The impact of COVID‐19 on the wait times and severity of surgical glaucoma cases evaluated at a tertiary eye center

Abstract

Aims/Purpose: COVID‐19 has caused shortages in health services worldwide. In Canada, this led to a relocation of medical staff, which paradoxically acted as potential barriers to access to care when considering the significant delays reported in elective surgeries. The purpose of this study was to assess the effect of pandemic related delays on the wait times and severity of surgical glaucoma cases in a single tertiary referral center in Quebec, Canada.Methods: In this retrospective cohort study, 182 and 201 eyes of patients who underwent glaucoma surgery at Hôpital Saint‐Sacrement, Quebec City, between the periods of March 1 to June 30, 2019 (pre‐pandemic) and 2021 (pandemic), were included. Severity data included mean visual field deficit, intraocular pressure (IOP), number of drops, and preoperative best corrected visual acuity (BCVA). The times from referral to surgery (referral time) and from listing date to surgery (listing time) were calculated.Results: Visual field deficit was −11.6 ± 7.7 dB in 2019 versus −11.6 ± 7.5 dB in 2021 (p = 0.92). Mean preoperative IOP was 21.1 ± 9.70 mmHg in 2019 versus 20.0 ± 9.52 mmHg in 2021 (p = 0.25). The mean MAVC in the affected eye was 0.60 ± 0.72 LogMAR in 2019 versus 0.55 ± 0.73 LogMAR (p = 0.07). The mean number of preoperative drop classes was 3 ± 1 in both groups (p = 0.56). The mean number of patients referred with oral glaucoma medication increased from 45 to 70 in 2019 and 2021 respectively (p = 0.03). Time to consultation was 122 ± 120 days in 2019 versus 144 ± 136 days in 2021 (p = 0.17), whereas time to list was 48 ± 57 days in 2019 versus 38 ± 43 days in 2021 (p = 0.05).Conclusions: There were no statistically significant differences in the severity of surgical glaucoma cases operated on during the pandemic. Waiting list time decreased, possibly secondary to the prioritization of more urgent glaucoma cases over other ophthalmic surgeries. These reassuring data suggest that the barriers of the pandemic did not lead to a severe worsening of access to care for surgical glaucoma patients.ReferencesFelfeli, Tina et al. The ophthalmic surgical backlog associated with the COVID‐19 pandemic: a population‐based and microsimulation modelling study. CMAJ Open. vol.9 (4) 1063–1072. 23 Nov. 2021, https://doi.org/10.9778/cmajo.20210145