Epidemiological impact of the COVID-19 pandemic on enucleation cases in Germany

Abstract

To determine the rate of enucleation in Germany and the impact that the COVID-19 pandemic may have had on its characteristics. The rates of enucleation in Germany during 2019 and 2020 were extracted from the diagnosis-related groups (DRG) registry using the operation and procedure classification system codes 5‑163.0 through 5‑163.23 and 5‑163.x. The data were statistically analyzed. The number of enucleations showed a16.6% reduction from 1295cases in 2019 compared to 1080cases in 2020 (p = 0.17). In both years men averaged 54.1% of cases. Patients older than 65years represented 53% and 56% of cases in 2019 and 2020, respectively. The most common indication for enucleation in both years was phthisis bulbi (n = 373 and n = 307, respectively), accounting for 29.7% of the cases, followed by choroidal malignancies (24%). Enucleation with the simultaneous introduction of an alloplastic orbital implant into Tenon's capsule represented the most common procedure (38.7% combined 2‑year average), followed by asheathed variant (26.6%) and abulbar implant made of nonabsorbable microporous material (16.8%), without asignificant change between years. Enucleations without the introduction of an implant increased from 7.8% in 2019 to 11.1% in 2020 (p = 0.006). The proportion of patients undergoing areoperation slightly increased from 5.6% to 8% (p = 0.018). Most procedures (65.6%) were performed in large (> 1000 beds) public hospitals. Despite the decrease in the total number of procedures performed, the rate of enucleation in Germany was not significantly altered by the COVID-19 pandemic. The rate of enucleation without implants and reoperations significantly increased.