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In this retrospective single centre consecutive case series, the authors investigate the effect of suspending elective cataract surgery during the COVID-19 pandemic for a period of 19 weeks. They divided the study period, September 2019 to January 2021, into three intervals of: pre-restrictions, during and post-restrictions. The sample size was 15,689 phacoemulsification surgeries and 256 surgeons. The authors used the Cataract Posterior Capsule Rupture (PCR) Risk, a numerical value that reflects the relative risk of PCR based on the individual risk factors, to control for case complexity. The PCR rate was 0.99% pre-surgical restrictions and 1.62% in the 19 weeks after surgery restarting (Odds Ratio: 1.65; p=0.001; Relative Risk: 1.64). The difference remained significant when controlled for the level of the surgeon, the time of year, the PCR risk value and when excluding surgeons with less than 20, 50 or 100 cases performed. Abstinence had varying impact according to seniority; consultants remained the group with the lowest PCR rate despite suffering a significant increase, whereas registrars had the highest rate but the difference was not significant. Interestingly, fellows had the most robust increase in PCR rate, suggesting that surgical abstinence could have a particularly detrimental effect on surgeons at this intermediate level of seniority.

The effect of surgical abstinence on the risk of posterior capsule rupture during cataract surgery.
Matarazzo F, Phylactou M, Day AC, Maurino V.
2021 July; Epub ahead of print.
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Mahmoud Ahmed

Royal Liverpool University Hospital, UK.

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