Impact of COVID-19 pandemic on cataract surgical volume: A North Indian experience

Abstract

Purpose: To analyze the impact of the pandemic on trends in cataract surgical volume in 2020 in a high-volume tertiary care academic center in North India. Methods: The monthly cataract surgical volume for a large, high-volume, tertiary care academic center in North India was obtained from January 2018 through December 2020. Based on historical trends, we used time-series forecasting, probability sensitivity analysis, and linear regression models to estimate what the expected monthly cataract volume should have been from March 2020 onward. Results: In 2020, we expected to perform 7500 cases (assuming historical trends) but performed only 2500 cases (33% of the expected volume). The remaining 5000 cases (67% cases) constituted the “fixed” backlog. Assuming the ramp-up in cataract surgical volume starts in January 2021, results of the Monte Carlo simulation revealed that for our system, it would take on average 5 months (May 2021) under the optimistic scenario and 10 months (October 2021) under the ambivalent scenario to reach pre-pandemic expected surgical volume. There would be a collective backlog of 5500 cases under the optimistic scenario (8.8 months’ worth of cases) and a collective backlog of 6900 cases under the ambivalent scenario (11 months’ worth of cases). Conclusion: An intuitive approach and out-of-the-box solutions are required by the government and private institutes’ collaborative efforts to help mitigate the disruptions caused by the pandemic and lessen the backlog without causing provider burnout.

Trends in cataract surgery and healthcare system response during the COVID-19 lockdown in Malaysia: Lessons to be learned

“…Our findings are consistent with a Polish study [ 11 ]. Similarly, other countries [ [12] , [13] , [14] , [15] , [16] , [17] ] reported drastic reductions in the usual volume of cataract surgeries or ophthalmic procedures by 67 %–99 % in the early phase of the pandemic. However, the recovery of cataract surgeries was uneven across regions, independent of country income status.…”

“…Due to suspension of cases during the lockdown and incoming new cases that are performed below 100 % capacity (without a simultaneous increase in resources) during the recovery phase, a substantial cataract surgical backlog is likely. A study in India [ 14 ] estimated that it would take 10 months under the ambivalent scenario to reach pre-pandemic expected cataract surgical volumes once elective surgical suspension is lifted and surgeries resume, during which there would be a collective backlog of 11 months’ worth of cases. In high income countries [ 10 , 30 ], the time estimated to revert to pre-pandemic volumes under the pessimistic scenario is shorter—approximately 6–7 months.…”

Comparison of clinical parameters in patients with cataract surgery during and before COVID-19 pandemic

“…There are studies about cataract surgeries in this period. [7][8][9] In this study, we aimed to compare and discuss the clinical characteristics of patients who underwent cataract surgery, which is an elective case, before and during the pandemic.…”

Cataract referral pattern among Indian optometrists: A cross-sectional study

“…6 A recent single centre study showed that there was reduction of 20% in cataract surgeries during COVID 19 due to restrictions imposed by government. 7 The ministry has suggested gradually increasing the number of cataract operations nationwide in the fiscal years 2022-2023 to 7.5 million, 9 million in 2023-2024, and 10.5 million in 2024-25, for a total of 27 million operations over the following three years. 8 In India, optometrists are the primary eye care professionals who provide comprehensive eye and visual examination that includes refraction, prescribing spectacles, detecting and diagnosing ocular diseases and referring for appropriate management.…”

“…Similarly, the criteria for the referral of patients for cataract surgery to ophthalmologists have not been studied till date. Given the predicted increase in the global prevalence of age-related cataract and the growing backlog of cataract surgical cases in India, [6][7][8] the current study aimed to investigate the practice of cataract referral among Indian optometrists.…”