Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California, USA.
Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut, USA.
Ophthalmic Epidemiol. 2022 Dec;29(6):604-612. doi: 10.1080/09286586.2021.2015394. Epub 2021 Dec 22.
The COVID-19 pandemic has had a profound effect on the delivery of healthcare in the United States and globally. The aim of this study was to evaluate the impact of COVID-19 on common ophthalmic procedure utilization and normalization to pre-pandemic daily rates.
Leveraging a national database, Clinformatics™ DataMart (OptumInsight, Eden Prairie, MN), procedure frequencies and daily averages, defined by Current Procedural Terminology codes, of common elective and non-elective procedures within multiple ophthalmology sub-specialties were calculated. Interrupted time-series analysis with a Poisson regression model and smooth spline functions was used to model trends in pre-COVID-19 (January 1, 2018-February 29, 2020) and COVID-19 (March 1, 2020-June 30, 2020) periods.
Of 3,583,231 procedures in the study period, 339,607 occurred during the early COVID-19 time period. Anti-vascular endothelial growth factor injections (44,412 to 39,774, RR 1.01, CI 0.99-1.02; = .212), retinal detachment repairs (1,290 to 1,086, RR 1.07, CI 0.99-1.15; = .103), and glaucoma drainage implants/trabeculectomies (706 to 487, RR 0.93, CI 0.83-1.04; = .200) remained stable. Cataract surgery (61,421 to 33,054, RR 0.77; CI 0.76-0.78; < .001), laser peripheral iridotomy (1,875 to 890, RR 0.82, CI 0.76-0.88; < .001), laser trabeculoplasty (2,680 to 1,753, RR 0.79, CI 0.74-0.84; < .001), and blepharoplasty (1,522 to 797, RR 0.71, CI 0.66-0.77; < .001) all declined significantly. All procedures except laser iridotomy returned to pre-COVID19 rates by June 2020.
Most ophthalmic procedures that significantly declined during the COVID-19 pandemic were elective procedures. Among these, the majority returned to 2019 daily averages by June 2020.
COVID-19 大流行对美国和全球的医疗保健服务产生了深远影响。本研究旨在评估 COVID-19 对常见眼科手术利用情况的影响,并使其恢复到大流行前的日常水平。
利用全国数据库 Clinformatics™ DataMart(OptumInsight,Eden Prairie,MN),根据当前操作术语(Current Procedural Terminology)代码,计算了多个眼科亚专业中常见的选择性和非选择性手术的手术频率和日常平均值。采用泊松回归模型和平滑样条函数的中断时间序列分析来模拟 COVID-19 前(2018 年 1 月 1 日至 2020 年 2 月 29 日)和 COVID-19 期间(2020 年 3 月 1 日至 6 月 30 日)的趋势。
在研究期间的 3583231 例手术中,有 339607 例发生在 COVID-19 早期。抗血管内皮生长因子注射(44412 至 39774,RR 1.01,CI 0.99-1.02;= 0.212)、视网膜脱离修复(1290 至 1086,RR 1.07,CI 0.99-1.15;= 0.103)和青光眼引流植入物/小梁切除术(706 至 487,RR 0.93,CI 0.83-1.04;= 0.200)保持稳定。白内障手术(61421 至 33054,RR 0.77;CI 0.76-0.78;< 0.001)、激光周边虹膜切开术(1875 至 890,RR 0.82,CI 0.76-0.88;< 0.001)、激光小梁成形术(2680 至 1753,RR 0.79,CI 0.74-0.84;< 0.001)和眼睑成形术(1522 至 797,RR 0.71,CI 0.66-0.77;< 0.001)均显著下降。COVID-19 大流行期间,除激光虹膜切开术外,所有手术均恢复到 COVID-19 前的水平。到 2020 年 6 月,所有手术均恢复到 COVID-19 前的水平。
COVID-19 大流行期间显著下降的眼科手术大多为选择性手术。在这些手术中,大多数手术在 2020 年 6 月前恢复到 2019 年的日常水平。