Year one of COVID-19 pandemic: Effect of lockdown and unlock phases on cataract surgery at a multi-tier ophthalmology network

Abstract

Purpose: To describe the impact of lockdown and unlock phases of the COVID-19 pandemic on cataract surgery at a multitier ophthalmology network. Methods: This cross-sectional hospital-based study included 106,279 eyes operated between March 23, 2019 and March 31, 2021. The data of patients who underwent cataract surgery presenting during the lockdown and unlock phases were compared with the respective periods in the previous year before COVID-19. Results: The cataract surgeries performed decreased to 5.6% (839/14,994) of pre-COVID-19 volumes during the lockdown phase. There was a gradual recovery of the cataract surgeries performed to 86.7% of pre-COVID-19 volumes by May 2020 and exceeded by 17.9% by September 2020. There was a decrease in the number of women who underwent cataract surgery during the lockdown phase (49.11%) compared to the pre-COVID-19 (52.59%) or unlock phase (52.29%, P < 0.001). Patients operated during the lockdown phase were younger when compared to other groups ( P < 0.001). The mean LogMAR presenting visual acuity at the time of surgery was worse in patients operated during the lockdown phase (1.84 ± 1.16) as compared to pre-COVID-19 (1.39 ± 1.05) and unlock phases (1.51 ± 1.08, P =<0.001). The proportion of patients with total cataracts were higher during the lockdown and unlock phases compared to the pre-COVID-19 phase ( P < 0.001). Conclusion: The first year of the COVID-19 pandemic saw a drastic reduction in the surgical volume in the lockdown phase, which recovered quickly during the unlock period. Patients of younger age, male gender, poor presenting visual acuity, denser cataracts, and living close to the surgical center were able to access surgical care due to lockdown restrictions.

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.…”

“…In our study, the majority of patients who underwent cataract surgery were aged 40 years and above (98 %). However, during the lockdown, the number of cataract surgeries performed in older patients were relatively fewer than those in younger patients, which have been observed in studies in India [ 13 ] and Saudi Arabia [ 19 ]. Older age is an important risk factor for increased COVID-19 related morbidity and mortality [ 27 ] in all phases of the pandemic, which may have led to healthcare professionals postponing cataract surgeries in older patients, or patients themselves electing to defer their surgeries even if hospitals have resumed elective surgeries under strict infection control procedures [ 20 ].…”

“…Studies in some regions gathered similar results to ours [ [18] , [19] , [20] ]. In other regions [ 12 , 13 , 21 ], cataract surgeries returned to or exceeded pre-COVID-19 vol a few months after the initial cancellation of elective ophthalmic service during the pandemic.…”

Immediate sequential bilateral cataract surgery is a reasonable and safe option during a pandemic

“…With the onset of the coronavirus disease 2019 (COVID-19) pandemic, ophthalmological examination and surgical methods have undergone numerous modifications and limits [1] . Initially, all elective surgeries including cataract surgery were canceled [2] . For this reason, unfortunately, the number of patients waiting for cataract surgery had significantly increased.…”

Ten-year results of scleral-fixated intraocular lens implantation: outcomes of ab externo scleral fixation with 10-0 polypropylene suture

“…12 This is important in the context of an increasing life expectancy globally coupled with an increase in cataract surgical coverage and decrease in the mean age for cataract surgery. [13][14][15] It is also known that ocular trauma and lens subluxation are more likely in younger individuals, making it necessary to know about the long-term outcomes of this surgical technique. [16][17][18] Our study attempts to fill these lacunae in the literature, and we describe the long-term (10 years and longer) outcomes of sutured SF IOL implantation.…”