Impact of Early COVID-19 Pandemic on Common Ophthalmic Procedures Volumes: A US Claims-Based Analysis.

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Abstract

PURPOSE: The COVID-19 pandemic has had a profound effect on the delivery of healthcare in the United States and globally. The aim of this study was to evaluate the impact of COVID-19 on common ophthalmic procedure utilization and normalization to pre-pandemic daily rates.METHODS: Leveraging a national database, Clinformatics DataMart (OptumInsight, Eden Prairie, MN), procedure frequencies and daily averages, defined by Current Procedural Terminology codes, of common elective and non-elective procedures within multiple ophthalmology sub-specialties were calculated. Interrupted time-series analysis with a Poisson regression model and smooth spline functions was used to model trends in pre-COVID-19 (January 1, 2018-February 29, 2020) and COVID-19 (March 1, 2020-June 30, 2020) periods.RESULTS: Of 3,583,231 procedures in the study period, 339,607 occurred during the early COVID-19 time period. Anti-vascular endothelial growth factor injections (44,412 to 39,774, RR 1.01, CI 0.99-1.02; p =.212), retinal detachment repairs (1,290 to 1,086, RR 1.07, CI 0.99-1.15; p =.103), and glaucoma drainage implants/trabeculectomies (706 to 487, RR 0.93, CI 0.83-1.04; p =.200) remained stable. Cataract surgery (61,421 to 33,054, RR 0.77; CI 0.76-0.78; p <.001), laser peripheral iridotomy (1,875 to 890, RR 0.82, CI 0.76-0.88; p <.001), laser trabeculoplasty (2,680 to 1,753, RR 0.79, CI 0.74-0.84; p <.001), and blepharoplasty (1,522 to 797, RR 0.71, CI 0.66-0.77; p <.001) all declined significantly. All procedures except laser iridotomy returned to pre-COVID19 rates by June 2020.CONCLUSION: Most ophthalmic procedures that significantly declined during the COVID-19 pandemic were elective procedures. Among these, the majority returned to 2019 daily averages by June 2020.

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