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The evidence reviewed supports DMEK as a safe and effective treatment for endothelial failure. With respect to visual recovery time, visual outcomes, and rejection rates, DMEK seems to be superior to DSEK and to induce less refractive error with similar surgical risks and EC loss compared with DSEK. The rate of air injection and repeat keratoplasty were similar in DMEK and DSEK after the learning curve for DMEK.

In both studies, the Orbscan system obtained statistically significantly different and higher values for corneal thickness. Regression analysis suggests that over the range of values in this study, the two devices differ by a constant amount (intercept and slope). The nonzero intercept of this regression shows that the values from the devices differ and cannot be directly substituted for each other. We therefore conclude that in this study, Orbscan system measurements of corneal thickness were 23 to 28 microm greater than ultrasonic pachymeter measurements. Linear regression equations may be developed for the results of measurements from the two devices and used as a precise transformation factor for the values obtained with the two devices.