[Causes of amputations performed during a 9-year period in hospitals affiliated to Kerman University of Medical Sciences]

Amputation has different causes and is increasing in many countries. This study tried to determine the etiology of the amputations in one of the relatively large cities of Iran. Method: This retrospective study was undertaken on all of the amputees in hospitals affiliated to Kerman University of Medical Sciences during 9 years. Patients' demographic features including age and sex, as well as the amputated limb and its etiology, side and level were recorded. The level of amputation was recorded as minor [below wrist or ankle] or major [above wrist or ankle] too. In whole, 624 patients were enrolled into the study. The number of amputees per year was 54-118 ones. From all participants, 508 ones [31.4%] were male and 118 ones [18.6%] were female. Mean age of male participants was less than females'. Upper extremities had been amputated more than of lower ones and while 61.9% [n=386] of the amputations were major, 38.1% [n=238] were minor. Overall, the most common cause of amputation was trauma and the most common level was transmetatarsal. The most common level for major amputations was below knee. In the present study, in contrast to similar studies in the developed countries, trauma was found to be the major cause of all types of amputations and in all age groups, which emphasizes the need for preventive measures in the country

[Surgical treatment of severely traumatized eyes with no light perception]

To evaluate the anatomical and functional outcomes of surgical treatment in severely traumatized eyes with no light perception [NLP] vision. In this prospective interventional case series, 18 eyes of 18 patients with severe trauma and NLP vision and RAPD of 3-4+ admitted in Nikookari Hospital, Tabriz-Iran during 2002-2005 underwent deep vitrectomy and other appropriate procedures for one to three times and were followed for 11 to 36 months. All eyes had NLP vision at the time of surgery and underwent the operations 3-14 days after the injury. After mean follow up of 20.5 months, except for one case of phthisis, other eyes achieved acceptable anatomic and functional outcomes. Postoperative vision was NLP in one case due to orbital fracture and optic nerve disruption, light perception in three cases, hand motion in four cases, counting fingers in three cases and 20/100-20/200 or better in seven eyes. NLP vision with RAPD of 3-4+ alone may not be indication for enucleation. Performing exploratory surgery within 14 days after the injury may salvage the globe and improve vision, this approach also entails positive psychological effects on patients and relatives

[Deep vitrectomy for diabetic macular edema associated with taut and thickened posterior hyaloid]

To evaluate the effectiveness of pars plana vitrectomy and posterior hyaloid stripping in decreasing macular thickness and improving vision in diabetic macular edema. This prospective interventional case series includes 30 eyes of 25 diabetic patients with diabetic macular edema with macular thickness exceeding 170 microns and thickened posterior hyaloid. BCVA and macular thickness measured by OCT were evaluated preoperatively and 4-6 months postoperatively. Macular perfusion was evaluated by means of fluorescein angiography preoperatively. Treatment consisted of pars plana vitrectomy and stripping of posterior hyaloid. Mean preoperative macular thickness was 53 1.97 +/- 126.52 [micro]m which decreased to 365.2 +/- 103.2, postoperatively [P< 0.001]. Mean preoperative BCVA [Log MAR] was 0.82 +/- 0.39 which improved to 0.65 +/- 0.34 postoperatively [P=0.006]. According to Pearson correlation coefficient, macular perfusion and presurgical BCVA