Prospective audit of ptosis surgery at the Singapore National Eye Centre: two-year results.

PURPOSE: To evaluate the demographics, presentation, and surgical outcomes of patients undergoing ptosis surgery in an Asian population in a prospective manner. METHODS: A prospective ptosis audit was conducted over a 2-year period from January 2010 to December 2011 in a tertiary eye hospital in Singapore. All patients undergoing ptosis surgery by, or under the supervision of, an oculoplastic-trained consultant in the institution were included. Institutional Review Board approval was obtained for the study. RESULTS: This study comprises 302 patients, of which 236 were acquired and 66 were congenital ptosis cases. Levator repair (77.2%) was the most commonly performed procedure, followed by levator resection (13.9%) and brow suspension (8.9%). Forty-seven (10.1%) eyes had readjustment within 2 weeks, the reasons for readjustment being eyelid height undercorrection (n = 35), eyelid height overcorrection (n = 9), and unsatisfactory eyelid contour (n = 4). Postoperatively, 93.8% of patients showed an increase in marginal reflex distance-1 (MRD1), 91.3% achieved symmetry or <1 mm of asymmetry in MRD1, 98.5% had good eyelid contour, and 74.3% had symmetric eyelid crease. On a scale of 1 to 10, 83.1% of patients gave a subjective grade of 7 or better. CONCLUSIONS: This study is the first prospective ptosis surgery audit in an Asian population and takes a leading step in assessing both subjective and objective surgical outcomes in a prospective manner. With the continuation of this audit in years to come, it will allow us to generate clinical outcomes in a robust manner and allow for more reliable benchmarking with major centers elsewhere.

Orthokeratology-related infectious keratitis: a case series.

PURPOSE: To describe five patients who developed infectious keratitis after the use of overnight orthokeratology contact lenses. METHODS: Retrospective case report of five patients with infectious keratitis seen in Singapore National Eye Centre between 2001 and 2006. RESULTS: Five children between the ages of 9 and 14 years, who wore their lenses for an average of 1.5 months before developing orthokeratology-related infectious keratitis, were seen and treated at the Singapore National Eye Centre. All five patients had cultures that were positive for Pseudomonas aeruginosa. They were treated with fortified cefazolin (50 mg/mL) and gentamicin (14 mg/mL) and responded well, with resolution of the infectious keratitis. Although most patients had a best-corrected visual acuity of 20/40 or better after the resolution of the acute infection, they all showed a central or paracentral residual scar. CONCLUSIONS: Because of the safety issues involved, orthokeratology should be used with caution in children.