Timing and Reoperation Rate of Rhegmatogenous Retinal Detachments Occurring During Major Ophthalmology Meetings

Abstract

BACKGROUND AND OBJECTIVE: To investigate whether surgical management of newly diagnosed rhegmatogenous retinal detachment (RRD) varies if patients are diagnosed during a major national ophthalmology conference. PATIENTS AND METHODS: This retrospective cohort study included 34,759 patients with incident RRD, of whom, 1,246 (3.6%) were diagnosed during dates of three national ophthalmology conferences, and 1,170 (3.4%) underwent surgery during conference dates. The authors identified patients with primary repair with cryotherapy, laser, scleral buckle, pneumatic retinopexy, or pars plana vitrectomy. Multinomial logistic regression models were used to determine patients' likelihood of receiving each type of repair within 30 days of their diagnosis depending on whether they were diagnosed during a national ophthalmology conference. Linear regression models were used to determine the relationship between the date patients were diagnosed and how long they waited to receive a repair. Main outcome measures included days between diagnosis with RRD and RRD repair, receiving repair on the same day of diagnosis, and reoperation rate within 30 days of the primary repair. RESULTS: Mean time from diagnosis to repair was 1.5 days (standard deviation: ± 2.4 days), and 71% of patients underwent repair within a day of diagnosis. Repairs were followed by a second surgery within 30 days in 11.1% of patients. Patients diagnosed during conferences waited 0.23 days longer between diagnosis and repair compared with patients diagnosed outside of conference dates ( P = .001). Patients diagnosed with RRD during conferences were less likely to receive surgical repair within a day of diagnosis compared to patients diagnosed during non-conference dates ( P = .037). Patients who were diagnosed with RRD during a conference date and also received surgery during a conference date were more likely to undergo a second surgery within 30 days of the primary procedure ( P = .006) CONCLUSIONS: Patients diagnosed with RRD during national ophthalmology conference dates waited slightly longer for surgery, were slightly less likely to receive surgery within a day, and were more likely to undergo a second surgery within 30 days of the primary procedure. The “national meeting effect” phenomenon is present in ophthalmology, albeit to a lesser degree that is likely not visually significant. [ Ophthalmic Surg Lasers Imaging Retina . 2020;51:328–337. ]

The impact of the COVID-19 Pandemic on rhegmatogenous retinal detachment treatment patterns

“…The treatment pattern was changed by the presurgery characteristics and surgeons’ considerations during the COVID-19 Pandemic. Contrary to the previous report of higher prevalence of secondary surgeries during the national conference [ 13 ], we achieved a comparable VA outcome and retinal attachment rate in the COVID-19 pandemic group compared with the pre-COVID-19 group, which may suggest that adjustment on the treatment pattern according to patient characteristics and RRD service is effective in treating RRD patients during the COVID-19 Pandemic.…”

“…Previous reports focusing on RRD progression found that prolonged preoperative waiting time is related to the development of macular-off RRD [ 5 ], irreversible macular damage [ 6 – 8 ], proliferative vitreoretinopathy (PVR) progression [ 9 ], and development of choroidal detachment (CD) [ 10 ]. In addition, previous studies have shown that during national meetings or holiday-time, reduced staffing is often associated with adverse patient outcomes, changes in treatment patterns, and care delays in acute cardiovascular conditions [ 1 , 11 , 12 ] and RRD patients [ 13 ].…”

The Impact of the Covid-19 Pandemic on Rhegmatogenous Retinal Detachment Treatment Patterns

“…The treatment pattern was changed by the presurgery characteristics and surgeons' considerations during the COVID-19 pandemic. Contrary to the previous report of higher prevalence of secondary surgeries during the national conference [7], we achieved a comparable VA outcome and retinal attachment rate in the COVID-19 pandemic group compared with the pre-COVID-19 group, which may suggest that adjustment on the treatment pattern according to patient characteristics and RRD service is effective in treating RRD patients during the COVID-19 pandemic.…”

The impact of the COVID-19 pandemic lockdown on rhegmatogenous retinal detachment services—Experiences from the Tongren eye center in Beijing

“…Patients with RRD are considered emergency cases and are reported to receive surgery 1–7 days after the onset of symptoms [ 5 , 12 – 14 ]. During Beijing’s top-level COVID-19 emergency response, the 14-day quarantine period led to prolonged presurgical waiting times in the COVID-19 pandemic group (28days vs. four days).…”

“…It can lead to irreversible visual damage if it is not treated in time [ 4 ]. RRD patients experiencing long delays for surgery are considered more likely to undergo a second surgery within 30 days of the primary procedure [ 5 ].…”