Purpose <p>To investigated the prevalence of anterior corneal scars after Descemet’s membrane endothelial keratoplasty (DMEK), and the results of transepithelial phototherapeutic keratectomy (transPTK) in affected patients.</p> Methods <p>Records were reviewed of all patients who underwent DMEK at the study center between March 2014 and December 2020. Patients were included if surgery had been performed for Fuchs endothelial corneal dystrophy or bullous keratopathy and no relevant concomitant eye disease was documented. Two groups were formed based on postoperative CDVA (Snellen): CDVA ≤ 0.7 (group 1), and CDVA ≥ 0.8 (group 2). After PTK was established at the study center, records of group 1 were reviewed again (“follow-up”), including pre- and postoperative data in those patients that had undergone wavefront-guided PTK.</p> Results <p>Of 760 eyes that received DMEK, 420 were included in the analysis. A corneal scar was documented in 11.2% (47/420). These had a mean (± SD) CDVA of 0.66 ± 0.17. Mean CDVA in eyes without corneal scarring was 0.81 ± 0.11 (<i>p</i> &lt; 0.01). A corneal scar was present in group 1 in 25% (29/116), and in group 2 in 6% (18/304) (<i>p</i> &lt; 0.01). Fifty-seven eyes of group 1 were re-examined during the follow-up, yielding a prevalence of corneal scars of 29.8% (17/57). Of these, 23.5% (4/17) were candidates for PTK and 3 received treatment. Six months after transPTK, no corneal scar was seen, and CDVA was 1.0.</p> Conclusion <p>Patients with reduced CDVA after DMEK should be examined for corneal scars, since transPTK can achieve full recovery of vision in selected cases.</p>