Ali Hendi Alghamdi

Purpose: To describe a modification of the Yamane double-needle technique using partial-thickness scleral groove-flap coverage of the terminal haptic flanges for secondary IOL implantation in eyes without adequate capsular support. Methods: This surgical technique report describes a modified approach to flanged intrascleral haptic fixation (ISHF). At two fixation sites 180° apart, partial-thickness scleral grooves are created. After haptic externalization and cauterization, the terminal flanges are guided into the grooves and buried beneath scleral tissue rather than positioned directly beneath the conjunctiva. Results: The technique was successfully performed in three eyes requiring secondary IOL implantation without adequate capsular support. At 12 months postoperatively, all patients demonstrated stable IOL centration with complete conjunctival epithelialization over the haptic sites. No cases of haptic exposure, endophthalmitis, or flange-related irritation were observed. Conclusion: The scleral groove-flap modification preserves the essential workflow of the Yamane technique while providing additional scleral tissue coverage over the terminal haptic flanges. In this small case series without a comparison group, the technique was associated with stable IOL centration, complete conjunctival epithelialization, and no observed haptic exposure during 12 months of follow-up.

Purpose To narratively review clinical use of topical and periocular tacrolimus in ophthalmology, with emphasis on allergic keratoconjunctivitis (VKC/AKC), ocular GVHD, post‑keratoplasty prophylaxis, and selected keratitis/uveitis indications. Methods Narrative search of PubMed/Scopus through October 2025 focusing on prospective, randomized, and comparative studies of topical/periocular tacrolimus; recent formulation advances (nanoemulsions, in‑situ gels, cyclodextrin complexes) were included. Results Across VKC/AKC, tacrolimus (0.03–0.1% ointment; 0.05–0.1% solutions/suspensions) improves signs/symptoms and reduces steroid burden; comparative data suggest faster epithelial healing than topical corticosteroid in shield ulcers. In ocular GVHD, pilot randomized data demonstrate symptom relief with acceptable safety. Observational studies suggest benefit as post‑keratoplasty adjunct in high‑risk grafts. Emerging delivery systems address solubility, residence time, and tolerability and show promising preclinical pharmacokinetics. Conclusion Tacrolimus is a practical steroid‑sparing therapy for severe ocular surface inflammation. Priority trials should be formulation‑specific with standardized outcomes and pharmacokinetic endpoints, alongside pediatric safety registries and head‑to‑head comparisons versus cyclosporine 2% and soft steroids.

We report a rare coexistence of Pellucid Marginal Degeneration (PMD) and Fuchs' heterochromic iridocyclitis (FHI) in a 40-year-old female. The overlap of corneal ectasia and chronic uveitis created significant diagnostic and surgical challenges, highlighting the importance of individualized planning in complex anterior segment diseases. The patient presented with painless, progressive visual decline in the right eye. Clinical examination revealed inferior corneal thinning, mature cataract, pigmented keratic precipitates, and peripheral anterior synechiae (PAS). Corneal tomography confirmed PMD with a characteristic "crab-claw" pattern. The patient underwent phacoemulsification with posterior chamber intraocular lens implantation. Postoperatively, visual acuity improved, although optic disc cupping and persistent PAS underscored the need for long-term glaucoma surveillance. The coexistence of PMD and FHI is exceptionally rare. PMD complicates surgical planning by affecting keratometric reliability and corneal biomechanics, while FHI contributes to cataract formation, intraocular inflammation, and risk of secondary glaucoma. Multimodal imaging, tailored surgical strategy, and vigilant postoperative follow-up are key to optimizing outcomes. Simultaneous PMD and FHI represent a unique clinical entity requiring comprehensive assessment and individualized management. Tailored surgical planning and vigilant surveillance are essential to preserve vision and mitigate long-term risks.

Background: The study was set up to investigate the toxicological effects of the aqueous extract of onion (Allium cepa L.) peel (OP) in rats, in vivo. Methods: A total of 30 rats were randomly divided into 4 groups. Acute oral toxicity was investigated using three different doses of OP, where the first group of rats was given distilled water and served as -ve control, the three rest groups given (250, 500 and 1000 mg/kg) of OP daily for 14 days orally. Rats were observed during the short term and the long term. On the 15th day, the rats were anesthetized with diethyl ether and blood samples were taken to evaluate hematological, biochemical, liver and kidney function. All main organs were collected in formalin and sent for histopathological investigations. Results: OP exhibited a significant increase in the time of anesthesia among the group admitted with the lowest dose (250 mg/kg). It showed a significant increase in lymphocyte levels. OP showed an elevation in all liver function parameters except, albumin level. The blood glucose level was reduced after OP extract treatment. No renal effects were observed. Furthermore, histopathological results showed normal results comparable to the untreated group, except mild inflammation was observed in the lung. Conclusions: We conclude that the dry onion peel aqueous extract was found to be free from any toxic effect on the rat’s main organs. However, it showed mild toxicity in the liver profile.

Introduction: Glaucoma is a disease that increases the intraorbital pressure (IOP) affecting the optic nerve causing visual field defects up to total blindness if left unmanaged. It is often asymptomatic and one of the leading causes of blindness worldwide. Awareness of glaucoma risk factors and symptoms can promote early diagnosis, reducing complications. Aim: To assess awareness and knowledge of Al-Baha population about glaucoma risk factors and symptoms. Methods: A population-based cross-sectional study included 411 adults from Al-Baha town from June to December 2022. A semi-structured questionnaire measured awareness and knowledge of glaucoma. A knowledge score, ranging from 0 to 10, was calculated, with 6 or higher indicating good glaucoma knowledge. Data analysis was performed using SPSS 25. Descriptive statistics and chi-square tests assessed associations. Multivariable logistic regression determined factors associated with awareness. Variables with P-value < 0.05 were considered statistically significant. Results: A total of 411 respondents completed the questionnaire, with 34.3% being males, 35% aged 18-25, only 5 having glaucoma, and 14.4% having a family history of glaucoma. The most common source of information about glaucoma was people with glaucoma, followed by news media. Of the 411 respondents, 75.2% were aware of glaucoma, and 49.8% had a good knowledge score (mean knowledge score: 4.39). The chi-square test revealed a significant correlation between knowledge and having glaucoma or a family member with it (P<0.05). Conclusion: The study revealed low awareness and knowledge of glaucoma and its associated risk factors among the population of Al-Baha. There is a need for educational and screening programs to promote early disease diagnosis.

This study on Buddleja polystachya highlights its phytochemical composition, antimicrobial activity, and cytotoxic impacts. The study emphasizes the plant’s potential to treat ocular diseases by identifying important compounds involved in the bioactivity through GC-MS analysis. This study explores the antimicrobial and cytotoxic potential of Buddleja polystachya (stem and leaves) extracts, with a focus on their application in treating bacterial ocular infections and their efficacy against MCF7, HT29, and HepG2 cancer cells. Through comprehensive GC-MS analysis, a diverse array of phytochemicals was identified within Buddleja polystachya stem and leaves extracts, including carbohydrates, phenolic derivatives, fatty acids, and steroidal components. The extracts were then evaluated for their biological activities, revealing significant antimicrobial properties against a range of bacterial strains implicated in ocular infections. The research findings demonstrate that stem extracts derived from Buddleja polystachya demonstrated high to moderate cytotoxic effects on cancer cell lines MCF7, HT29, and HepG2. Notably, these effects were characterized by varying IC₅₀ values, which suggest distinct levels of sensitivity. In contrast, leaf extracts exhibited reduced cytotoxicity when tested against all these cell lines, although they did so with a significantly higher cytotoxicity aganist HepG2 cells. The results of this investigation highlight the potential therapeutic utilization of Buddleja polystachya extracts in the management of ocular infections and cancer. These results support the need for additional research to elucidate the underlying mechanisms of action of these extracts and explore their potential as drugs.

Background: Edible fruits and resins provide various benefits to mankind including potential medicinal applications. This study aimed to determine the cytotoxicity, selectivity, and clonogenicity of fruits and exudates of certain Saudi medicinal plants (Anethum graveolens (BEP-09), Opuntia ficus-indica (L.) Miller (BEP-10), Boswellia serrata Roxb. ex Colebr. (BEP-11), and Commiphora myrrha (BEP-12)) against human liver adenocarcinoma (HepG2). Methods: Initial cytotoxicity and cell line selectivity against different cell lines were screened using MTT assay. The most promising extract was subjected to gas chromatography-mass spectrometry (GC-MS) analysis to determine the main phytoconstituents. Clonogenicity was checked for the most active extract. Results: The selected plants’ fruits and resins possess a significant cytotoxic activity estimated as IC50. The fruit of BEP-10 was found to be the most active extract against liver cancer cells (IC50 = 2.82) comparable to both doxorubicin (IC50 = 1.40) and camptothecin (IC50 = 1.11). It showed a selectivity index of 4.47 compared to the normal human foetal lung fibroblast (MRC5) cells. BEP-10 showed a dose-dependent clonogenic effect against HepG2 cells comparable to the effect of doxorubicin. The GC-MS chromatogram of BEP-10 extract revealed the presence of eight small polar molecules, representing 73% of the total identified compounds and the rest three molecules (27%) were non-polar constituents. The furan derivatives represent the chief components in BEP-10 (16.3%), while the aldehyde 5-(hydroxymethyl)-2-furancarboxaldehyde was found to be the main molecule (13.2%). Conclusion: The fruits of BEP-10 have a potential cytotoxic effect particularly against HepG2. The identified phytoconstituents in the tested plant extract might contribute to the investigated cytotoxic activity.

Background: Metastatic secondary ocular tumors spread from systemic malignancies, including breast cancer. This study aimed to evaluate the cytotoxicity of extracts from 5 medicinal plants native to Saudi Arabia. Methods: For preliminary activity screening, cytotoxicity using the MTT assay and selectivity index determinations were made for medicinal plant extracts against various cancer cell-lines. The most promising extract was subjected to GC-MS analysis to determine the phytochemical composition. Clonogenic assays were performed using the most promising extract to confirm the initial results. Finally, western blot analysis was used to determine the modulation in expression of survivin and P27 suppressor genes in the human breast adenocarcinoma (MCF7) cell-line to understand the potential mechanistic properties of the active plant extract. Results: The 5 plant extracts showed various cytotoxic activity levels using IC₅₀. The most active extract was found to be the leaves of Capparis spinosa L. (BEP-07 extract) against the MCF7 breast cancer cell-line (IC₅₀ = 3.61 ± 0.99 μg/ml) and selectivity index of 1.17 compared to the normal human fetal lung fibroblast (MRC5) cells. BEP-07 extract showed a dose dependent clonogenic effect against the MCF7 colonies which was comparable with the effect of doxorubicin. BEP-07 extract caused a significant decrease of survivin and increase in P27 expression compared to control GAPDH at its highest dose (14 µg/ml). The GC-MS chromatogram of Capparis spinosa L. (BEP-07 extract) revealed the existence of 145 compounds, belonging to the diverse classes of phytoconstituents. Fatty acids and their derivatives represent 15.4%, whilst octadecanoic acid, 2,3-dihydroxypropyl ester was the principal component (7.9%) detected. Conclusion: Leaves of Capparis spinosa L. (BEP-07 extract) exhibited a significant cytotoxic effect particularly against breast cancer cells. It exhibited this effect through survivin inhibition and via P27 upregulation. The detected phytoconstituents in the plant extract might be involved in tested cytotoxic activity, while further investigations are required to complete the drug candidate profile.

Aim: This study measured and evaluated the socioeconomic burden of people living with keratoconus in Saudi Arabia. Methods: This study employed a cross-sectional design, a Keratoconus Economic Burden Questionnaire, and a convenient sample of 89 keratoconus patients (58.4% male) drawn from multiple regions in Saudi Arabia. It was conducted using online surveys, and the data were analyzed using appropriate quantitative techniques. Results: The mean age and annual income of the participants were 33.24 (SD = 6.82) years and USD 9046.52 (SD = 16,866.48), respectively, with only 37% being employed for wages. Up to 94.4% needed glasses or contact lenses at least once a week, and 73.0% received care from optometrists. The condition forced 45.9% of the respondents to change careers or leisure activities, with a further 51.3% having to take time off work. The mean annual out-of-pocket expenses for buying and maintaining glasses or contact lenses, as well as traveling and accommodation for keratoconus-related treatment were USD 2341.76 (SD = 3053.09), with 48.32 incurring upwards of USD 3240 over the period. The treatment costs increased with disease duration, r(89) = 0.216, p < 0.05. Regression results showed that the existence of comorbid eye disease, changing glasses at least once a year, and wearing either glasses or contact lenses at least once a week individually had statistically significant negative effects on the total annual keratoconus treatment costs, while disease duration, utilization of optometrists, and taking time off had a statistically significant increase on the total cost (p < 0.05). Conclusion: With a prevalence rate of 1 in 375, progressive debilitation, and the lifetime nature of the disease, keratoconus is a critical public health concern in Saudi Arabia. The resulting visual impairment and discomfort, as well as both direct and indirect economic burdens, have considerable impacts on the patient’s quality of life.