Interpretable Machine Learning-Based Risk Score for Predicting Ten-Year Corneal Graft Survival After Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty in Asian Eyes.

Purpose: To predict 10-year graft survival after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) using a machine learning (ML)-based interpretable risk score.

Methods: Singapore Corneal Transplant Registry patients (n = 1687) who underwent DALK (n = 524) or PK (n = 1163) for optical indications (excluding endothelial diseases) were followed up for 10 years. Variable importance scores from random survival forests were used to identify variables associated with graft survival.

Hyaluronic acid gel injection for dysthyroid upper eyelid retraction in Asian patients.

Purpose: To evaluate the role of hyaluronic acid (HA) filler injection in the management of upper eyelid retraction (UER) in thyroid eye disease (TED).

Methods: Retrospective interventional series of all patients with TED who had undergone HA injection, from February 2011 to April 2013 by a single surgeon (Y-DK) in a tertiary medical institution. Outcome measures: Mean margin reflex distance 1 (MRD1) pre- and post-filler.

Machine Learning to Analyze Factors Associated With Ten-Year Graft Survival of Keratoplasty for Cornea Endothelial Disease.

Purpose: Machine learning analysis of factors associated with 10-year graft survival of Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK) in Asian eyes.

Methods: Prospective study of donor characteristics, clinical outcomes and complications from consecutive patients ( = 1,335) who underwent DSAEK (946 eyes) or PK (389 eyes) for Fuchs' endothelial dystrophy (FED) or bullous keratopathy (BK) were analyzed. Random survival forests (RSF) analysis using the highest variable importance (VIMP) factors were determined to develop the optimal Cox proportional hazards regression model.

Implementation of an enhanced recovery protocol in patients undergoing mastectomies for breast cancer: an interrupted time-series design.

Background: We reviewed internal data and the current literature to update our enhanced recovery protocol (ERP) for patients undergoing a total breast mastectomy. Following implementation, the protocol was audited by chart review and compliance reminders were sent through email.

Objective: Our primary research aim was to examine the protocol compliance following the update.

Prebending of Prefabricated Orbital Implants: Towards Improved Orbital Angle Symmetry Post Craniofacial Trauma Surgery.

Purpose: Reconstructive surgery after craniofacial trauma aim to restore orbital anatomy for function and aesthetic reasons. The purpose of this study is to improve postoperative orbital symmetry with the use of prebent prefabricated titanium implants.

Methods: In this retrospective study, patients with combined unilateral medial wall and floor fractures who underwent orbital reconstruction surgery were selected.

Orbital Implants in Orbital Fracture Reconstruction: A Ten-Year Series.

Study Design: Retrospective comparative interventional series of all patients who had undergone orbital fracture repair by 2 senior orbital surgeons in a single tertiary trauma center from January 2005 to December 2014.

Objective: To compare the outcomes of different implants used for various types of orbital fractures.

Methods: Patients were evaluated by age, gender, etiology of fracture, clinical findings, type of fractures, and implant used.

Comparative Study of Long-term Graft Survival Between Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty.

Purpose: Endothelial failure and immunological graft rejection remain long-term complications leading to late graft failure in penetrating keratoplasty (PK). Deep anterior lamellar keratoplasty (DALK) has emerged as a viable alternative that enables preservation of the host's endothelial cells to eliminate risks of endothelial rejection and failure. The aim of this study was to compare long-term graft survival between PK and DALK.

A Novel Method of CT Exophthalmometry in Patients With Thyroid Eye Disease.

Purpose: Conventional computed tomography (CT) exophthalmometry requires an intact lateral orbital wall and is therefore not feasible in patients who have undergone any form of lateral orbital wall surgery where the normal bony landmark may be lost or displaced. The purpose of our study is to validate an alternative method of CT exophthalmometry utilizing the posterior clinoid (PC) process as a new reference point that will allow for reproducible comparison of the anterior-posterior globe position in the preoperative and postoperative settings.

Design: Cohort study.

Use of a Mouse Model of Experimentally Induced Endometriosis to Evaluate and Compare the Effects of Bisphenol A and Bisphenol AF Exposure.

Background: Endometriosis is a gynecological disease affecting 1 in 10 women of reproductive age. Endometriosis incidence has risen; however, whether this rise is due to disease awareness or environmental contamination is not known.

Objective: The objective of this study was to determine if bisphenol A (BPA) or bisphenol AF (BPAF) potentiate the development of endometriosis and if hormonal status alters how toxicant exposure affects disease.

Methotrexate as an Adjuvant in Severe Thyroid Eye Disease: Does It Really Work as a Steroid-Sparing Agent?

Purpose: To compare the efficacy and safety of adjunctive oral methotrexate with intravenous pulsed methylprednisolone against methylprednisolone alone in the treatment of severe thyroid eye disease.

Methods: Retrospective review of clinical data of patients with severe sight-threatening thyroid eye disease with compressive optic neuropathy treated with methylprednisolone with and without methotrexate. Eye disease outcome measures (e.

Orbital apex venous cavernous malformation with optic neuropathy: treatment with multisession gamma knife radiosurgery.

Purpose: To evaluate the efficacy and safety of multisession gamma knife radiosurgery (GKRS) for orbital apex venous cavernous malformation causing optic neuropathy.

Methods: Retrospective cohort study in a single tertiary institution from January 2007 to December 2016 on patients who underwent multisession GKRS for orbital apex venous cavernous malformations causing optic neuropathy.

Results: There were 12 patients included in our study.

Efficacy and safety of pulsed intravenous methylprednisolone in early active thyroid eye disease.

: The mainstay of therapy for active inflammatory phase of thyroid eye disease (TED) is immunosuppression. Patients in our centre with early active TED are treated with pulsed intravenous methylprednisolone (IVMP). Two different protocols are offered in our centre: High dose (1g/day for 3 days, monthly for 6 months), or EUGOGO protocol (500 mg weekly for six weeks, followed by 250 mg weekly for the next 6 weeks).

Lowering of the High Eyelid Crease in Revision Upper Eyelid Surgery.

Background: High placement of the lid crease is a common complication in upper eyelid surgery. Correction of the high crease by revision surgery is challenging and has not been well-reported.

Methods: This is a retrospective interventional study of patients who underwent revision eyelid surgery with lowering of the lid crease from 2008 to 2016 at a tertiary institution.

Transconjunctival Triamcinolone Injection for Upper Lid Retraction in Thyroid Eye Disease-A New Injection Method.

Purpose: To evaluate the role of transconjunctival triamcinolone acetonide (TA) injection in the management of upper eyelid retraction in thyroid eye disease.

Methods: Retrospective interventional review of all patients who underwent transconjunctival TA injection (40 mg/mL) for thyroid eye disease-related upper eyelid retraction from January 2010 to December 2016 in a single tertiary institution. The present study comprised 2 groups: Patients receiving only TA injection (group 1), and patients receiving both TA injection and other immunosuppressive therapy (group 2).

Conservatively Treated Orbital Blowout Fractures: Spontaneous Radiologic Improvement.

Purpose: To determine if conservatively treated blowout fractures of the orbit undergo spontaneous improvement based on radiologic findings.

Design: Prospective, noncomparative series.

Participants: Patients with conservatively treated orbital blowout fractures in a single tertiary institution from 2012 through 2016 with initial and follow-up computed tomography (CT) scans.

The tear cytokine profile in patients with active Graves' orbitopathy.

Purpose: The primary aim of this study is to isolate cytokines specific for active Graves' orbitopathy (GO) in the tears of affected patients. The secondary aim is to identify other cytokines of interest and to look at the profile of their levels over time.

Methods: This is a prospective pilot study conducted at the Singapore National Eye Centre.

Radiologic Parameters of Orbital Bone Remodeling in Thyroid Eye Disease.

Purpose: To radiologically examine for the presence of bony remodeling of the orbit in thyroid eye disease (TED).

Methods: Computed tomography (CT) scans of 248 orbits of 124 patients with TED and 185 orbits of 138 controls were retrospectively reviewed, and the following parameters measured: the angle of the inferomedial orbital strut (AIOS), the angle of the medial wall (AMW), and the diameters of the extraocular muscles. The association of TED with the AIOS or AMW was analyzed with linear regression models, and the correlations between the AMW or AIOS measurements with the extraocular muscle measurements were determined.

Serum IgG2 and tissue IgG2 plasma cell elevation in orbital IgG4-related disease (IgG4-RD): Potential use in IgG4-RD assessment.

Aims: To determine the role of serum and tissue IgG2 in orbital biopsies with the histological features of IgG4-related disease (IgG4-RD) in comparison with non-IgG4-related orbital inflammatory disorders (OID), including autoimmune disorders.

Methods: This is an international (Sheffield, UK, and Singapore) collaborative, retrospective case review of 69 patients (38 from Singapore National Eye Centre and 31 from Royal Hallamshire Hospital, Sheffield) with orbital inflammatory biopsies between 2002 and 2016. Clinical information and histology were reviewed and cases were classified into three groups: Group 1: IgG4-RD orbital inflammation (n=43); Group 2: idiopathic OID (n=12) and Group 3: autoimmune OID (n=14).

Use of bioresorbable implants for orbital fracture reconstruction.

Purpose: Bioresorbable implants offer several advantages over permanent implants and serve as a useful alternative in the reconstruction of orbital fractures. Our aim of the study was to evaluate the clinical effectiveness and safety of various bioresorbable implants in the repair of orbital fractures.

Methods: A retrospective review of all patients who had undergone orbital fracture repair with bioresorbable implants in a single tertiary trauma centre from January 2005 to December 2014 was performed.

Endometriosis: where are we and where are we going?

Endometriosis currently affects ~5.5 million reproductive-aged women in the U.S.

Hypofractionated Radiotherapy for Breast Cancer Including Risk-adapted Boost: Update on Tolerance and Efficacy of an Accelerated START A Regime.

Aim: To present an update of a prospective study evaluating an accelerated hypofractionated whole breast irradiation (WBI) schedule of the START A trial plus hypofractionated boost in breast cancer patients.

Patients And Methods: One hundred and forty consecutive patients ≥55 years were included in this study. Patients received postoperative WBI with 13×3.

Clinical Features and Treatment Outcomes of Orbital Inflammatory Disease in Singapore: A 10-Year Clinicopathologic Review.

Purpose: 1) To assess the clinical profile and treatment outcomes of orbital inflammatory disease in the local population, and 2) classify patients using current histopathological criteria.

Methods: Ten-year retrospective clinicopathologic review of patients diagnosed with orbital inflammatory disease who underwent tissue biopsy from January 2001 to December 2011 at a tertiary referral centre in Singapore. Data collection included patient demographics, clinical presentation, investigations, systemic disease, histopathology review, clinical classification, medical and surgical management, response to treatment and recurrence rates.

A dosimetric comparison of real-time adaptive and non-adaptive radiotherapy: A multi-institutional study encompassing robotic, gimbaled, multileaf collimator and couch tracking.

Purpose: A study of real-time adaptive radiotherapy systems was performed to test the hypothesis that, across delivery systems and institutions, the dosimetric accuracy is improved with adaptive treatments over non-adaptive radiotherapy in the presence of patient-measured tumor motion.

Methods And Materials: Ten institutions with robotic(2), gimbaled(2), MLC(4) or couch tracking(2) used common materials including CT and structure sets, motion traces and planning protocols to create a lung and a prostate plan. For each motion trace, the plan was delivered twice to a moving dosimeter; with and without real-time adaptation.