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In Reply We thank Shanbhag et al for commenting on our study. In short, they question whether, based on our article describing the learning curve for 18 novel DMEK surgeons,1 the procedure would be a better alternative to DSEK and PK. The main concerns expressed are that the study does not contain reliable data on best-corrected visual acuity, the decrease in endothelial cell density would be higher than in earlier techniques, and about one-fifth of eyes required a secondary intervention. Furthermore, according to long-term studies PK would still be preferable over endothelial keratoplasty, and unless technique improvements are reached, DMEK may not hold potential to become a preferred method for treatment of endothelial disorders.2
Monnereau C, Dapena I, Melles GRJ. Descemet Membrane Endothelial Keratoplasty—Reply. JAMA Ophthalmol. 2015;133(6):725. doi:10.1001/jamaophthalmol.2015.0486