ABSTRACT
@#With the resumption of elective surgeries during this COVID-19 pandemic, surgeons and facilities should implement infection prevention and control measures to ensure the safety of patients and health care workers. This advisory highlights the key principles, risk stratification considerations, and recommended approach regarding Covid-19 testing prior to elective ophthalmic surgeries.
Subject(s)
COVID-19ABSTRACT
@#This document offers guidance to help the ophthalmologist plan for the safe resumption of elective surgical care. There are 4 sections: (I) COVID-19 Awareness, (II) Preparedness, (III) Patient Issues, and (IV) Delivery of Safe and High-Quality Care. Each section contains key issues to be addressed before elective surgery may be safely reinstituted. Understanding the capabilities of health facilities (e.g., testing, operating rooms) as well as the potential limitations in manpower and supplies will remain important, while keeping an eye out on subsequent waves of COVID-19.
Subject(s)
COVID-19ABSTRACT
Objective@#To report the clinical profile and treatment outcomes of neovascular glaucoma (NVG). @*Methods@#A retrospective cohort study was done in a single tertiary hospital. Medical records of patients diagnosed with NVG from January 2000 to August 2018 were reviewed and pertinent data were collected. Study outcomes included visual acuity (VA) and intraocular pressure (IOP) and were analyzed for eyes that received any of the following: intravitreal bevacizumab (IVBe), pan-retinal photocoagulation (PRP), trabeculectomy with mitomycin (trab-MMC), or diode laser cyclophotocoagulation (DLCP) with at least 1 month of follow-up. @*Results@#There were 162 patients (181 eyes) diagnosed with NVG. Mean age at the time of diagnosis was 55.6 ± 14 years. Diabetic retinopathy (DR) was observed in 81 (45%) eyes and central retinal vein occlusion (CRVO) in 48 (27%) eyes. Baseline VA was hand movement in 67 (37%) eyes and no light perception (NLP) in 49 (27%) eyes. Only 60 (33%) eyes had ≥1 month of follow up (mean of 73 ± 119.1 weeks) after procedures were done. IVBe was done in 22 (37%) eyes, trab-MMC in 20 (33%), PRP in 22 (37%), and DLCP in 24 (40%) eyes. IOP decreased from 45 to 20 mmHg (p<0.001) but VA decreased from LogMAR 1.7 to 2.1 (p<0.01). There was significant VA decrease in eyes that underwent a single procedure (p<0.02) but none in eyes that underwent 2 or 3 procedures. Nonetheless, there was significant IOP decrease (p<0.05) when one procedure was done. Of the 49 eyes that had baseline sight, 19 (41%) converted to NLP (p<0.01).@*Conclusion@#Most patients presenting with advanced NVG had DR and CRVO. Procedures led to better IOP but not VA and some lost vision. Aggressive screening for NVG among high-risk groups is warranted to institute treatment early.