Effect of the COVID-19 pandemic on cataract surgery by residents who had routine surgical simulator training during residency

ABSTRACT Purpose: To assess the effect of the coronavirus disease 2019 (COVID-19) pandemic on cataract surgery by residents who had mandatory surgical simulator training during residency. Methods: In this retrospective, observational analytical study, the total number of cataract surgeries and surgical complications by all senior residents of 2019 (2019 class; prepandemic) and 2020 (2020 class; affected by the reduced number of elective surgeries due to the COVID-19 pandemic) were collected and compared. All residents had routine mandatory cataract surgery training on a virtual surgical simulator during residency. The total score obtained by these residents on cataract challenges of the surgical simulator was also evaluated. Results: The 2020 and 2019 classes performed 1275 and 2561 cataract surgeries, respectively. This revealed a reduction of 50.2% in the total number of procedures performed by the 2020 class because of the pandemic. The incidence of surgical complications was not statistically different between the two groups (4.2% in the 2019 class and 4.9% in the 2020 class; p=0.314). Both groups also did not differ in their mean scores on the simulator's cataract challenges (p<0.696). Conclusion: Despite the reduction of 50.2% in the total number of cataract surgeries performed by senior residents of 2020 during the COVID-19 pandemic, the incidence of surgical complications did not increase. This suggests that surgical simulator training during residency mitigated the negative effects of the reduced surgical volume during the pandemic.

Isolated abducens nerve palsy associated with coronavirus disease: an 8-month follow-up / Paresia isolada do nervo abducente associada ao COVID-19: 8 meses de seguimento

ABSTRACT We report the case of a previously healthy 48-year-old man who developed an isolated abducens nerve palsy 18 days after presenting with coronavirus disease (COVID-19) confirmed by reverse transcriptase polymerase chain reaction. His main complaint at arrival was double vision. Ocular examination revealed a sixth cranial nerve palsy in the left eye. The incomitant esotropia at arrival was 30 prism diopters. Abduction was markedly limited, while adduction was normal in the left eye. The patient underwent complete clinical, neurological, and neuroimaging investigations, including cerebrospinal fluid sample analysis to rule out infectious causes. A conservative approach with orthoptic therapy and Fresnel prism was opted. Eight months after the onset of COVID-19, regression of the strabismus was observed, and the patient reported complete recovery of the diplopia. This case suggests that isolated abducens nerve palsy caused by severe acute respiratory syndrome coronavirus 2 infection may improve with a conservative approach.

RESUMO Reportamos o caso de homem previamente hígido, 48 anos, com paralisia isolada do nervo abducente 18 dias após infecção pelo novo coronavírus (COVID-19) confirmada por reação cadeia polimerase de transcriptase reversa. A principal queixa do paciente na admissão era diplopia. O exame ocular revelou paralisia do sexto nervo craniano do olho esquerdo. Esotropia incomitante no exame inicial media 30 dioptrias prismáticas. Abdução estava limitada com adução completa no olho esquerdo. O paciente foi submetido a investigação clínica e neurológica com exame de neuroimagem, incluindo análise de amostra do líquido cefalorraquidiano para descartar causas infecciosas. Optou-se por abordagem conservadora com terapia ortóptica e prisma de Fresnel. Oito meses após a infecção pelo COVID-19, o paciente evoluiu com regressão do estrabismo e informou recuperação completa do quadro. Este relato sugere que paralisia isolada do nervo abducente causada por SARS-CoV-2 pode melhorar com abordagem conservadora.

Effects of COVID-19 pandemic on stress level of residents and fellows during ophthalmology training

Purpose: To evaluate the impact of coronavirus disease 2019 (COVID?19) on the mental health of residents and fellows in ophthalmology. Methods: A questionnaire composed of 42 questions was applied to Brazilian residents and fellows in Ophthalmology. The questionnaire addressed the demographics of participants, their working conditions before and during the COVID?19 pandemic, and the Perceived Stress Scale (PSS?10). Results: The study had a total of 271 participants in Ophthalmology training, from which 100 were fellows and 171 were residents. Before the pandemic, Ophthalmology residents and fellows had a higher workload (P < 0.001), and residents worked more hours than fellows (P = 0.001). During the pandemic, the workload of both residents and fellows decreased and equalized (P = 0.195). No correlation was found between the working hours during the pandemic and their stress level were observed (P = 0.760). Higher stress scores were identified in women ophthalmologists (P = 0.001) as well as in residents and fellows that had their surgical training interrupted during the pandemic (P < 0.001). Conclusion: The stress level of residents and fellows during the COVID?19 pandemic was similar, however, those that had their surgical training interrupted during the pandemic presented higher level of stress. Female physicians also presented higher level of stress compared to male physicians

Prevalência de infecção chagásica em doadores de sangue no estado de Pernambuco, Brasil / The prevalence of chagasic infection among blood donors in the State of Pernambuco, Brazil

A doença de Chagas é uma infecção sistêmica de evolução crônica cujo agente etiológico é o parasita Trypanosoma cruzi. O último relato encontrado sobre a soroprevalência da doença em doadores de sangue realizado na capital pernambucana, Recife, data de 1970, onde foi encontrada uma prevalência de 4,4 por cento em doadores de um hospital local. Devido à falta de informações divulgadas sobre a infecção por T. cruzi e sendo Pernambuco uma região endêmica para esta enfermidade, o presente estudo se propôs a analisar o perfil dos doadores de sangue do Hemocentro de Pernambuco (Hemope), que apresentaram reatividade para doença de Chagas, no período de 2002 a 2007. O perfil dos doadores inaptos foi avaliado de acordo com gênero, idade e procedência segundo as mesorregiões de Pernambuco. Foi encontrada uma prevalência de 0,17 por cento para doença de Chagas e 6,89 por cento das bolsas descartadas deveram-se a essa reatividade. Em relação ao gênero dos doadores, foi significativamente maior a contribuição dos homens (p<0,0001). A faixa etária de 18-30 anos apresentou menor quantidade de sorologias reativas (20,21 por cento). Foi verificado também que, na Região Metropolitana do Recife, a quantidade de reações inconclusivas foi estatisticamente maior que a quantidade de sorologias reagentes (p=0,0440). Desta forma, estudos epidemiológicos fornecem dados importantes no sentido de se avaliar diretamente o risco de transmissão de uma doença por transfusão sanguínea e permitem que também em regiões endêmicas se avalie a eficácia das medidas para o controle vetorial.

Chagas disease is a systemic infection with a chronic onset transmitted by Trypanosoma cruzi. The last study conducted in Recife, capital of Pernambuco state, was carried out during 1970. At that time a prevalence of 4.4 percent was found among blood donors of a local hospital. Due to the lack of epidemiology data on T. cruzi infection and as Pernambuco is an endemic region, the present study describes the profile of blood donors who presented reactivity for Chagas disease during the period of 2002 to 2007 in the state's blood bank (Hemope). The profile of unsuitable donors was evaluated according to gender, age and according to the meso-regions of Pernambuco. A prevalence of 0.17 percent was found for Chagas disease, whereas 6.89 percent of the rejected blood bags were due to this reactivity. As far as gender is concerned, the reactivity of men was higher than that of women (p<0.0001). Additionally, the age group between 18-30 years was less infected (20.21 percent). On analyzing the reactivity in each one of the meso-regions of the state, it was found that, in the Metropolitan Region of Recife, the number of inconclusive reaction cases was statistically higher than the number of reactive serology cases (p=0.0440). Thus, epidemiological studies provide important data to indirectly evaluate the risk of blood-borne diseases and allow indirect evaluation of the effectiveness of vectorial control measures in endemic regions.