The Impact of COVID-19 on Acute and Elective Corneal Surgery at Moorfields Eye Hospital London

Nizar Din,1 Maria Phylactou,1 Julia Fajardo-Sanchez,1 Martin Watson,1 Sajjad Ahmad1,2 1Cornea and External Eye Disease Service, Moorfields Eye Hospital, London, UK; 2Institute of Ophthalmology, University College London, London, UKCorrespondence: Nizar DinMoorfields Eye Hospital, 162 City Road, Lond...

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Autores principales:	Din N, Phylactou M, Fajardo-Sanchez J, Watson M, Ahmad S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	covid-19 corneal surgery perforations trauma Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/7d86db90ab2c43a69eb3ec605ce0d5be
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spelling	oai:doaj.org-article:7d86db90ab2c43a69eb3ec605ce0d5be2021-12-02T15:32:58ZThe Impact of COVID-19 on Acute and Elective Corneal Surgery at Moorfields Eye Hospital London1177-5483https://doaj.org/article/7d86db90ab2c43a69eb3ec605ce0d5be2021-05-01T00:00:00Zhttps://www.dovepress.com/the-impact-of-covid-19-on-acute-and-elective-corneal-surgery-at-moorfi-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Nizar Din,1 Maria Phylactou,1 Julia Fajardo-Sanchez,1 Martin Watson,1 Sajjad Ahmad1,2 1Cornea and External Eye Disease Service, Moorfields Eye Hospital, London, UK; 2Institute of Ophthalmology, University College London, London, UKCorrespondence: Nizar DinMoorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UKEmail nizar.din@nhs.netPurpose: Moorfields Eye Hospital sits as a major tertiary centre for ophthalmic care in the United Kingdom and became a central hub to provide safe and effective ophthalmic care across London and surrounding regions during the COVID-19 pandemic. We explore the impact on both the acute and elective corneal services during the first wave of this pandemic.Methods: A retrospective review of the proportion of corneal transplants and anterior segment trauma repairs was performed during the period of March 23rd to July 1st 2020 compared with an identical period in 2019. Data were acquired from our in-house electronic patient records.Results: A 92% reduction in corneal elective work was observed during the lockdown period compared with an identical period in 2019, with only 10 elective cases in total being performed. In addition, 91 corneal cross-linking and 76 therapeutic lasers were cancelled. There were 15 cases of primary repair for anterior segment trauma compared with 6 cases pre-COVID-19. A similar scenario occurs with removal of foreign body (4 cases during COVID-19 period versus no cases during pre-COVID-19 era) and with traumatic lens aspirations (6 cases during COVID-19 compared with 2 pre-COVID-19). Interestingly, a statistical difference (p=0.03) was found in the time interval from presentation of symptoms to emergency corneal surgery. During the COVID-19 period, a delay of 1.5 days ± 2.29 (range 0– 10 days) occurred compared with 0.8 days ± 1.54 (range 0– 6 days) pre-COVID-19.Conclusion: Stringent risk stratification reduced elective corneal surgery capacity during the lockdown thereby preserving social distancing requirements. However, an apparent increase in emergency corneal surgery seen is likely attributed to centralisation of ophthalmic services during the pandemic crisis, alongside increased domestic injuries. Despite the challenges posed, successful delivery of corneal surgery occurred whilst helping to identify lessons in preparations for future pandemics and current inefficiencies in healthcare delivery.Keywords: COVID-19, corneal surgery, perforations, traumaDin NPhylactou MFajardo-Sanchez JWatson MAhmad SDove Medical Pressarticlecovid-19corneal surgeryperforationstraumaOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 1639-1645 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	covid-19 corneal surgery perforations trauma Ophthalmology RE1-994
spellingShingle	covid-19 corneal surgery perforations trauma Ophthalmology RE1-994 Din N Phylactou M Fajardo-Sanchez J Watson M Ahmad S The Impact of COVID-19 on Acute and Elective Corneal Surgery at Moorfields Eye Hospital London
description	Nizar Din,1 Maria Phylactou,1 Julia Fajardo-Sanchez,1 Martin Watson,1 Sajjad Ahmad1,2 1Cornea and External Eye Disease Service, Moorfields Eye Hospital, London, UK; 2Institute of Ophthalmology, University College London, London, UKCorrespondence: Nizar DinMoorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UKEmail nizar.din@nhs.netPurpose: Moorfields Eye Hospital sits as a major tertiary centre for ophthalmic care in the United Kingdom and became a central hub to provide safe and effective ophthalmic care across London and surrounding regions during the COVID-19 pandemic. We explore the impact on both the acute and elective corneal services during the first wave of this pandemic.Methods: A retrospective review of the proportion of corneal transplants and anterior segment trauma repairs was performed during the period of March 23rd to July 1st 2020 compared with an identical period in 2019. Data were acquired from our in-house electronic patient records.Results: A 92% reduction in corneal elective work was observed during the lockdown period compared with an identical period in 2019, with only 10 elective cases in total being performed. In addition, 91 corneal cross-linking and 76 therapeutic lasers were cancelled. There were 15 cases of primary repair for anterior segment trauma compared with 6 cases pre-COVID-19. A similar scenario occurs with removal of foreign body (4 cases during COVID-19 period versus no cases during pre-COVID-19 era) and with traumatic lens aspirations (6 cases during COVID-19 compared with 2 pre-COVID-19). Interestingly, a statistical difference (p=0.03) was found in the time interval from presentation of symptoms to emergency corneal surgery. During the COVID-19 period, a delay of 1.5 days ± 2.29 (range 0– 10 days) occurred compared with 0.8 days ± 1.54 (range 0– 6 days) pre-COVID-19.Conclusion: Stringent risk stratification reduced elective corneal surgery capacity during the lockdown thereby preserving social distancing requirements. However, an apparent increase in emergency corneal surgery seen is likely attributed to centralisation of ophthalmic services during the pandemic crisis, alongside increased domestic injuries. Despite the challenges posed, successful delivery of corneal surgery occurred whilst helping to identify lessons in preparations for future pandemics and current inefficiencies in healthcare delivery.Keywords: COVID-19, corneal surgery, perforations, trauma
format	article
author	Din N Phylactou M Fajardo-Sanchez J Watson M Ahmad S
author_facet	Din N Phylactou M Fajardo-Sanchez J Watson M Ahmad S
author_sort	Din N
title	The Impact of COVID-19 on Acute and Elective Corneal Surgery at Moorfields Eye Hospital London
title_short	The Impact of COVID-19 on Acute and Elective Corneal Surgery at Moorfields Eye Hospital London
title_full	The Impact of COVID-19 on Acute and Elective Corneal Surgery at Moorfields Eye Hospital London
title_fullStr	The Impact of COVID-19 on Acute and Elective Corneal Surgery at Moorfields Eye Hospital London
title_full_unstemmed	The Impact of COVID-19 on Acute and Elective Corneal Surgery at Moorfields Eye Hospital London
title_sort	impact of covid-19 on acute and elective corneal surgery at moorfields eye hospital london
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/7d86db90ab2c43a69eb3ec605ce0d5be
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The Impact of COVID-19 on Acute and Elective Corneal Surgery at Moorfields Eye Hospital London

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