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The study aimed to compare the outcomes of two surgical approaches, sequential Descemet membrane endothelial keratoplasty (DMEK) and combined DMEK, in patients with Fuchs endothelial corneal dystrophy (FECD) and cataract. A systematic literature review and meta-analysis were conducted, analyzing studies that reported on both approaches. The main outcome measure was the improvement in corrected distance visual acuity (CDVA), with secondary outcomes including postoperative endothelial cell density (ECD), rebubbling rate, and primary graft failure rate. The analysis of 667 eyes from five studies found no significant difference between the two approaches in terms of CDVA improvement, postoperative ECD, rebubbling rate, and primary graft failure rate. However, the overall quality of the included studies was assessed as low, emphasizing the need for randomized controlled trials to further investigate these findings.
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