{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T02:50:54Z","timestamp":1781923854518,"version":"3.54.5"},"reference-count":32,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Evidence for Descemet's membrane endothelial keratoplasty (DMEK) in patients under 30 years old remains limited, although understanding outcomes in this demographic is important given the requirement for decades of graft function and concerns about long-term DMEK survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective case series at Moorfields Eye Hospital of consecutive patients under 30 years undergoing DMEK between 2015 and 2022. Primary outcome was change in best-corrected visual acuity (BCVA). Secondary outcomes included change in central corneal thickness (CCT), graft failure rates, and post-operative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      18 eyes of 17 patients underwent DMEK surgery (mean age 22.7\u2009\u00b1\u20095.1) over a mean follow-up of 1072.1\u2009\u00b1\u2009869.8 days. Mean BCVA improvement was 0.36 logMAR from pre-operative to final follow-up (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05), though significant improvements occurred at 1-month and 12-month intervals (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001 and\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01, respectively). CCT improved significantly from baseline by 111.3\u2005\u03bcm (95% CI, 64.3\u2013158.2\u2005\u03bcm,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). At final follow-up, 22.2% of eyes achieved BCVA \u2264 0.3 logMAR (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20094). No patient achieved BCVA \u2264 0.1 logMAR. Rebubbling was performed 9 times (50%) in 8 eyes and was similar between both SF6 and air (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Post-operative complications occurred in 11.1% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20092) with no rejection episodes, although secondary graft failure occurred in 22.2% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20094), all within 12 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DMEK effectively improves visual and anatomical outcomes in patients under 30, though with higher complication rates than older populations. The complex pathology and longer follow-up requirements in this demographic necessitate careful patient selection and realistic expectations. Larger prospective studies are needed to establish definitive guidelines for this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721261415768","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T18:24:51Z","timestamp":1769106291000},"page":"881-887","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of descemet's membrane endothelial keratoplasty in patients under thirty years old"],"prefix":"10.1177","volume":"36","author":[{"given":"Shafi","family":"Balal","sequence":"first","affiliation":[{"name":"Moorfields Eye Hospital NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0755-7242","authenticated-orcid":false,"given":"Imran Karim","family":"Janmohamed","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Maidstone and Tunbridge Wells NHS Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Song","sequence":"additional","affiliation":[{"name":"Moorfields Eye Hospital NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Hussain","sequence":"additional","affiliation":[{"name":"Moorfields Eye Hospital NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sundas","family":"Maqsood","sequence":"additional","affiliation":[{"name":"Moorfields Eye Hospital NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Maurino","sequence":"additional","affiliation":[{"name":"Moorfields Eye Hospital NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2007.09.021"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2009.07.010"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.09.019"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2017.08.015"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-85138-4"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2020.07.018"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000002616"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000002540"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000002737"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000002701"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjo.2018.05.012"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e31821ddd25"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000000118"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/750567"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2016.07.002"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000002120"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2018.11.014"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2020.06.023"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2016-309653"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2015.08.005"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2020.100863"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000001374"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0000000000001095"},{"key":"e_1_3_2_25_2","first-page":"911","article-title":"Distinctive and pervasive alterations in aqueous humor protein composition following different types of glaucoma surgery","volume":"21","author":"Rosenfeld C","year":"2015","unstructured":"Rosenfeld C, Price MO, Lai X, et al. 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