Journal of Clinical and Diagnostic Research. 2023 May, Vol-17(5): NC06-NC09 6 6 DOI: 10.7860/JCDR/2023/62866.17896 Original Article Ophthalmology Section Cataract Surgery Trends during Lockdown and Unlocking Periods of COVID-19 Pandemic: A Cross-sectional Hospital-based Study ANUPAM CHATTORAJ 1 , KALPAMOI KAKATI 2 , S BANDOPADHYAY 3 , VIJAY K SHARMA 4 , BV RAO 5 , NEERAJ SHARMA 6 , VIPIN RANA 7 INTRODUCTION The COVID-19 pandemic has taken the world by storm from early 2020 onwards and had devastating effects on all aspects of human life including education, healthcare, economy, psychosocial and recreational [1]. At the outset, it was believed that the spread could be controlled by imposing severe restrictions/curbs for a short period of time but the restrictions and curbs continued at various levels of intensity for last almost two years [2,3]. During the initial intense phase of the pandemic and the lockdown, all elective surgeries were suspended in healthcare centres. This impacted most of ocular surgeries including corneal transplantation, vitreoretinal surgeries and cataract surgeries [4,5]. Once the restrictions were relaxed in June 2020, patients who required early surgery, started surfacing. Cataract surgery, the most commonly performed surgery in the world, resumed around June 2020 in most centres, especially in cases that required urgent surgery [6]. Initial reports and studies suggested that phacoemulsification, being an aerosol generating procedure, bears a high risk for transmitting COVID- 19 virus [7,8]. The health ministry guidelines mandated COVID- 19 RT-PCR test preoperatively during intense phase of COVID- 19 [9]. The pandemic curve flattened over the next few months and the number of patients requiring elective cataract surgeries increased. Most centres started performing phacoemulsification with various degrees of precautions [10]. Preoperative, negative COVID-19 RT-PCR was an essential prerequisite everywhere. The vaccination rollout among healthcare workers and elderly started in January 2021. Once the healthcare staff and the patients received the first dose of vaccine, COVID-19 guidelines were reviewed and modified accordingly if the patient was asymptomatic [11]. This study aims to analyse the two years trends of cataract surgery during the lockdown and unlocking periods of COVID-19 pandemic in a tertiary care hospital in eastern India and compare differences in trends during first lock and unlock period to second lock and unlock period. MATERIALS AND METHODS A cross-sectional, hospital-based study was conducted in Ophthalmology department of a tertiary care centre in eastern India. Study adheres to declaration of Helsinki and approved by Institutional Ethical Committee (IEC) (no 100039/IEC/study/2022 dt 28 July 2022). None of the patient identifiable parameters were used in the data collection. Written informed consent was obtained from all patients. Inclusion criteria: All patients who had significant cataract and planned for cataract surgery from January 2020 to March 2022 were included in the study. Exclusion criteria: Patients without significant cataract were excluded from the study. Keywords: Coronavirus disease-19, Healthcare, Phacoemulsification ABSTRACT Introduction: Coronavirus Disease-2019 (COVID-19) has affected healthcare access to population around the world. India also had its own set of problems for patients with disruption of healthcare services during the pandemic. This also brought in unique challenges for ophthalmologists who adapted to new challenges to provide quality care to the patients including those reporting for cataract surgery. Aim: To find out cataract surgery trends and demographic variables during lockdown and unlocking periods of COVID-19 pandemic. Materials and Methods: This cross-sectional hospital-based study was conducted at Ophthalmology department of a tertiary care centre in eastern India, from January 2020 to March 2022. Trends of cataract surgery including numbers, demographic factors, visual acuity at presentation, difference during first and second lock and unlock periods etc were compared during various lock and unlock period over more than two years. Results: A total of 3,843 patients were planned for surgery and 3,594 patients underwent cataract surgery. A total of 218 patients reported being positive for COVID-19 preoperatively and voluntarily dropped out from surgery. A total of 24 patients were found to be positive during preoperative Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) work- up and were excluded from surgery. Seven patients didn’t report for the surgery. A total of 59 patients reported febrile illness during one month postoperative period. There was dip in cataract surgery during lockdown periods (from 178.33 every month in pre COVID-19 period to near zero during first lockdown period) but recovery was much faster during second unlock period compared to first unlock period. Conclusion: The study concludes that there was drastic decrease in number of patients undergoing cataract surgery during COVID-19 pandemic. Predominantly young, male patients who had advanced morphology of cataracts with poor visual acuity accessed healthcare set-up for cataract surgery during initial lock and unlock period. Similar trend was seen during second lock and unlock period with rapid recovery of numbers and demography of cataract surgery patients to pre- COVID-19 levels.