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7% vs. 18.3%, P = 0.014). There was also a positive correlation between PK and DALK surgical volumes (Spearman rank correlation coefficient = 0.57, P 0.001). The main reasons for surgeon preference for DALK over PK were a desire to preserve the endothelium, intraoperative safety, and decreased complications. Longer surgical time and low patient volume were cited as barriers to adoption of DALK. Alterations in DALK technique that reduce surgical time and providing more learning opportunities for DALK might improve adoption. Alteratio
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