537 Implications of Covid-19 on Vitreoretinal and Cataract Surgery

The coronavirus pandemic (COVID-19) has greatly impacted ophthalmic surgery, including changes to surgical protocols and training. We explored the effects on vitreoretinal and cataract surgeries, which constitute the commonest areas of ophthalmic surgery. Method Literature searches were performed for the terms “vitreoretinal”, and “cataract”, each in combination with “surgery” and “Covid-19”. Relevant results were assessed to determine perceived impact on ophthalmic theatres. Results 36 search results were analysed; 25 and 11 for cataract and vitreoretinal surgery respectively. Efforts to reduce infection rates have significantly reduced non-urgent operations, with reports of just 5.7% of ophthalmologists in certain areas performing cataract surgeries. Furthermore, surgeons have been advised to perform bilateral cataract surgery, and to combine phacoemulsification with vitreoretinal surgery, thereby avoiding deferred operations and further exposure. Other recommended changes in surgical strategies to enhance safety include three-dimensional heads-up displays for vitreoretinal surgeries, novel microscope drapes, and virtual consultations for surgery follow-up. Various reports indicate a negative impact on junior surgeon training and mental well-being; indeed, The Royal College of Ophthalmology has recommended assigning operations to experienced surgeons. Conclusions Ophthalmic surgery rates and protocols have been impacted in the effort to reduce Covid-19 spread. Trainee surgeon education and well-being warrant further attention.