Simons RWP, et al. - Using data from a multicentre randomized clinical trial, a cost-effectiveness analysis was performed to assess the cost-effectiveness of ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) vs standard DSAEK. For this investigation, they included and randomized 64 eyes of 64 patients with Fuchs’ endothelial dystrophy to UT-DSAEK (n = 33) or DSAEK (n = 31). Data reported that societal costs were €9431 for UT-DSAEK and €9110 for DSAEK. In both groups, quality-adjusted life years (QALYs) were 0.74. Findings revealed that the probability of cost-effectiveness ranged from 37% to 42%, assuming that the maximum acceptable ICER ranged from €2500–€80 000 per QALY. DSAEK favoured the baseline case analysis since UT-DSAEK costs were higher while QALYs were similar. However, additional analyses for UT-DSAEK or DSAEK did not reveal any preference. To reduce uncertainty, further cost-effectiveness studies are required.