Intraoperative Complication Rates in Cataract Surgery After Resuming Surgery Following the COVID-19 Shutdown

Area of Science:

• Ophthalmology
• Surgical Outcomes
• Public Health

Background:

• The coronavirus disease 2019 (COVID-19) pandemic led to widespread operating room (OR) shutdowns, impacting elective surgical procedures.
• Resumption of elective surgeries required adaptation to new protocols and potential changes in surgeon performance and patient safety.
• Understanding the impact of such interruptions on cataract surgery outcomes is crucial for patient care and surgical training.

Purpose of the Study:

• To evaluate surgeon performance and intraoperative complication rates for cataract surgery following the COVID-19 OR shutdown.
• To assess subjective surgeon experiences and anxiety levels upon returning to surgical practice.
• To compare cataract surgery outcomes before and after the pandemic-induced surgical hiatus.

Main Methods:

• A retrospective comparative study analyzed 480 cataract surgeries at a tertiary academic center, categorized as Pre-Shutdown (Jan 1-Mar 18, 2020) and Post-Shutdown (May 11-Jul 31, 2020).
• Complex cataract surgeries and intraoperative complication rates were compared between the two periods.
• A survey was administered to gather subjective surgeon experiences and concerns, particularly regarding phacoemulsification.

Main Results:

• A total of 480 cases were analyzed (306 Pre-Shutdown, 174 Post-Shutdown).
• The frequency of complex cataract surgeries significantly increased Post-Shutdown (5.2% vs 21.3%; p<0.00001).
• Intraoperative complication rates did not show a statistically significant difference between the Pre-Shutdown and Post-Shutdown periods (9.2% vs 10.3%; p=0.75).

Conclusions:

• Despite a significant increase in complex cataract surgeries and heightened surgeon anxiety after the COVID-19 hiatus, complication rates remained stable.
• Phacoemulsification was identified as a key area of concern for surgeons returning to practice.
• The findings provide insights into surgical expectations and outcomes following prolonged surgical interruptions, informing future practice and training.