Complication rates in cataract surgery before and during the COVID-19 pandemic.

Objective: To assess the cataract surgery (CS) complication rates before and during the COVID-19 pandemic.

Design: Retrospective, cross sectional study.

Methods: Medical records of patients undergoing CS at two surgery centers in Winnipeg from January 2018 to April 2022 were reviewed. The study periods were pre-COVID-19 (January 1, 2018 to March 31, 2020) and COVID-19 (April 1, 2020 to April 30, 2022). Complication rates for endophthalmitis, sulcus-positioned intraocular lens (IOL) implant, anterior chamber IOL (ACIOL) implant, capsular tension ring (CTR) insertion, cumulative dissipated phacoemulsification energy (CDE), posterior capsular rupture (PCR), unplanned anterior vitrectomy, and return to the OR within one month of surgery were compared.

Results: 45,559 patients were included. Pre-COVID-19 rates were compared to COVID-19 rates and stated as per 100 cataract surgeries. Endophthalmitis rates increased from 0.008 to 0.028 (RR 0.27, p=0.09). Sulcus IOL implant rates increased from 0.61 to 1.00 (RR 0.61, p<0.0001). ACIOL implant rates increased from 0.53 to 0.68 (RR 0.78, p=0.05). CTR usage rates increased from 0.48 to 0.75 (RR 0.63, p=0.001). Average CDE increased from 4.6 to 6.7 (p=0.0030). PCR rates decreased from 0.49 to 0.38 (RR 1.3, p=0.14). Unplanned anterior vitrectomy rates decreased from 0.43 to 0.36 (RR 1.18, p=0.35). Return to OR rates remained unchanged at 0.59 and 0.58 (RR 1.01, p=0.93).

Conclusions: Our study found significant increases in some CS complication rates when comparing the defined pre-COVID interval to the COVID interval.