ESCRS - PO110 - The Impact Of The Covid-19 Pandemic On Cataract Surgery Volume, Training, And Complication Rates: Results From A Tertiary Uk Teaching Hospital

The Impact Of The Covid-19 Pandemic On Cataract Surgery Volume, Training, And Complication Rates: Results From A Tertiary Uk Teaching Hospital

Published 2022 - 40th Congress of the ESCRS

Reference: PO110 | Type: ESCRS 2022 - Posters | DOI: 10.82333/s3bq-3072

Authors: Aaminah Haq 1 , Sarah Twallin* 2 , Jennifer Doyle 3 , Sher Aslam 1

1Ophthalmology,Oxford Eye Hospital,Oxford,United Kingdom, 2Ophthalmology,Prince Charles Eye Unit,Windsor,United Kingdom, 3Ophthalmology,Stoke Mandeville Hospital,Aylesbury,United Kingdom

Purpose

The Covid-19 pandemic resulted in elective day-case activity across many specialties being suspended across the country in order to minimise patient attendance to the hospital setting and reduce risk of COVID-19 exposure. In Ophthalmology, cataract surgery was significantly impacted.

This study investigates the effects of these measures on cataract surgery volume, training opportunities and complication rates.

Setting

The data was gathered at the Oxford Eye Hospital; a large tertiary unit in Oxford, UK.

Methods

A retrospective analysis was conducted in a single tertiary centre of all patients who had undergone cataract surgery within the time period January 2016 to December 2020. Data from the time period of the COVID-19 pandemic lockdowns and following months (March 2020 to December 2020) could then be compared to the preceding 4 years.

Data was extracted from an electronic medical record (EMR) system (Medisoft Limited, Leeds, UK) to identify the volume of cases performed during each period. The grade of operating surgeon operating, date of operation, age of patient, co-morbidities and surgical complications were available.

Results

Elective cataract surgery was cancelled across our theatres on 17/03/2020. One cataract list resumed in April 2020. 10 operations were performed in April 2020. The pre-pandemic mean was 314 cases per month. Our centre did not return to pre-pandemic volume until November 2020.

All complication rates increased to 13.64% in May 2020 and remained above average until November 2020. The posterior capsule rupture (PCR) rate was also above average. The peak in PCR rate was in October 2020: 3.17% for consultants, 7.14% for fellows and 2.97% for trainees. In comparison, the mean PCR rate was 1.18% for consultant-led operations pre-pandemic in 2018, 1.42% for fellows and 3.97% for operations in which trainees were the primary surgeon. 

Conclusions

There was a large reduction in the number of adult cataract surgeries performed during the first lockdown and there was a slow recovery back to pre-pandemic numbers. This recovery was associated with a temporary spike in complication rates (including posterior capsule rupture) which then returned to average over a period of several months. The number done by trainees and fellows was comparable pre-pandemic but after the first lockdown, in the recovery period, trainee operating numbers superseded even consultant cases. This was due to an effort to support novice surgeons in the recovery of their skills. When comparing the complexity of cases, there did not appear to be an increase when surgery was resumed after the first lockdown.