&lt;p&gt;Vitreoretinal Surgery in the Post-Lockdown Era: Making the Case for Combined Phacovitrectomy&lt;/p&gt;

Antaki, Fares; Milad, Daniel; Javidi, Simon; Dirani, Ali

doi:10.2147/opth.s270934

Cited by 13 publications

(11 citation statements)

References 15 publications

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“…However, due to the vision impairment caused by post-vitrectomy cataract formation and the prolonged duration of the COVID-19 pandemic and lockdown, even non-emergent surgeries like cataract removal may be inevitable to maintain the quality of life of the patients. It seems reasonable to perform phacovitrectomy instead of vitrectomy alone whenever possible to minimize the number of visits and operations in ophthalmology centers [ 22 ]. Also, this combined procedure decreases the use of personal protective equipment (PPE) by 50% compared with sequential surgery and saves costs per patients by 17–20% [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

Retinal detachment during COVID-19 era: a review of challenges and solutions

Roshanshad

Binder

2021

Spektrum Augenheilkd.

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Summary Background Since the beginning of the Coronavirus disease 2019 (COVID-19) pandemic, there have been obstacles in the proper diagnosis and management of many diseases. We evaluated the changes in retinal detachment (RD) presentation and surgery during the COVID-19 pandemic and propose solutions to minimize the detrimental effects of lockdown on RD diagnosis. Materials and methods PubMed, Embase, Scopus, Web of Science, and Google Scholar were searched for relevant articles with the keywords “Retinal detachment” AND “Coronavirus OR COVID-19 OR SARS OR MERS.” Results The COVID-19 lockdown was associated a 53–66% reduction in RD presentation. The decrease in the rate of macula-on RD, the increase in the mean duration of symptoms, and the rise in the number of patients with proliferative vitreoretinopathy were all suggestive of a delayed presentation of RD. Moreover, a drop of 56–62% in RD repair surgeries was observed. However, the most frequently performed ophthalmic surgery changed from cataract surgery in April 2019 to RD repair in April 2020. Using phacovitrectomy instead of vitrectomy alone can reduce the number of operations in ophthalmology centers, decrease the use of personal protective equipment by 50%, and cut costs per patient by 17–20%. Also, developing a well-organized telemedicine system can decrease unnecessary visits and delayed presentations. Conclusion Delay in RD presentation and surgery is associated with a poorer prognosis. Optimizing the guidelines of RD management and developing a well-organized telemedicine system can minimize the impact of lockdown on RD management.

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Section: Resultsmentioning

confidence: 99%

Retinal detachment during COVID-19 era: a review of challenges and solutions

Roshanshad

Binder

2021

Spektrum Augenheilkd.

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“…Due to postoperative complications involving the crystalline lens, more than half of phakic patients who underwent vitrectomy for RRD repair subsequently needed cataract surgery within 1 year [5]. Thus, combined phacovitrectomy was encouraged for patients aged 50 or older due to the lower cost of surgery, reduced complications and better visual outcome [6][7][8][9]. In 10-17% of cases of RRD with macular involvement, it was impossible to measure the axial length (AL) using optic biometry (IOLMaster) because of the limitations of the machine, such as dense media opacity, poor fixation by the patients or the lack of an available machine [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Differences in Axial Length and IOL Power Based on Alternative A-Scan or Fellow-Eye Biometry in Macula-Off Rhegmatogenous Retinal Detachment Eyes

2021

Ophthalmol Ther

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Introduction: This study was performed to observe the potential refractive prediction error based on alternative A-scan ultrasound and fellow-eye biometry for phacovitrectomy in macula-off rhegmatogenous retinal detachment (RRD) eyes. Methods: Phakic macula-off RRD eyes without axial length (AL) measurements obtained using IOLMaster were included. Vitrectomy without lens extraction was performed for RRD repair.Preoperative AL was measured using alternative A-scan ultrasound (AL-US). Postoperative AL was obtained in eyes with silicone oil tamponade (AL-SO) and preoperative fellow-eye biometry (AL-FE) using IOLMaster. Other eyes that faced the same preoperative situation but underwent phacovitrectomy based on felloweye biometry were recruited as controls.Results: AL-US, AL-FE, and AL-SO were 25.39 ± 2.14 mm, 25.85 ± 2.16 mm and 26.08 ± 2.53 mm, respectively. The Bland-Altman agreement among AL-US, AL-FE and AL-SO was good (95.5%, 21/22 of cases were in the LoA). The mean IOL power calculated using AL-US (Power-US), AL-FE (Power-FE) and AL-SO (Power-SO) was 16.81 ± 7.19 D, 14.74 ± 6.95 D and 13.54 ± 8.32 D, respectively. The difference between AL-US and AL-SO was significant (P \ 0.05), while that between AL-FE and AL-SO was not (P [ 0.05). The difference between Power-US and Power-SO was significant (P \ 0.05), while that between Power-FE and Power-SO was not (P [ 0.05). Nine eyes underwent phacovitrectomy based on fellow-eye biometry and had a final postoperative myopic shift of 0.64 ± 0.78 D. Conclusions: Alternative A-scan ultrasound led to a significant difference in AL and a prediction error in IOL power, while fellow-eye biometry provided similar results to silicone oil-filled eyes after RRD repair.

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“…34 With consideration of the implications of delay in surgery and economic benefits, authors have advocated for bilateral surgeries 35 and combined procedures such as phacovitrectomy. 36 In addition to the delay to surgery while a patient is on the wait-list, there is an inherent delay in presentation to specialized surgical care. [37][38][39] These delays are shown to be further exacerbated by the COVID-19 pandemic and patient hesitation to seeking care in the ophthalmology setting.…”

Section: Discussionmentioning

confidence: 99%