Impact of COVID-19 pandemic on cataract surgical volume: A North Indian experience

Abstract

Purpose: To analyze the impact of the pandemic on trends in cataract surgical volume in 2020 in a high-volume tertiary care academic center in North India. Methods: The monthly cataract surgical volume for a large, high-volume, tertiary care academic center in North India was obtained from January 2018 through December 2020. Based on historical trends, we used time-series forecasting, probability sensitivity analysis, and linear regression models to estimate what the expected monthly cataract volume should have been from March 2020 onward. Results: In 2020, we expected to perform 7500 cases (assuming historical trends) but performed only 2500 cases (33% of the expected volume). The remaining 5000 cases (67% cases) constituted the “fixed” backlog. Assuming the ramp-up in cataract surgical volume starts in January 2021, results of the Monte Carlo simulation revealed that for our system, it would take on average 5 months (May 2021) under the optimistic scenario and 10 months (October 2021) under the ambivalent scenario to reach pre-pandemic expected surgical volume. There would be a collective backlog of 5500 cases under the optimistic scenario (8.8 months’ worth of cases) and a collective backlog of 6900 cases under the ambivalent scenario (11 months’ worth of cases). Conclusion: An intuitive approach and out-of-the-box solutions are required by the government and private institutes’ collaborative efforts to help mitigate the disruptions caused by the pandemic and lessen the backlog without causing provider burnout.

Trends in cataract surgery and healthcare system response during the COVID-19 lockdown in Malaysia: Lessons to be learned

“…Our findings are consistent with a Polish study [ 11 ]. Similarly, other countries [ [12] , [13] , [14] , [15] , [16] , [17] ] reported drastic reductions in the usual volume of cataract surgeries or ophthalmic procedures by 67 %–99 % in the early phase of the pandemic. However, the recovery of cataract surgeries was uneven across regions, independent of country income status.…”

“…Due to suspension of cases during the lockdown and incoming new cases that are performed below 100 % capacity (without a simultaneous increase in resources) during the recovery phase, a substantial cataract surgical backlog is likely. A study in India [ 14 ] estimated that it would take 10 months under the ambivalent scenario to reach pre-pandemic expected cataract surgical volumes once elective surgical suspension is lifted and surgeries resume, during which there would be a collective backlog of 11 months’ worth of cases. In high income countries [ 10 , 30 ], the time estimated to revert to pre-pandemic volumes under the pessimistic scenario is shorter—approximately 6–7 months.…”