Purpose: Patients who undergo evisceration often experience psychosocial problems because of their facial disfigurement. Our purpose is to assess pre and post-operative quality of life and psychological changes in patients who have undergone an evisceration procedure.
Methods: Thirteen female and 13 male patients who visited the Ophthalmology Clinic of the Istanbul Haydarpaşa Numune Training and Research Hospital for an evisceration procedure were included in this study. Study was designed as prospective. The socio-demographic data of the patients was assessed; both ophthalmological and psychiatric examinations were performed. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Short Form-36 quality of life questionnaire(SF-36), Beck Anxiety Scale(BAS), and Beck Depression Scale(BDS) were performed prospectively during the pre-evisceration period and post-implantation of eye prosthesis period.
Results: The results showed that 53.8% of the patients reported experiencing general changes in their lives after their loss of vision. Fifty percent of patients reported experiencing a loss in their daily living activities, 34.6% reported losing their jobs and 19.2% their spouses or partners. The mean time from the development of vision loss to the evisceration procedure was 14.7 ± 14.1(min 0-max54) years. The scale scores of the BAS and BDS were statistically significant before the evisceration procedure and after the implantation of an eye prosthesis (p=0.000, p=0.000 respectively). There was a statistically significant difference in the sub-scale scores in the quality of life questionnaire before the evisceration procedure and after implantation of the eye prosthesis, except for the social functionality sub-scale.
Conclusion: Loss of vision has deep impacts on peoples life. Implantation of eye prosthesis does not contribute to visual function, but positively contributes to patients psychological status and quality of life. A multidisciplinary approach is needed at this long path ranging from vision loss to eye implantation.
Key words: Evisceration, loss of vision, eye prosthesis, quality of life, psychiatric disorder
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