Emergent Ophthalmic Surgical Care at a Tertiary Referral Center During the COVID-19 Pandemic

Abstract

Purpose To characterize the delivery of emergent ophthalmic surgical care during April 2020 of the COVID-19 pandemic compared with the same time interval the year prior. Design Retrospective, observational before-and-after study Methods Review and characterization of each emergent/urgent procedure performed during April 2020 and April 2019 at a single tertiary ophthalmology referral center. Information collected included the details of patient presentation, diagnosis, surgical procedure, and preoperative COVID-19 testing. Results In total, 117 surgical procedures were performed on 114 patients during the month of April 2020 compared with 1,107 performed in April 2019 ( p < 0.0001). Retinal detachment repair was the most common procedure (37, 31.6%) in April 2020 while elective cataract surgery (481, 47.3%) was most common in April 2019. The mean age of patients was 50.0 years in April of 2020 compared to 59.0 years (p<0.0001) the year prior. During April 2020, the mean age of surgeons performing procedures was 42.3 years compared to 48.4 years (p<0.0001) during April 2019. In April 2020, all but 5 patients (96%) had RT-PCR based COVID-19 testing prior to their procedure. One patient (0.88%) had a positive COVID-19 test . Conclusions The COVID-19 pandemic decreased our institution’s surgical volume in April 2020 to approximately 10% of the usual volume. The pandemic changed the type of cases performed and led to a statistically significant decrease in both the age of our surgeons and patients relative to the same interval in the year prior. Broad preoperative screening led to one positive COVID-19 test in an asymptomatic patient.

The Ophthalmic Surgical Backlog caused by the COVID-19 Pandemic: A population-based and microsimulation modelling study

“…Following March 15, 2020, the pandemic shutdowns resulted in 97% reduction of surgical volumes and an associated increase in the number of patients awaiting surgery. Similar drastic reductions by 77-90% of the usual volume of surgeries performed have been noted at other tertiary ophthalmic surgical centres in North America 23 and Europe. 24 Despite the gradual recovery in surgical activity, without any increases in resources to support the backlog of surgical cases, incoming new urgent cases will lead to further delays in surgeries for semi-urgent and non-urgent cases.…”

Emergency treatment of ophthalmologic diseases during the first phase of SARS-CoV2 pandemic in a tertiary referral center in Germany – the COVID-DETOUR questionnaire study

“…Within this group, retinal detachments were the most common singular cause with 41.9%, followed by retinal vessel disorders (12.9%). Comparable gures for retinal detachments have been reported from a tertiary center in the USA (10). Corneal disorders and neuro-ophthalmologic diseases followed with 14.0% and 10.8%, respectively.…”

“…We included patients with an acute need for treatment as an inpatient, regardless of whether surgery was indicated or not. This has to be considered when comparing the numbers from this setting to other studies reporting on emergency department visits (8,9) or ophthalmic surgical care (10).…”

Trends in emergency ophthalmic care during COVID-19: A comparative analysis

“…These findings are supported by a prior study examining emergent ophthalmic surgery during the COVID-19 pandemic, which also demonstrated a significant increase in the proportion of retinal detachment repairs and trauma-related surgical cases during COVID-19. [ 9 ] Furthermore, the proportion of patients completing follow-up was lower during the COVID-19 pandemic. The reasons behind the decrease may be related to patient hesitation to return to a medical center during the pandemic after an initial ED visit.…”