Abstract
BackgroundIn concordance with medical recommendations in response to COVID-19, Emory Healthcare limited surgical procedures starting March 16, 2020. We investigated the impact of these recommendations on the number, types, and urgency of surgical retina cases.MethodsWe conducted a retrospective review of all surgical patients at the Retina division of the Emory Eye Center from February 17–April 12, 2020 and during the same time period in 2019 and 2018. The demographics of patients and the number, types and urgency of retina surgeries were collected. Descriptive statistics for each variable were reported. Univariate analysis was carried out using the chi-square test or Fisher’s exact test for categorical covariates.ResultsFrom February 17–March 15 to March 16–April 12, 2020, total surgeries decreased from 87 to 34. Emergent cases, occurring within 7 days of surgical order placement, decreased from 23 to 18 (p = 0.0056), and urgent cases, occurring within 21 days of surgical order placement, decreased from 26 to 4 (p = 0.0380). From March 16–April 12, 2019 there were 62 surgeries: 21 emergent (34%), 14 urgent (23%). From March 16–April 12, 2018 there were 68 surgeries: 15 emergent (22%), 21 urgent (30%). After March 16, 2020, average patient age decreased from 39.4 to 25.7 years. There were no statistically significant differences in racial make-up or insurance coverage for those having surgery prior to versus after March 16, 2020.ConclusionNational recommendations for ophthalmologic surgeries during COVID-19 disproportionately affected older patients and patients with urgent cases at our tertiary care academic medical center. These results may inform the ophthalmologic field of the potential effects of pandemics such as COVID-19 on the surgical retina care of patients.
Highlights
In response to the ongoing COVID-19 pandemic, ophthalmologists across the United States had to cancel surgical procedures, modify schedules, and determine which patients necessitated clinic visits and which did not
We performed a retrospective study on all ophthalmologic visits, surgical case orders, and surgical procedures for the corresponding 8-week time period in 2018 and 2019 to evaluate changes in care delivery during COVID-19 compared to the same time period in previous years, similar to the analysis of trauma patients completed by Christey et al [3]
There was a statistically significant difference in insurance coverage for patients during COVID-19 compared to prior years (Table 1, p < 0.0001), which might be due to the increase in percentage of patients with insurance “not recorded” in their electronic medical record in 2020
Summary
In response to the ongoing COVID-19 pandemic, ophthalmologists across the United States had to cancel surgical procedures, modify schedules, and determine which patients necessitated clinic visits and which did not. On March 18, 2020, the AAO and the American Society of Retina Specialists (ASRS) made official recommendations for ophthalmologists to cease treatment deemed non-urgent or elective [1, 2]. Emory Healthcare limited patient visits and surgical procedures. While cancelling non-urgent and elective surgical procedures helped reallocate resources for COVID-19 patients, urgent and emergent care needs may continue at their previous rates or increase either immediately or soon after the lockdown is lifted. In concordance with medical recommendations in response to COVID-19, Emory Healthcare limited surgical procedures starting March 16, 2020. We investigated the impact of these recommendations on the number, types, and urgency of surgical retina cases
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