Rethinking Elective Cataract Surgery Diagnostics, Assessments, and Tools after the COVID-19 Pandemic Experience and Beyond: Insights from the EUROCOVCAT Group

Abstract

The progressive deterioration of the visual function in patients on waiting lists for cataract surgery has a negative impact on their quality of life, especially in the elderly population. Patient waiting times for cataract surgeries in many healthcare settings have increased recently due to the prolonged stop or slowdown of elective cataract surgery as a result of coronavirus disease 19 (COVID-19). The aim of this review is to highlight the impact of such a “de-prioritization” of cataract surgery and to summarize some critical issues and useful hints on how to reorganize cataract pathways, with a special focus on perioperative diagnostic tools during the recovery phase and beyond. The experiences of a group of surgeons originating from nine different countries, named the European COVID-19 Cataract Group (EUROCOVCAT), have been combined with the literature and recommendations from scientific ophthalmic societies and healthcare institutions. Key considerations for elective cataract surgery should include the reduction of the number of unnecessary visits and examinations, adoption of precautionary measures, and implementation of telemedicine instruments. New strategies should be adopted to provide an adequate level of assistance and to guarantee safety conditions. Flexibility will be the watchword and regular updates would be necessary following scientific insights and the development of the pandemic.

Impact on Visual Acuity in Neovascular Age Related Macular Degeneration (nAMD) in Europe Due to COVID-19 Pandemic Lockdown

“…The COVID-19 pandemic has drastically modified how outpatient care is given in healthcare practices all around the world. Thus, during the worst phases of the COVID-19 outbreak, in order to reduce the chance of transmitting the virus to patients and healthcare personnel, providers have deferred elective and preventive visits, and outpatient visits have been restricted to more urgent and emergent care [ 3 , 4 , 5 , 6 , 7 , 8 ].…”

“…Ophthalmologists are in a high-risk category for COVID-19 infection due to close proximity with patients during their examination (conjunctival, tear secretions, and aerosol secretions) [ 4 ]. Thus, clinical practice of high-volume specialties not directly involved in COVID-19 care, such as ophthalmology, were particularly affected.…”

Ocular Involvement of SARS-CoV-2 in a Polish Cohort of COVID-19-Positive Patients

“…The ophthalmological implications of the severe and acute respiratory coronavirus disease (COVID-19) caused by the strain SARS CoV-2 are not yet well described, and therefore are reason for increasing investigations. The involvement of the eye in the process of SARS CoV-2 infection is suggested by mostly anecdotical evidence on limited numbers of patients, not thoroughly characterized [ 1 ]. On the other hand, the implication of ocular infection and the possibility of viral diffusion through the eyes should be seriously taken into consideration [ 2 , 3 ].…”

Assessment of Patients’ Confidence Regarding a New Triage Concept in a Medical Retina Clinic during the First COVID-19 Outbreak

“…For instance, the early treatment of nAMD patients leads to better visual acuity outcomes [5,6]. Conversely, delayed or suspended essential ophthalmological treatment may cause rapid and substantial vision impairment or even irreversible blindness [5,15,16]. An increase in the rates of vision impairment among patients receiving IVI treatment could lead to long-term undesirable effects on quality of life, including daily activities, social interactions, and work opportunities.…”