Influence of COVID-19 pandemic on the cataract services in a district hospital

Abstract

Purpose: In March 2020, COVID-19 was declared a pandemic by the World Health Organization. The COVID-19 pandemic significantly disrupted the healthcare system, including the number of elective ophthalmic procedures conducted worldwide, resulting in a large-scale deferment of cataract surgeries after the Malaysian government recommended to postpone all nonessential elective surgeries to minimise the virus transmission and to augment the hospital resources to cope with a surge in COVID-19 cases. This study assessed the influence and impact of the COVID-19 pandemic on the cataract services in a district hospital. Study design: Retrospective descriptive analysis. Methods: This study analysed cataract surgery services in the period between January 1, 2017 and 31 December 31, 2021. Data were extracted from the electronic medical records. The study population was further divided into 3 groups according to the COVID-19 pandemic status: pre-pandemic, lockdown and recovery phase. Results: A total of 8,125 eyes were included in this study. During the lockdown phase, there was a 42% decline in the number of surgeries done compared to the pre-COVID-19 phase. A higher number of patients (53.5%) presented with severe visual impairment or blindness during the lockdown phase as compared to 40.2% during the pre-COVID-19 phase. The number of lens-related complications was markedly higher (2.58%) during the lockdown phase, as compared to the pre-COVID-19 phase (0.64%). During the end of the recovery phase studied, there was an early increment in the number of surgeries done, surpassing that of the pre-COVID-19 phases. Conclusion: The COVID-19 pandemic caused a drastic reduction in the number of cataract surgeries performed during the lockdown phase, causing more patients to suffer from avoidable blindness due to cataract, and leading to a higher rate of lens-related complications. An intuitive approach and reorganisation of ophthalmic care services are essential in order to lessen the backlog without causing burnout among healthcare workers.