Browsing by Author "Enyedi, Laura B."

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Health-related quality of life in children with untreated intermittent exotropia and their parents
    (Elsevier, 2021) Holmes, Jonathan M.; Hercinovic, Amra; Melia, B. Michele; Leske, David A.; Hatt, Sarah R.; Chandler, Danielle L.; Dean, Trevano W.; Kraker, Raymond T.; Enyedi, Laura B.; Wallace, David K.; Mohney, Brian G.; Cotter, Susan A.; Ophthalmology, School of Medicine
    Purpose To determine whether health-related quality of life (HRQOL) scores improved or worsened over 3 years of observation in childhood intermittent exotropia without treatment. Methods A total of 111 children aged 3-11 years with intermittent exotropia were assigned to observation in a previously reported randomized trial comparing patching with observation. The intermittent exotropia questionnaire (IXTQ) was administered at baseline, 6 months, and 36 months. Rasch-calibrated IXTQ domain scores (Child, Proxy, Parent-psychosocial, Parent-function, and Parent-surgery) were compared between time points. The Child IXTQ was administered only to children ≥5 years of age (n = 78). Results Overall, Child IXTQ and Proxy IXTQ scores showed no significant change over 36 months (mean improvement from baseline to 36 months of 3.2 points [95% CI, −1.9 to 8.2] and −2.4 points [95% CI: −7.9 to 3.1], resp.). By contrast, Parent-psychosocial, Parent-function, and Parent-surgery domain scores all improved over 36 months (mean improvements of 12.8 points [95% CI, 5.9-19.6] and 14.2 points [95% CI, 8.0-20.3] and 18.5 points [95% CI, 9.7-27.3], resp.). Conclusions HRQOL of children with intermittent exotropia remains stable with observation over 3 years (by both child and proxy report), whereas parental HRQOL improves.
  • Thumbnail Image
    Item
    Improvement in health-related quality of life following strabismus surgery for children with intermittent exotropia
    (Elsevier, 2021-04-24) Holmes, Jonathan M.; Hercinovic, Amra; Melia, B. Michele; Leske, 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.; Ophthalmology, School of Medicine
    Purpose: 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.
  • Thumbnail Image
    Item
    Postoperative infection following strabismus surgery: case series and increased incidence in a single large referral center
    (Elsevier, 2019) House, Robert J.; Rotruck, Jill C.; Enyedi, Laura B.; Wallace, David K.; Saleh, Ezzeldin; Freedman, Sharon F.; Ophthalmology, School of Medicine
    Purpose To identify and analyze cases of postoperative infection following strabismus surgery at a large referral center and to report the incidence, risk factors, and outcomes. Methods An electronic database search identified strabismus procedures at Duke Eye Center from July 1996 to October 2017. Diagnosis codes for periocular infections were used to further identify patients with possible infections following strabismus surgery. Results Of 9,111 strabismus surgeries, 13 (0.14%) met criteria for probable infection, all occurring since October 2012 (0/6580 before vs 13/2531 [0.51%] after; P < 0.0001). Mean age of infection cases was 11.4 years; 11 patients (85%) were under 18 years of age. Associated previous diagnoses were genetic abnormalities with associated developmental delay (n = 5 [38%]), previous skin or ear infection (n = 4 [31%]), and acute or chronic rhinitis (n = 3 [23%]). Infection site cultures revealed methicillin-resistant Staphylococcus aureus (n = 3 [23%]), methicillin-sensitive S. aureus (n = 3 [23%]), and Streptococcus pyogenes/group-A Streptococcus (n = 2 [15%]). Only 1 case had bilateral infection. Infection remained extraocular in all cases, but one eye lost light perception secondary to optic atrophy. No common surgeon/procedure/preparation-related risks were identified. Conclusions A unifying explanation for the increase in post–strabismus surgery infections at Duke Eye Center was not identified. Potential risk factors include age <18 years, developmental delay, immune compromise, preceding nonocular infection, and bacterial colonization.