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

Am J Ophthalmol. 2021 Feb:222:368-372. doi: 10.1016/j.ajo.2020.08.044. Epub 2020 Sep 2.

Abstract

Purpose: This study characterized the delivery of emergent ophthalmic surgical care during April 2020 of the coronarvirus disease-19 (COVID-19) pandemic compared with the same interval the previous year.

Design: Retrospective observational before-and-after study.

Methods: This study reviewed and characterized each emergent and/or 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 < .0001). Retinal detachment repair was the most common procedure (n = 37; 31.6%) in April 2020, whereas elective cataract surgery (n = 481; 47.3%) was the most common procedure in April 2019. The mean age of patients was 50.0 years in April 2020 compared with 59.0 years (P < .0001) the previous year. During April 2020, the mean age of surgeons performing procedures was 42.3 years compared with 48.4 years (P < .0001) during April 2019. In April 2020, all but 5 patients (96%) had reverse transcriptase polymerase chain reaction based COVID-19 testing before 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 previous year. Broad preoperative screening led to 1 positive COVID-19 test in an asymptomatic patient.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • COVID-19 / epidemiology*
  • Comorbidity
  • Elective Surgical Procedures / methods*
  • Eye Diseases / epidemiology
  • Eye Diseases / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures / methods*
  • Pandemics*
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies
  • SARS-CoV-2*
  • Tertiary Care Centers / statistics & numerical data*