4.6 Article

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

Journal

AMERICAN JOURNAL OF OPHTHALMOLOGY
Volume 222, Issue -, Pages 368-372

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.ajo.2020.08.044

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Funding

  1. NATIONAL INSTITUTES OF HEALTH [P30EY014801]
  2. Department of Defense [W81XWH-13-1-0048]
  3. Research to Prevent Blindness

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During the COVID-19 pandemic in April 2020, there was a significant decrease in surgical volume compared to the previous year, leading to changes in the types of procedures performed and a decrease in the age of both surgeons and patients. Broad preoperative screening resulted in only 1 positive COVID-19 test in an asymptomatic patient.
center dot 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 ophthal-mology referral center. Information collected included the details of patient presentation, diagnosis, surgical pro-cedure, 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 com-mon 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 pa-tients 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 reac-tion 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 approx-imately 10% of the usual volume. The pandemic changed the type of cases performed and led to a statistically signif-icant 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. (Am J Ophthalmol 2021;222:368-372. (c) 2020 Elsevier Inc. All rights reserved.)

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