Trends in Ophthalmology Resident Operative Experience and the Early Impact of the COVID-19 Pandemic.

Purpose  This study aimed to evaluate trends in ophthalmology resident operative experience and the early impact of the novel coronavirus disease 2019 (COVID-19) pandemic. Design  Present study is a retrospective analysis of the Accreditation Council for Graduate Medical Education (ACGME) Case Log System. Participants  Anonymized graduating resident case logs from 2011 to 2020 academic years (AYs) were examined for this study. Methods  Regression analysis for each procedure category was performed to identify trends between 2011 and 2019 AYs. Unpaired two-tailed t -test compared 2018 to 2019 and 2019 to 2020 AY's for each category surgeon (S) and as surgeon and assistant (S + A). Main Outcome Measures  Mean and median cases as (S) and (S + A) during 2011 to 2019 AYs. Comparison between 2018 to 2019 and 2019 to 2020 AY's for each category as (S) and (S + A) to evaluate the impact of the COVID-19 pandemic. Results  Total ophthalmology procedures as (S) rose from a mean of 479.6 to 601.3 ( p  < 0.001; R ²  = 0.96; Δ/year = 16.9) and a median of 444 to 537 ( p  < 0.001; R ²  = 0.97; Δ/year = 13.1). Total procedures as (S + A) rose from a mean of 698.1 to 768 ( p  < 0.01; R ²  = 0.83; Δ/year = 9.07) and a median of 677 to 734 ( p  < 0.05; R ²  = 0.61; Δ/year = 6.64). Cataract procedures as (S) rose from a mean of 152.8 to 208 ( p  < 0.001; R ²  = 0.99; Δ/year = 7.98) and a median of 146 to 197 ( p  < 0.001; R ²  = 0.97; Δ/year = 7.87). Cataract procedures as both (S + A) rose from a mean 231.4 to 268.7 ( p  < 0.001; R ²  = 0.95; Δ/year = 5.5) and a median of 213 to 254 ( p  < 0.001; R ²  = 0.93; Δ/year = 5.33). Between 2018 to 2019 and 2019 to 2020 AYs, the first pandemic year was associated with significant reductions in total procedures (601.3-533.7 [ p  < 0.0001]) as (S) and 768.0 to 694.4 ( p  < 0.0001) as (S + A), cataract surgery (208-162.2 [ p  < 0.0001]) as (S) and 268.7 to 219.1 ( p  < 0.0001) as (S + A), and glaucoma surgery (16.3-14.2 [ p  = 0.0068]) as (S) and 25.6 to 22.6 ( p  = 0.0063) as (S + A). Conclusion  During 2011 to 2019 AYs, cataract, intravitreal injections, glaucoma, and total procedures increased significantly. During the early period of the COVID-19 pandemic (2019-2020 AY), national halting of elective procedures had a precipitous effect on resident cataract surgery experience to volumes similar to 2013 to 2014 AY where the mean was twice the current required minimum number. With few exceptions, other procedure volumes remained stable.