’s quality of life, in parental assessment of the child’s quality of life, and in quality of life for the parent.en-USIUPUI Open Access PolicyChildrenQuality of lifeStrabismus surgeryIntermittent exotropiaArticle