TY - JOUR
T1 - Social and Quality-of-Life Impact of Refractive Surgery in Children With Developmental Disorders and Spectacle Nonadherence
AU - Strelnikov, Jacob
AU - Zdonczyk, Alexandra
AU - Pruett, John R.
AU - Culican, Susan
AU - Tychsen, Lawrence
AU - Gordon, Mae
AU - Marrus, Natasha
AU - Todorov, Alexandre
AU - Reynolds, Margaret
N1 - Publisher Copyright:
© 2024 Elsevier Inc.
PY - 2025/1
Y1 - 2025/1
N2 - PURPOSE: Children with autism spectrum disorder and intellectual disability often cannot tolerate wearing spectacles or contact lenses, which are the standard-of-care for treating ametropia.1,2 We aimed to assess the impact of refractive surgery on social functioning and vision-specific quality-of-life (VSQOL) in this population. DESIGN: Prospective, before-and-after case series. METHODS: Setting: Single, academic tertiary care center. Study population: 18 children with autism spectrum disorder and/or intellectual disability, ametropia, and spectacle nonadherence were included in the analysis. Procedure: Participants underwent refractive surgery with either intraocular lens implantation or keratectomy. Parents completed the Social Responsiveness Scale (SRS-2) and Pediatric Eye Questionnaire (PedEyeQ) at baseline and 1, 6, and 12 months postsurgery.3,4 Main outcome measures: Median change in SRS-2 T-scores and PedEyeQ scores 12 months after surgery, compared to baseline. The minimum clinically important difference was set at 5 points for the SRS-2 and 10 points for the PedEyeQ. RESULTS: At 12 months after surgery, statistically significant improvements were observed in the SRS-2 domains of Social Awareness (8 points, 95% CI 2-13, P = .03) and Social Motivation (7 points, 95% CI 2-15, P = .03). Total SRS-2 T-score improved in a clinically important manner for 56% (10/18) of patients, but the median change was not statistically significant (5 points, 95% CI –1 to 9, P = .10). VSQOL showed statistically significant improvements in the domains of Functional Vision (40 points, 95% CI 7-73, P = .02) and Bothered by Eyes/Vision (23 points, 95% CI 3-45, P = .02). CONCLUSIONS: Refractive surgery led to clinically and statistically significant improvements in domains of social functioning and VSQOL at 12 months after surgery. A narrow majority of patients demonstrated a clinically important improvement in overall social functioning, but these changes were not statistically significant. The results suggest that refractive surgery in children with neurodevelopmental disorders, ametropia, and spectacle nonadherence may provide developmental and quality-of-life benefits. Larger, controlled studies are required to validate these findings.
AB - PURPOSE: Children with autism spectrum disorder and intellectual disability often cannot tolerate wearing spectacles or contact lenses, which are the standard-of-care for treating ametropia.1,2 We aimed to assess the impact of refractive surgery on social functioning and vision-specific quality-of-life (VSQOL) in this population. DESIGN: Prospective, before-and-after case series. METHODS: Setting: Single, academic tertiary care center. Study population: 18 children with autism spectrum disorder and/or intellectual disability, ametropia, and spectacle nonadherence were included in the analysis. Procedure: Participants underwent refractive surgery with either intraocular lens implantation or keratectomy. Parents completed the Social Responsiveness Scale (SRS-2) and Pediatric Eye Questionnaire (PedEyeQ) at baseline and 1, 6, and 12 months postsurgery.3,4 Main outcome measures: Median change in SRS-2 T-scores and PedEyeQ scores 12 months after surgery, compared to baseline. The minimum clinically important difference was set at 5 points for the SRS-2 and 10 points for the PedEyeQ. RESULTS: At 12 months after surgery, statistically significant improvements were observed in the SRS-2 domains of Social Awareness (8 points, 95% CI 2-13, P = .03) and Social Motivation (7 points, 95% CI 2-15, P = .03). Total SRS-2 T-score improved in a clinically important manner for 56% (10/18) of patients, but the median change was not statistically significant (5 points, 95% CI –1 to 9, P = .10). VSQOL showed statistically significant improvements in the domains of Functional Vision (40 points, 95% CI 7-73, P = .02) and Bothered by Eyes/Vision (23 points, 95% CI 3-45, P = .02). CONCLUSIONS: Refractive surgery led to clinically and statistically significant improvements in domains of social functioning and VSQOL at 12 months after surgery. A narrow majority of patients demonstrated a clinically important improvement in overall social functioning, but these changes were not statistically significant. The results suggest that refractive surgery in children with neurodevelopmental disorders, ametropia, and spectacle nonadherence may provide developmental and quality-of-life benefits. Larger, controlled studies are required to validate these findings.
UR - http://www.scopus.com/inward/record.url?scp=85203406791&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2024.08.009
DO - 10.1016/j.ajo.2024.08.009
M3 - Article
C2 - 39168367
AN - SCOPUS:85203406791
SN - 0002-9394
VL - 269
SP - 20
EP - 29
JO - American journal of ophthalmology
JF - American journal of ophthalmology
ER -