Changes to glaucoma surgery patterns during the coronavirus disease 2019 pandemic: a shift towards less invasive procedures.

PURPOSE: The aim of the study was to compare the quantity, type of glaucoma surgeries, and the disease stage before and during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This was a retrospective, single-centre consecutive case series that included medical records of patients who underwent glaucoma surgery at the University Hospital in Bialystok between 4 September, 2018, and 3 March, 2020 (pre-pandemic group) and compared it with patients treated between 4 March, 2020, and 4 September, 2021 (pandemic group). Adult patients with primary or secondary open-angle or closed-angle glaucoma who underwent surgery were included in this study. Finally, 534 operated eyes (362 and 172 eyes operated on before and during the pandemic, respectively) were examined. RESULTS: The number of glaucoma surgeries dropped by 50% during the pandemic compared to a similar pre-pandemic period, with a significant difference in the kind of procedure between the two groups (p < 0.001). The most common procedures in the pre-pandemic group were Ex-Press implantation (33.7%) and trabeculectomy (31.5%). Within the pandemic group, half of the eyes underwent trabeculectomy (50.0%), followed by Preserflo microshunt (11.6%), iStent (8.7%), and transscleral cyclophotocoagulation (TSCP) (8.7%). A significant difference in the average intraocular pressure was revealed among patients who qualified for surgery. CONCLUSION: The COVID-19 pandemic is associated with a decrease in the number of extended antiglaucoma procedures and an increase in the number of short procedures performed, such as TSCP and minimally invasive glaucoma surgery.Key MessagesOur study has shown the negative impact of the COVID-19 pandemic in reducing the number of antiglaucoma procedures.The number of glaucoma surgeries dropped by 50% during the pandemic compared to those in a similar pre-pandemic period, and the type of performed procedures has changed.The COVID-19 pandemic is associated with a decrease in the number of combined antiglaucoma procedures, in opposite: the number of minimally invasive glaucoma surgeries increased due to safety reasons.

The Impact of the COVID-19 Pandemic on Ophthalmology Residents: A Narrative Review.

The ongoing outbreak of the coronavirus disease 2019 (COVID-19) pandemic has drastically affected medical societies. We aim to provide an overview and summarize the information published so far concerning the impact of the COVID-19 pandemic on ophthalmology residency programs and the mental wellbeing of trainees, and to establish factors to help maintain successful residency training to ensure high-quality, specialist ophthalmic training. A literature search was conducted in October 2021 of the PubMed database for articles assessing the impact of the COVID-19 pandemic on the mental health of ophthalmology trainees and on ophthalmology residency programs. Cross-sectional survey studies, editorials, articles in scientific journals, letters to editors, and commentaries were considered; finally, 19 studies were included after excluding abstract-only publications and conference posters. The studies' demographic details, participant characteristics, interventions, outcomes, and limitations were extracted. Our summarized information showed the alarmingly significant impact of the COVID-19 pandemic on ophthalmology trainees' mental health and the associated considerable changes in ophthalmic training programs. Thus, in future, virtual training and surgical simulators should be permanently introduced, in addition to traditional teaching, to complete successful ophthalmology residency programs. Additionally, we emphasize the need for a widely facilitated and encouraged access to psychological support programs for healthcare workers, including ophthalmologists.

Impact of the COVID-19 pandemic on ophthalmic specialist training in Poland.

The aim of this study was to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on ophthalmology residency training in Poland. An anonymous self-administered online survey involving polish ophthalmology residents was conducted between February 15 and 28, 2021. Of the 126 residents who completed the survey, 88.9% (n = 112) and 89.7% (n = 113) felt that the COVID-19 pandemic had negatively impacted their surgical training and overall training programs, respectively. Trainees providing care to patients with COVID-19 and female trainees indicated a greater negative impact of the pandemic on the implementation of the specialization program (p = 0.008 and p = 0.015, respectively) and on the acquisition of practical skills (p = 0.014 and p = 0.021, respectively). Approximately 94% (n = 118) of the residents surveyed participated in virtual training during the pandemic, and 99.2% (n = 124) positively assessed the content and usefulness of online teaching in everyday clinical practice. The most common platforms used for online meetings were Zoom (62.7%, n = 79) and Microsoft Teams (50.8%, n = 64). Approximately 79% (n = 99) of residents believed that, after the pandemic is over, at least some of the training courses and conferences should be conducted online. In addition, 13.5% (n = 17) of residents reported that they would like to undergo training and specialization courses in virtual form only after the pandemic is over. In summary, the present findings indicate that the COVID-19 pandemic negatively impacted the implementation of the ophthalmology specialization program in Poland, with the greatest impact on surgical training. Trainees providing care to patients with COVID-19 are more likely to negatively assess the impact of the pandemic on the training process. Replacing traditional training with virtual methods was positively received by residents and considered very useful, and most residents reported a desire to maintain virtual training in ophthalmology in the future.

The Impact of Three Waves of the COVID-19 Pandemic on the Characteristics of Primary Rhegmatogenous Retinal Detachments at a Tertiary Referral Centre.

PURPOSE: This study assessed the effect of three waves of the COVID-19 pandemic primarily on the number and timing of referrals due to rhegmatogenous retinal detachment (RRD) and secondarily on the demographic or clinical characteristics of patients. PATIENTS AND METHODS: A retrospective single-centre analysis of medical records included 247 eyes from 247 patients who underwent primary RRD repair with (phaco) vitrectomy between January 1, 2019, and May 31, 2021. RESULTS: The percentage of referrals due to primary RRD during the first year of pandemic (March 2020-February 2021) was 16.5% (p=0.179) lower than a year earlier. The percentage of referrals during the first, second and third wave of the pandemic was 48.4%, 18.5% and 26.1% (p=0.029, 0.475, 0.343) lower than in the corresponding months of 2019. A rebound effect was observed only after the first wave. The numbers of referrals in April and May 2021 were similar as in the corresponding months of 2019. No significant differences were observed in the demographic and clinical characteristics of patients admitted before and during the COVID-19 pandemic, other than a tendency towards a higher representation of women, younger persons, longer duration of symptoms but better visual acuity in the latter group. Silicone oil tamponade was used more frequently during the pandemic than before. CONCLUSION: In this study, the COVID-19 pandemic affected the number and timing of referrals due to RRD and the clinical but not demographic characteristics of the patients. The effect lessened with the duration of the pandemic. Previously raised concerns regarding the delay in RRD referrals may no longer be valid during a potential fourth wave of the pandemic. The impact of the pandemic's waves should be analysed separately, as such an approach provides a better insight into the fluctuations in the number of referrals due to RRD than a year-to-year comparison.

Impact of Three Waves of the COVID-19 Pandemic on the Rate of Elective Cataract Surgeries at a Tertiary Referral Center: A Polish Perspective.

The aim of this study was to assess the effect of three waves of the COVID-19 pandemic on the number of elective cataract surgeries. A retrospective single-center consecutive case series study was performed. We included all 12,464 patients who received cataract surgery in the period between 1 January 2016 and 31 May 2021. Monthly numbers of cataract surgeries during the pandemic were compared with monthly numbers in the reference years 2016-2019. In the pandemic the number of cataract surgeries decreased by 53.4%. The monthly numbers during the first, second and third wave of the pandemic were 77.5%, 51.5% and 29.7% lower, respectively, compared with the reference level. No rebound effect was observed once the pandemic restrictions were eased. Simultaneous bilateral cataract surgeries (SBCS) constituted 6.5% of cataract procedures performed in April and May 2021 compared with 0.77% carried out between May 2019 and March 2021. While the pandemic-affected monthly numbers of cataract surgeries tend to increase recently, they are still below the prepandemic level. Patients should be encouraged to weigh the risks of COVID-19-related morbidity and mortality against the benefits of cataract surgery. Reorganization of the logistics of cataract services is advisable with consideration of SBCS as one of the options.