The Feasibility of Surface Electromyography in Monitoring Orbicularis Oculi Recovery after Anterior Approach Levator Aponeurosis Advancement.

INTRODUCTION: In this article, we propose a new application for eyelid surface electromyography (sEMG). By placing the electrode in the mid-pretarsal area of the upper eyelid, one can easily perform a fast examination and achieve repeatable results. We believe that this technique may increase the feasibility of eyelid sEMG in clinical practice. METHODS: 126 sEMG examinations of the upper eyelid were performed by using the above-described method. Thirty-nine controls and 29 ptotic patients were enrolled. The controls underwent one measurement while the ptotic patients were employed for four sessions: Before anterior approach levator aponeurosis advancement (LAA), 2 weeks, 3 months, and more than 6 months after surgery. The relaxation and maximal contraction of the orbicularis oculi muscle (OOM) using root mean square (RMS) values were measured. RESULTS: The results showed a statistically significant decrease in RMS values of the maximal contraction of the OOM 2 weeks after surgery (p < 0.05) and 3 months after surgery (p = 0.03). Six months postoperatively, there were no statistically significant differences in OOM activity compared to preoperative values (p = 0.2). CONCLUSIONS: Eyelid sEMG may be a useful diagnostic tool in post-operative OOM recovery monitoring. sEMG parameters of the maximal contraction of the OOM normalize within 6 months after anterior approach LAA. Electrode placement in the mid-pretarsal area of the upper eyelid offers several advantages and therefore may enhance the feasibility of sEMG in clinical practice.

Unilateral optic disc oedema as a first sign of ocular toxoplasmosis ­ case report. / Jednostronny obrzek tarczy nerwu wzrokowego jako pierwszy objaw toksoplazmozy ocznej ­ analiza przypadku.

Diagnostic procedure for unilateral optic disc oedema needs detailed medical history, careful physical examination and multiple additional tests. We present a very rare case of atypical unilateral anterior optic neuropathy as a sign of ocular toxoplasmosis in a young female. All diagnostic and therapeutic challenges have been discussed.

[Micropulse 577 nm laser trabeculoplasty--a prospective pilot study]. / Trabekuloplastyka laserowa w trybie mikropulsów laserem 577 nm--pilotazowe badanie prospektywne.

PURPOSE: To evaluate the efficacy of micropulse 577 nm laser trabeculoplasty. MATERIAL AND METHODS: Prospective clinical trial designed for 30 patients diagnosed with open angle glaucoma. The micropulse 577 nm laser trabeculoplasty was performed in one eye of each patient in the lower half of trabecular meshwork. The intraocular pressure was measured using two independent methods--Pascal tonometer and iCare tonometer--at baseline (before surgery), at 3 h, 24 h, 2 weeks and 1 month following the procedure. Pressure measurement results were compared between the treated and untreated eyes. Treatment was considered successful if the intraocular pressure dropped by ≥ 3 mmHg or ≥ 20% as compared to the baseline values or ≥ 20% as compared to the fellow eye. RESULTS: The study was conducted on 11 patients. In the treated group, Pascal tonometry showed the mean decrease of the intraocular pressure by 1.7 mmHg (7.5%). The same value for the untreated eyes was 1.8 mmHg (8.1%). The results obtained using iCare tonometer showed the same proportions. The treatment did not lower intraocular pressure as compared to the untreated fellow eyes. There were no adverse effects. Even though it was impossible to perform the proper statistical analysis due to the small number of treated patients the study was eventually interrupted for ethical reasons, because of the failure to decrease the intraocular pressure in the treated group of 11 patients. CONCLUSIONS: The treatment appeared to be safe but ineffective in the treated group. Further research is needed to modify laser parameters for the improvedefficacy and the maintained good safety profile of the procedure.

Itraorbital organic foreign body - radiological methods in diagnosis - case report.

Intraorbital foreign bodies, especially non-metallic ones, remain an important diagnostic and therapeutic problem. Organic foreign bodies contain large quantities of bacterial flora contributing to rapid onset of inflammation which may promptly damage the optic nerve. Further progression of inflammation may involve the structures of central nervous system. US examination is a preliminary, commonly available diagnostic method, although it is not always successful in visualizing foreign bodies. CT scan remains a standard investigation used to visualize intraorbital foreign bodies, although with organic foreign bodies, its results may be inconclusive. MRI allows for visualization and precise identification of foreign bodies, which is vital for surgery. The issue of intraorbital foreign bodies is an interdisciplinary problem requiring the co-operation between ophthalmologists and neurosurgeons.