A Year of Living Dangerously: Challenges and Recommendations for Safely Performing Ophthalmic Surgery During the COVID-19 Pandemic, from Start to Finish

Abstract

The COVID-19 pandemic has forced all nations to take an active role in infection control incorporating recommendations and measures to control viral dissemination. The epidemiological impact is very diverse and dynamic, even within the same region. Scientific knowledge regarding SARS-CoV-2 continues to improve every day with protocols needing to be updated and adjusted on a regular basis. Ophthalmology is a medical specialty identified to be at high risk for several reasons: it has very close doctor-patient contact, the virus has been detected in tears, and the ocular surface serves as a gateway to developing the infection. We have reviewed the current information on SARS-CoV-2 in the ophthalmologic field and provide up-to-date recommendations to help create protocols that can adapt to the dynamic situation of ophthalmologic institutions, patient cases, economic situations and access to diagnostic tests. This paper outlines the main recommendations regarding the initial consultation and outpatient clinics, measures to apply in the operating room (OR), and suggestions for post-surgical controls. Triage, according to the patient’s conditions and eye pathology, reduction of the time the patient is at the institution, social distancing, correct use of personal protective equipment (PPE), barrier methods, hygiene, as well as other recommendations mentioned in this document, will allow physicians to take care of the visual health of the patients while reducing the impact of the COVID-19 pandemic.

Keywords:

• SARS-CoV-2
• COVID-19
• ophthalmology
• eye
• surgery

Disclaimer

The authors would like to declare that this document contains recommendations based on the best evidence found at the moment of writing, and also contains personal analysis considered important for ophthalmology.

This document does not have the intention to set a standard of care and cannot ensure a successful outcome in every situation. These guidelines aim to help adapt protocols according to the regional, local and individual hospital policies and expertise. New information regarding this topic may change the recommendations in this review in a significant way; and therefore, we cannot warrant the completeness of the guidance.

Acknowledgments

To Ana Vigil for her support and technical assistance. To Carolina Inés Salica for her dedication and technical assistance in her field. To Marcelo Reyes for his contribution to the topic in his expertise in diagnostic imaging. To all members of the Committee for Prevention of Ocular Infections that help and inspire to seek a deeper understanding of this pandemic as well as ways to help mitigate its impact.

We wish to make a special mention for Dr. Li Wenliang to whom this article is dedicated, along with all the colleges and healthcare workers who departed while providing health service to their communities during the COVID-19 pandemic.

Disclosure

Roberto Pineda ll reports personal fees from Sanofi-Genzyme and royalties from Elsevier, outside the submitted work. The authors report no other potential conflicts of interest for this work.

Additional information

Funding

The authors declare no specific grant for this research.