Resident-performed immediate sequential bilateral cataract surgery during the COVID19 pandemic

ABSTRACT

Purpose: Minimizing healthcare-related exposures for patients and providers are paramount during the coronavirus (COVID-19) pandemic. We performed a retrospective cohort study to compare visual outcomes and patient satisfaction in senior residentperformed immediate sequential bilateral cataract surgery (ISBCS) versus delayed sequential bilateral cataract surgery (DSBCS). Methods: All ISBCS and DSBCS patients who underwent senior resident-performed cataract surgery in the Comprehensive Ophthalmology division of a single academic institution from May to September 2020 were included. Outcome measures were final corrected distance visual acuity (CDVA), final manifest refraction (MRx), incidence of intraoperative and postoperative complications, total number of clinical and surgical visits, and patient satisfaction, assessed postoperatively by telephone questionnaire. Results: Fourteen (22 eyes) and 28 (56 eyes) patients underwent senior residentperformed ISBCS and DSBCS, respectively. Final CDVA was 20/25 or better in 21 (95%) ISBCS eyes and 51 (91%) DSBCS eyes (p=0.670). The deviation of final MRx from target refraction was within 0.50 D in 17 (77%) ISBCS eyes and 47 (84%) DSBCS eyes (p=0.522). There was no significant difference in intraoperative (p=1.000) or postoperative (p=1.000) complications. ISBCS patients averaged 3.5 fewer visits than DSBCS patients (5.9 vs 9.5, p<0.001). All ISBCS and 20 DSBCS patients (87%) reported they were overall “very satisfied” or “satisfied” with their experience (p=0.701), and there was no significant difference in the overall visual function 7 score, where 0 indicates the worst possible functional impairment and 100 indicates no disability (p=0.561). Finally, five of the six senior residents who performed the ISBCS cases included in this study reported that they preferred performing ISBCS over DSBCS. Conclusions: This early experience demonstrates that senior resident-performed ISBCS is as safe and effective as DSBCS, with the added benefit of averaging fewer in-person visits for patients. Residency programs should consider offering senior resident-performed ISBCS to select patients during the COVID-19 pandemic.