When Cataract Surgeries Resumed in 2020, Complications Decreased

Richard HC Zegers, MD, PhD

New data indicated that a decrease in elective cataract surgery complications following the onset of the COVID-19 pandemic was a result of the enforced intermission of performance.

A study presented at the Netherlands Ophthalmological Society Annual Congress titled “Complications during elective cataract surgery: did the COVID-19 surgical lockdown affect operative results?” examined the effect that the mandatory 2-month halt in these procedures had on the prevalence of related complications.

In 2020, many countries enacted a surgical lockdown for several months in response to the spread of COVID-19. Richard HC Zegers, MD, PhD, Department of Ophthalmology, Diakonessenhuis Utrecht/Zeist, and a team of investigators aimed to answer the question: does an involuntary intermission of cataract surgery for 2 months cause and increase in complication rates?

Comparing the Data

Investigators compiled data from the Dutch cataract complication registration database. The collected information revealed pre-, intra-, and post-operative information of patients that underwent the procedure in the Netherlands.

The included time periods consisted of the 8 weeks of surgical intermission (calendar week 12-19), as well as the 6 weeks before (week 5-11) and the 6 weeks after (week 20-25). The selected dataset for 2020 was compared alongside those from 2016-2019.

Following information retrieval, investigators identified the trends related to complication rates and then determined if any provided statistical significance.

Complication Trends

When observing the surgical intermission period (SIP) in 2020, investigators found a significant decrease in complication rate between the 6 weeks before SIP (SIP-6) and the 6 weeks after SIP (SIP+6).

The rate of complications during SIP-6 in 2020 did not demonstrate a significant difference from the same time period in 2019. However, the relationship of SIP+6 during 2019 and 2020 showed a significant reduction in complications over time.

Investigators found an overall downward trend observed in the rate of complications throughout these periods during the years 2016-2020. They speculated that a possible explanation for this reduction could have been due to decreased time pressure from the surgical intermission period and the subsequent reduced number of procedures that occurred at the end of the intermission.

Another potential cause for this trend could have been the heightened awareness and cautiousness of the surgical teams when operations resumed after the 2 month recess.

"The enforced intermission, for a period of 2 months of performing elective cataract surgery due to the COVID 19-pandemic, seems to result in a decrease in complication rates,” investigators concluded.