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DeYoung C, Asahi MG, Rosenberg S, Pakhchanian H, Liu IZ, Bellur S, Raiker R, Dalal M. Ophthalmology procedure trends in the United States during the COVID-19 pandemic. Int Ophthalmol 2023; 43:4651-4668. [PMID: 37709910 DOI: 10.1007/s10792-023-02865-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 08/20/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE To evaluate the relationship between the COVID-19 pandemic and ophthalmic procedural volume. METHODS A retrospective cohort study using TriNetX, a federated electronic health record's research network was done. Monthly Current Procedural Terminology-specific volumes per healthcare organization were clustered chronologically to calculate average volumes into 3-month seasons to calculate average procedural volumes. An aggregate of the total pandemic period (March 2020-August 2021) was compared to corresponding figures in pre-pandemic timeframes. RESULTS Intravitreal injections were the most prevalent procedure in this time period with 320,106 occurrences. Phacoemulsification cataract surgery was the second most prevalent (N = 176,095) procedure. From March 2020 to August 2021, a mean pandemic volume of 266.7 (SD = 15) was observed, a 5% decrease (p < 0.05) in procedures compared to the pre-pandemic mean of 280.8 (SD = 26.1). Spring 2020 exhibited the sharpest seasonal decrease in procedural volume (- 88%). The largest count of statistically significant increases in procedure volume was in Spring 2021 (+ 18%). The aggregate mean volume per HCO showed significant decreases for 11 out of 17 procedures in the 12 month March 2020-February 2021 timeframe and significant decreases for 10 out of 17 procedures over the 18-month March 2020-August 2021 pandemic period. CONCLUSIONS This study highlights the relative inverse relationship between COVID-19 cases and ophthalmic procedure volume in America. Quantifying ophthalmic procedure trends is important in retrospectively assessing surgical disruptions and prospectively accommodating delayed surgeries. Furthermore, awareness of these trends could help ophthalmologists prepare should similar disruptions occur in the setting of future pandemics or national disasters.
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Affiliation(s)
- Charles DeYoung
- Sidney Kimmel Medical College at Thomas Jefferson University, 1025 Walnut St. #100, Philadelphia, PA, 19107, USA.
| | - Masumi G Asahi
- Department of Ophthalmology, George Washington University, Washington, DC, USA
| | - Sedona Rosenberg
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Haig Pakhchanian
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Ivan Z Liu
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Sunil Bellur
- Department of Ophthalmology, George Washington University, Washington, DC, USA
- National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rahul Raiker
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Monica Dalal
- Department of Ophthalmology, George Washington University, Washington, DC, USA
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Sathyanarayana T, Thrishulamurthy CJ, Kaur J, Prakash VA, Jagadeesh KM, Ahmed HS. The Effects of an Increased Workload in Cataract Surgery Since the Pandemic in a Tertiary Care Clinic. Rom J Ophthalmol 2023; 67:354-361. [PMID: 38239424 PMCID: PMC10793368 DOI: 10.22336/rjo.2023.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/22/2024] Open
Abstract
Objective: To evaluate the progress of cataract surgery in a training institution providing tertiary care since the removal of pandemic restrictions. To evaluate ocular and demographic characteristics of cataract cases in a tertiary care teaching institution since the lifting of pandemic restrictions. Methods: Patients who underwent cataract surgery in our clinic in the pre-pandemic period September 2019-March 2020 (group 1, n=353) and in the post-pandemic period September 2021-March 2022 (group 2, n=459) were retrospectively screened. The cases were operated by two educator ophthalmologists and residents. The main parameters evaluated were cataract morphology, surgical parameters, and posterior capsular rupture complications. Results: The case rate increased by 30% in group 2 once pandemic restrictions were relaxed. Preoperative best corrected visual acuity (BCVA) in groups 1 and 2 was 0.840±0.63 and 1.26±0.75 log MAR, respectively (p<0.001). The percentage of mature cataracts was 15.3% in group 1 and 31.2% in group 2 (p<0.001). Significantly higher cumulative dissipated energy (CDE), total aspiration time, and fluid amount (p<0.001 for all) were found in group 2. During the training phase, 25.2% of the cases in group 1 and 24.6% in group 2 were performed by resident doctors (p=0.870). Residents in groups 1 and 2 had mature cataract case rates of 6.7% and 13.3%, respectively (p<0.001). The incidences of posterior capsule rupture in the instances of residents was 3.4% in group 1 and 4.4% in group 2 (p=0.498). A negative correlation (r=-0.424, p<0.001) between CDE and BCVA and a positive correlation (r=0.40, p<0.001) between cataract hardness and CDE were both found. Conclusions: The number of cataract surgeries increased after the COVID-19 pandemic. Poor vision and increasing rates of mature cataracts are other effects of this backlog. Residents have to deal with challenging cases. Our results are just the tip of the iceberg. Urgent planning is needed to deal with the remaining cases. Abbreviations: COVID-19 = coronavirus infection, PCR = posterior capsular rupture, BCVA = best corrected visual acuity, IOP = intraocular pressure, CDE = cumulative dissipated energy, TAT = total aspiration time, ZD = zonular separation.
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Affiliation(s)
| | | | - Jasleen Kaur
- Department of Ophthalmology, Bangalore Medical College and Research Institute, India
| | | | | | - H Shafeeq Ahmed
- Department of Ophthalmology, Bangalore Medical College and Research Institute, India
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Chiku Y, Hirano T, Hoshiyama K, Iesato Y, Murata T. Impact of local COVID-19 alert levels on rhegmatogenous retinal detachment. Jpn J Ophthalmol 2023; 67:255-263. [PMID: 36795332 PMCID: PMC9932397 DOI: 10.1007/s10384-023-00980-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/18/2023] [Indexed: 02/17/2023]
Abstract
PURPOSE To investigate the impact of the local alert levels regarding coronavirus disease 2019 (COVID-19) on the clinical patterns of rhegmatogenous retinal detachment (RRD) in Japan. STUDY DESIGN Retrospective, single-center, consecutive case series. METHODS We compared two groups of RRD patients, a COVID-19 pandemic group and a control group. Based on the local alert levels in Nagano, five periods during the COVID-19 pandemic were further analyzed: epidemic 1 (state of emergency), inter-epidemic 1, epidemic 2 (second epidemic duration), inter-epidemic 2, and epidemic 3 (third epidemic duration). Patients' characteristics, including symptoms' duration before visiting our hospital, macula status, and retinal detachment (RD) recurrence rate in each period, were compared with those in a control group. RESULTS There were 78 patients in the pandemic group and 208 in the control group. The pandemic group had a longer duration of symptoms than the control group (12.0 ± 13.5 days vs. 8.9 ± 14.7 days, P = 0.0045). During the epidemic 1 period, patients had a higher rate of macula-off RRD (71.4% vs. 48.6%) and RD recurrence (28.6% vs. 4.8%) than the control group. This period also demonstrated the highest rates compared to all other periods in the pandemic group. CONCLUSION During the COVID-19 pandemic, RRD patients significantly delayed visiting a surgical facility. They showed a higher rate of macula-off and recurrence compared to the control group during the state of emergency than during other periods of the COVID-19 pandemic, although the difference was not statistically significant due to the small sample size.
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Affiliation(s)
- Yoshiaki Chiku
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621 Nagano, Japan
| | - Takao Hirano
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Nagano, Japan.
| | - Ken Hoshiyama
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621 Nagano, Japan
| | - Yasuhiro Iesato
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621 Nagano, Japan
| | - Toshinori Murata
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621 Nagano, Japan
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Alagorie AR, Sorour OA, Eltoukhy H, Nassar E. Evaluation of Urgent Retinal Practice and Safety Measures for Physicians and Patients During COVID-19 Pandemic. Clin Ophthalmol 2022; 16:1197-1205. [PMID: 35480622 PMCID: PMC9037724 DOI: 10.2147/opth.s355628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the impact of the COVID-19 pandemic on urgent retina practice and factors influencing adherence of physicians and patients to safety measures. Methods In this clinical audit, urgent or emergent vitreoretinal surgical disorders that presented to our hospital during the period of 15th March-15th May 2020 were compared with the period just before the pandemic declaration (15th December 2019-15th February 2020). Additionally, two questionnaires assessing the adherence to safety measures were circulated to the medical personnel and a sample of patients. The collected data were analyzed, and accordingly, recommendations were proposed to the hospital administration and specific corrective measures were applied. The outcome of applying these corrective measures was assessed in the re-audit cycle during the period of 15th June-15th August 2020. Results There was a significant decrease in the number of urgent or emergent vitreoretinal surgical disorders that presented to our hospital during the pandemic (161 versus 302 cases in a similar period before the pandemic; p = 0.022). Just with the pandemic recession, there was a significant increase in the number of urgent cases (391 versus 161 cases during the pandemic; p = 0.006), also there was an increased number of complex cases. Residents and fellows were less compliant than attending physicians in adherence to safety measures. Conclusion Delayed presentation of urgent retinal cases during the pandemic highlights the importance of public awareness of urgent conditions that need immediate medical or surgical care. Attention to young physicians during the pandemic is crucial as they are less adherent to safety measures due to work overload.
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Affiliation(s)
| | - Osama A Sorour
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hesham Eltoukhy
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Elsayed Nassar
- Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Ayub G, de Vasconcelos JPC, Costa VP. The Impact of Covid-19 in the Follow-Up of Glaucoma Patients in a Tertiary Center: A Comparison Between Pre-Pandemic and Pandemic Periods. Clin Ophthalmol 2021; 15:4381-4387. [PMID: 34764632 PMCID: PMC8573208 DOI: 10.2147/opth.s334147] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/19/2021] [Indexed: 01/28/2023] Open
Abstract
Purpose To evaluate the impact of Covid-19 on the treatment and follow-up of glaucoma patients in a tertiary center. Materials and Methods We compared the total number of outpatient clinical visits, visual field exams, surgical procedures and medications released in the pre-pandemic period (March 2019–February 2020) and pandemic period (March 2020–February 2021). We also performed a paired analysis, which included patients who were examined in both periods, comparing the number of visits and medications. Results The total number of outpatients clinical visits, visual field exams, surgical procedures and medications released decreased 92.52% (7117 vs 532), 93.84% (1525 vs 94), 72.74% (682 vs 145) and 19.63% (23,259 vs 18,692), respectively, when the pre-pandemic and pandemic periods were compared. The mean number of annual clinical visits per patient (1.8 ± 0.79 vs 1.04 ± 0.18, p<0.0001) and surgical procedures per patient (1.46 ± 0.92 vs 1.13 ± 0.41, p<0.0001) decreased significantly, whereas the mean number of medications released per patient did not change significantly (28.62 ± 19.11 vs 30.34 ± 20.15, p=0.97). In the paired analysis, the mean number of visits (n=423 patients) decreased from 1.86 ± 0.76 to 1.04 ± 0.19 (p<0.0001) and the mean number of medications (n=561 patients) decreased from 33.44 ± 18.61 to 31.97 ± 19.86 in the pre-pandemic and pandemic periods, respectively (p=0.393). Conclusion The Covid-19 pandemic dramatically decreased the number of outpatient visits and surgical procedures, impacting the follow-up of glaucoma patients in our service. We encourage other health care units to verify the impact of the pandemic in their own population to better prepare for a possible overload of uncontrolled glaucoma patients in the future.
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Affiliation(s)
- Gabriel Ayub
- Department of Ophthalmology, University of Campinas, Campinas, São Paulo, Brazil
| | | | - Vital Paulino Costa
- Department of Ophthalmology, University of Campinas, Campinas, São Paulo, Brazil
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The Impact of the COVID-19 Pandemic on Ophthalmology Residents: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111567. [PMID: 34770081 PMCID: PMC8583285 DOI: 10.3390/ijerph182111567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 12/31/2022]
Abstract
The ongoing outbreak of the coronavirus disease 2019 (COVID-19) pandemic has drastically affected medical societies. We aim to provide an overview and summarize the information published so far concerning the impact of the COVID-19 pandemic on ophthalmology residency programs and the mental wellbeing of trainees, and to establish factors to help maintain successful residency training to ensure high-quality, specialist ophthalmic training. A literature search was conducted in October 2021 of the PubMed database for articles assessing the impact of the COVID-19 pandemic on the mental health of ophthalmology trainees and on ophthalmology residency programs. Cross-sectional survey studies, editorials, articles in scientific journals, letters to editors, and commentaries were considered; finally, 19 studies were included after excluding abstract-only publications and conference posters. The studies’ demographic details, participant characteristics, interventions, outcomes, and limitations were extracted. Our summarized information showed the alarmingly significant impact of the COVID-19 pandemic on ophthalmology trainees’ mental health and the associated considerable changes in ophthalmic training programs. Thus, in future, virtual training and surgical simulators should be permanently introduced, in addition to traditional teaching, to complete successful ophthalmology residency programs. Additionally, we emphasize the need for a widely facilitated and encouraged access to psychological support programs for healthcare workers, including ophthalmologists.
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