The impact of COVID-19 lockdown on cataract surgery: a surgeons' perspective

In the last months, the whole world is dealing with an unprecedented public health crisis due to COVID-19 outbreak. Consequently, many governments have implemented lockdowns on a national level, affecting, among others, ophthalmic surgical practice in a globe scale.

The aim of this study is to evaluate the impact of surgical theatre lockdown due to COVID-19 pandemic on the surgical performance of cataract surgeons.

Intraoperative complications and surgical time of the first 160 cataract surgeries performed by eight consultants (20 cases each) after a two-month lockdown were recorded and analysed in a cross-sectional study. The results were plotted against the last 30 cases of each surgeon before the implementation of the lockdown (240 cases). Cataract surgeons were asked to rate their subjective perspective and difficulties faced after re-opening through a questionnaire.

The average duration of all surgeries after the lockdown was 19.1 ± 6.2 minutes showing a 14% increase compared to the one before the lockdown (16.8 ± 5.1 minutes, p = 0.0001). The complications rate was 2.09% (5/240 cases) before the abstention and 3.12% (5/160 cases) after the abstention not yielding any statistically significant difference (p = 0.74). When complicated surgeries were excluded from the analysis, surgical time was still higher after the lockdown (18.9 ± 5.9 minutes) than before (16.6 ± 5.0 minutes, p < 0.0001). 37.5% of consultants (3/8) stated that the two-month abstention from cataract surgeries has affected their surgical skills somewhat or a lot, while 62.5% (5/8) reported being more careful in their first cases after the lockdown. Most complications occurred in the hands of one surgeon who stated to be very anxious upon restart.

The operating theatres' lockdown due to COVID-19 pandemic did not seem to affect the intraoperative complications rate in cataract surgery. A slight increase of surgical duration was noted, while most surgeons reported being more careful upon restart.