Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers

Abstract

Background/objectives: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). Methods: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant. Results: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65–0.80 and 0.61–0.75, respectively, p < 0.001 for both). Conclusion: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.

Impact of the COVID-19 pandemic on ophthalmologic outpatient care: experience from an Italian Tertiary Medical Center

“…vitreoretinal and glaucoma surgery). In fact, this kind of analysis was performed by another recent paper we contributed to [ 6 ]. In the latter, the authors reported a significant reduction in surgical activity during the pandemic.…”

The Impact of COVID-19 on Diabetic Retinopathy Monitoring and Treatment

“…In a different study, at the Policlinico Hospital in Milan, Italy, there was an 81% decrease in intravitreal injections during the national lockdown from March 8 to March 31, 2020 [23]. A retrospective analysis of ophthalmic practices in 39 academic centers in Italy between March 10 and May 9, 2020 revealed an almost 50% decline in intravitreal injections for all indications [24].…”

“…Clinic restrictions, closure of private clinics, resource shortages, travel restrictions, lack of public transport facilities, and patient concerns were all factors that contributed to the decrease in intravitreal injections [24,25,29]. Younger patients and those with worse visual acuity in the fellow eye were more likely to adhere to anti-VEGF treatment [23,30].…”

The Impact of Covid-19 in the Follow-Up of Glaucoma Patients in a Tertiary Center: A Comparison Between Pre-Pandemic and Pandemic Periods

“…23 Also, as recommended by different ophthalmology societies, 12 , 14 we postponed non-urgent surgical interventions. A report from 39 academic ophthalmology centers in Italy, 15 another country severely impacted by the pandemic, compared surgical interventions of the 2-month lockdown period (March 10 to May 9, 2020) to pre-lockdown months (January 10 to March 9, 2020) and corresponding 2 months of 2019 (March 10 to May 9, 2019). Overall, the number of surgeries decreased 68.8% and 69.9%, respectively, with a reduction of 96.2% and 96.4% in the number of elective surgeries and 50.7% and 53.9% in the number of urgent surgeries.…”