Study finds COVID-19 led to significant decline in common eye surgeries

(Image Credit: AdobeStock/blvdone)

Investigators from the Department of Ophthalmology, Virginia Commonwealth University, and the Virginia Commonwealth University School of Medicine, both in Richmond, VA, reported an overall decrease in the rates of the 10 most common ophthalmic procedures performed during calendar years 2019 and 2020 and underscored the importance of recovery efforts to counteract the decreases.¹ The study was led by Raziyeh Mahmoudzadeh, MD.

The investigators wanted to undertake this study to determine the rates of decrease because of the profound effect that the COVID-19 pandemic exerted on healthcare delivery in general, including ophthalmic care. “The rapid influx of COVID cases placed increasing strain on hospital resources, health care workers, and the general population at large. To prioritize control over the pandemic, prevent its transmission, and mobilize space and resources for patients experiencing complications due to the virus, there were over 28 million elective surgery cancellations worldwide across several specialties, estimated by the COVIDSurg Collaborative² in a 12-week model,” Mahmoudzadeh and colleagues explained.

In this retrospective US cross-sectional study, the investigators compared data from Medicare Part B National Summary Data Files for 2019 and 2020. The participants included Medicare beneficiaries undergoing the 10 most common ophthalmic procedures, ie, a total of 3,879,533 procedures in 2019 and 3,181,439 in 2020. The primary outcome was the percentage change in the number of beneficiaries for each of the 10 most common ophthalmic procedures in each US state, they recounted.

The 10 most commonly performed procedures reported in a previous study by Patel et al.³ based on CPT codes were eye drug injection; cataract surgery with insertion of intraocular lens, stage 1; after cataract laser surgery; closed tear-duct opening; revision of eyelids; cataract surgery, complex; trabeculoplasty laser surgery; laser peripheral iridotomy; treatment of extensive retinopathy; and treatment of retinal lesion.

Reported decreases in ophthalmic procedures

Considering all of the most commonly performed procedures, the authors reported a decrease of 17.9% from 2019 to 2020.

The largest reduction was observed in laser peripheral iridotomy, 43.6%, and eye drug injections saw the smallest decrease, 1.5%.

Cataract surgery also saw a reduction of 23.0%. When the data were broken down by US region, the Northeast US experienced the greatest reductions in cataract surgery, 27.9%.

The investigators concluded, “These results show that the COVID-19 pandemic caused a notable drop in the number of common ophthalmic procedures among Medicare beneficiaries, especially in laser peripheral iridotomy, while eye drug injections saw minimal changes. The Northeast US experienced the largest reductions, highlighting the pandemic’s association with changes in eye care and indicating a need for focused recovery efforts in the hardest hit areas.”

The investigators further advised that these challenges will require ongoing attention to ensure that all patients receive the care they need, even in the face of future public health crises.

References

1. Mahmoudzadeh R, Samuel M, Wheeler S, et al. COVID-19 Pandemic and rates of common ophthalmic procedures among Medicare beneficiaries. JAMA Ophthalmol. Published online February 6, 2025. doi:10.1001/jamaophthalmol.2024.6065

2. COVIDSurg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. Br J Surg. 2020;107:1440-1449. doi:10.1002/bjs.11746

3. Patel LG, Peck T, Starr MR, et al. Clinical presentation of rhegmatogenous retinal detachment during the COVID-19 pandemic: a historical cohort study. Ophthalmology. 2021;128:686-692. doi:10.1016/j.ophtha.2020.10.009