Oculoplastic Surgeons’ Surgical, Clinical, and Management Experiences During the COVID-19 Crisis

During the COVID-19 crisis, the American Society of Ophthalmic Plastic and Reconstructive Surgeons (ASOPRS) recommended cessation of all nonurgent oculofacial services, imparting unprecedented challenges in patient care and practice management. An anonymous survey was performed to assess surgeons? surgical, clinical, and financial experiences during the COVID-19 restrictions. Results were collected from April 20 to May 1, 2020 and analyzed. A total 112 ASOPRS members participated. A significant majority (81.52%) performed surgeries during the COVID-19 restrictions. Fourteen percent did not allow trainee participation. While operating, 34.41% always wore an N-95 mask. Preoperative patient COVID-19 testing was mandated in 37.21% of practices. Fewer than half of surgeons were required to leave the operating room during intubation. A large majority (88.76%) of ASOPRS members used telemedicine, with most finding the virtual platform to function moderately well (62.92%) for oculofacial evaluations. Senior ASOPRS members were less interested in continuing virtual patient encounters in the future (P = .0130). Nearly all private practice surgeons (95.38%) had applied for federal funding and 83.51% expressed concern about the long-term financial well-being of their practice. ASOPRS surgeons have provided emergency oculofacial patient care during COVID-19, though often without proper safety precautions. New virtual patient evaluation platforms and financial practice hardships have posed additional challenges.

Oculoplastic fellow education during the COVID-19 crisis.

PURPOSE: In March 2020, the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) advised the suspension of all non-emergent oculofacial patient care, imparting unprecedented interruptions in fellowship training. METHODS: ASOPRS fellows and program directors were asked to complete an anonymous survey regarding their perceived impact of the COVID-19 crisis. RESULTS: Forty ASOPRS fellows (70.2%) participated, including 20 first-year and 20 second-year trainees, from all country regions. During the social distancing restrictions, 100% of fellows continued to participate in surgical procedures, including orbital biopsy (77.5%), abscess drainage (55.0%), fracture repair (45.6%), eyelid lesion excision (70.0%) and temporal artery biopsy (57.5%). ASOPRS fellows evaluated patients, including in emergency room (84.6%) and inpatient hospital (76.9%) settings, wearing surgical (85.0%) or N-95 (40.0%) masks, gloves (80.0%) and eye protection (62.5%).Most ASOPRS fellows (87.5%) participated in virtual interinstitutional education sessions and indicated a desire to continue this curriculum. Fellows also used available time for research (85.0%), independent study (77.5%), personal health (70.0%) and social interaction (60.0%).ASOPRS fellows reported COVID-19 restrictions to have a mild (72.5%) to moderate (27.5%) impact on their overall training, and most (75.0%) felt their surgical confidence to decline. Fellowship program directors also asserted a mild (72.2%), moderate (19.4%) or significant (5.6%) impact on subspecialty training, and 94.4% predict adverse effects on graduation case logs. CONCLUSIONS: During the COVID-19 restrictions most ASOPRS fellows participated in emergent clinical activities and novel telemedicine curriculum. Most fellows and program directors expressed concern regarding a negative impact on overall subspecialty education and surgical confidence.