Impact and Determinants of COVID-19 Pandemic on the Cataract Surgery Rate at a Tertiary Referral Center

Figures & data

Table 1 Overview of Patients Undergoing Cataract Surgery Before, During and After COVID-19 Pandemic

Variable	P1 No. (%)	P2 No. (%)	P3 No. (%)	P4 No. (%)	P value
Total number of surgeries	5092	71	116	4422
Monthly CS rate	299	20	116	260
Age in years
20 or less	43 (0.8%)	1 (1.4%)	0	30 (0.7%)	0.097
21–40	273 (5.4%)	8 (11.3%)	11 (9.5%)	261 (5.9%)	0.097
41–60	1703 (33.4%)	29 (40.8%)	28 (24.1%)	1378 (31.2%)	0.097
61–80	2828 (55.5%)	31 (43.7%)	71 (61.2%)	2539 (57.4%)	0.097
>80	245 (4.9%)	2 (2.8%)	6 (5.2%)	214 (4.8%)	0.097
Gender
Male	2517 (49.4%)	40 (56.3%)	62 (53.4%)	2259 (51%)	0.11
Female	2575 (50.6%)	31 (43.7%)	54 (46.6%)	2163 (49%)	0.11
Place of residence
Central	3133 (61.5%)	54 (76.1%)	78 (67.2%)	2735 (61.8%)	0.39
East	132 (2.6%)	2 (2.8%)	2 (1.7%)	100 (2.3%)	0.39
North	356 (7%)	3 (4.2%)	6 (5.2%)	315 (7.1%)	0.39
West	524 (10.3%)	3 (4.2%)	13 (11.2%)	489 (11.1%)	0.39
South	947 (18.6%)	9 (12.7%)	17 (14.7%)	783 (17.7%)	0.39
Laterality
OD	2563 (50.3%)	31 (43.7%)	52 (44.8%)	2218 (50.2%)	0.63
OS	2529 (49.7%)	40 (56.3%)	64 (55.2%)	2204 (49.8%)	0.63
BCVA in operated eye
20/20 to 20/50	842 (16.5%)	5 (7%)	15 (13%)	826 (19%)	<0.001
20/60 to 20/200	2164 (42.5%)	32 (45%)	46 (40%)	1775 (40%)	<0.001
20/300 to 20/400	776 (15%)	10 (14%)	20 (17%)	641 (14.5%)	<0.001
Less than 20/400	1310 (26%)	24 (34%)	35 (30%)	1180 (26.5%)	<0.001
BCVA in fellow eye
20/20 to 20/50	1554 (30.5%)	13 (18%)	31 (27%)	1449 (33%)	0.007
20/60 to 20/200	1915 (37.5%)	24 (34%)	43 (37%)	1605 (36%)	0.007
20/300 to 20/400	607 (12%)	10 (14%)	14 (12%)	482 (11%)	0.007
Less than 20/400	1016 (20%)	24 (34%)	28 (24%)	886 (20%)	0.007
Operating surgeon
Consultant	2854 (56%)	45 (63.4%)	71 (61%)	2184 (49.4%)	0.001
Trainee	2238 (44%)	26 (36.6%)	45 (39%)	2238 (50.6%)	0.001

Notes: P < 0.05 is statistically significant; BCVA denotes best corrected visual acuity; OD denotes right eye; OS denotes left eye; CS denotes cataract surgery; P1 denotes pre-Covid-19 phase which extended from November 1, 2018 to March 22, 2020; P2 denotes the Covid-19 lockdown phase from March 23, 2020 until July 6, 2020 during which all elective procedures were suspended; P3 denotes the first post-Covid-19 recovery phase from July 7, 2020 to August 8, 2020 where cataract surgeries resumed to partial capacity with a maximum of two cataract surgeries per session; P4 denotes the second post-Covid-19 recovery phase from August 9, 2020 to January 6, 2022 during which all cataract surgeries resumed to full capacity.

Figure 1 Monthly cataract surgery rate ratio by gender of patient.

Notes: P1 denotes pre-Covid-19 phase which extended from November 1, 2018 to March 22, 2020; P2 denotes the Covid-19 lockdown phase from March 23, 2020 until July 6, 2020 during which all elective procedures were suspended; P3 denotes the first post-Covid-19 recovery phase from July 7, 2020 to August 8, 2020 where cataract surgeries resumed to partial capacity with a maximum of two cataract surgeries per session; P4 denotes the second post-Covid-19 recovery phase from August 9, 2020 to January 6, 2022 during which all cataract surgeries resumed to full capacity.

Figure 2 Monthly cataract surgery rate ratio by experience level of surgeon.

Notes: P1 denotes pre-Covid-19 phase which extended from November 1, 2018 to March 22, 2020; P2 denotes the Covid-19 lockdown phase from March 23, 2020 until July 6, 2020 during which all elective procedures were suspended; P3 denotes the first post-Covid-19 recovery phase from July 7, 2020 to August 8, 2020 where cataract surgeries resumed to partial capacity with a maximum of two cataract surgeries per session; P4 denotes the second post-Covid-19 recovery phase from August 9, 2020 to January 6, 2022 during which all cataract surgeries resumed to full capacity.

Table 2 Cataract Surgery Rate Based on Intraoperative Complication Rate

	Yes		No		Validation
	No. (%)	Rate per Month	No. (%)	Rate per Month
P1	233 (4.57%)	14	4859 (95.43%)	286	P = 0.260
P2	6 (8.45%)	2	65 (91.55%)	18.5
P3	4 (3.45%)	4	112 (96.55%)	112
P4	170 (3.84%)	10	4252 (96.16%)	250

Notes: P < 0.5 is statistically significant; P1 denotes pre-Covid-19 phase which extended from November 1, 2018 to March 22, 2020; P2 denotes the Covid-19 lockdown phase from March 23, 2020 until July 6, 2020 during which all elective procedures were suspended; P3 denotes the first post-Covid-19 recovery phase from July 7, 2020 to August 8, 2020 where cataract surgeries resumed to partial capacity with a maximum of two cataract surgeries per session; P4 denotes the second post-Covid-19 recovery phase from August 9, 2020 to January 6, 2022 during which all cataract surgeries resumed to full capacity.