Impact of Early COVID-19 Pandemic on Common Ophthalmic Procedures Volumes: A US Claims-Based Analysis

ABSTRACT

Purpose

The COVID-19 pandemic has had a profound effect on the delivery of healthcare in the United States and globally. The aim of this study was to evaluate the impact of COVID-19 on common ophthalmic procedure utilization and normalization to pre-pandemic daily rates.

Methods

Leveraging a national database, Clinformatics™ DataMart (OptumInsight, Eden Prairie, MN), procedure frequencies and daily averages, defined by Current Procedural Terminology codes, of common elective and non-elective procedures within multiple ophthalmology sub-specialties were calculated. Interrupted time-series analysis with a Poisson regression model and smooth spline functions was used to model trends in pre-COVID-19 (January 1, 2018–February 29, 2020) and COVID-19 (March 1, 2020–June 30, 2020) periods.

Results

Of 3,583,231 procedures in the study period, 339,607 occurred during the early COVID-19 time period. Anti-vascular endothelial growth factor injections (44,412 to 39,774, RR 1.01, CI 0.99–1.02; p = .212), retinal detachment repairs (1,290 to 1,086, RR 1.07, CI 0.99–1.15; p = .103), and glaucoma drainage implants/trabeculectomies (706 to 487, RR 0.93, CI 0.83–1.04; p = .200) remained stable. Cataract surgery (61,421 to 33,054, RR 0.77; CI 0.76–0.78; p < .001), laser peripheral iridotomy (1,875 to 890, RR 0.82, CI 0.76–0.88; p < .001), laser trabeculoplasty (2,680 to 1,753, RR 0.79, CI 0.74–0.84; p < .001), and blepharoplasty (1,522 to 797, RR 0.71, CI 0.66–0.77; p < .001) all declined significantly. All procedures except laser iridotomy returned to pre-COVID19 rates by June 2020.

Conclusion

Most ophthalmic procedures that significantly declined during the COVID-19 pandemic were elective procedures. Among these, the majority returned to 2019 daily averages by June 2020.

KEYWORDS:

• COVID-19
• ophthalmology
• procedure utilization
• pandemic
• cataract
• lasers
• retinal detachment
• blepharoplasty
• trabeculectomy

Disclosure statement

No potential conflict of interest was reported by the author(s).

Statement of submission

This paper has not been published anywhere previously and it is not simultaneously being considered for any other publication.

Ethics Statement

This study involves human participants, but an Ethics Committee(s) or Institutional Board(s) exempted this study. As a secondary analysis of deidentified administrative data, this study was exempt from Stanford University Institutional Review Board approval.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

ADAreceived support from the Stanford MedScholars Research Grant. General support for Byers Eye Institute comes from NEI National Eye Institute P30-EYO26877 and Research to Prevent Blindness. The sponsor or funding organization had no role in the design or conduct of this research.