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

Al-khersan, Hasenin; Kalavar, Meghana A.; Tanenbaum, Rebecca; Lazzarini, Thomas A.; Patel, Nimesh A.; Yannuzzi, Nicolas A.; Sridhar, Jayanth; Townsend, Justin H.; Berrocal, Audina M.; Ansari, Zubair A.

PURPOSE: To characterize the delivery of emergent ophthalmic surgical care during April 2020 of the COVID-19 pandemic compared with the same time interval the year prior. DESIGN: Retrospective, observational before-and-after study METHODS: Review and characterization of each emergent/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< 0.0001). Retinal detachment repair was the most common procedure (37, 31.6%) in April 2020 while elective cataract surgery (481, 47.3%) was most common in April 2019. The mean age of patients was 50.0 years in April of 2020 compared to 59.0 years (p<0.0001) the year prior. During April 2020, the mean age of surgeons performing procedures was 42.3 years compared to 48.4 years (p<0.0001) during April 2019. In April 2020, all but 5 patients (96%) had RT-PCR based COVID-19 testing prior to 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 year prior. Broad preoperative screening led to one positive COVID-19 test in an asymptomatic patient.