Safety and Efficacy of Cataract Surgery Under a Local Infection Control Protocol Before and During a COVID-19 Wave in Thailand for Healthcare Workers and Patients: A Prospective Cohort from a Secondary Center

在泰国新冠疫情爆发前后,采用当地感染控制方案进行白内障手术对医护人员和患者的安全性和有效性:一项来自二级中心的前瞻性队列研究

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Abstract

PURPOSE: To assess the effectiveness of a local infection control protocol for cataract surgery (CS) during the coronavirus disease (COVID-19) pandemic and determine the trend of CSs and visual outcomes during this period, as compared to the pre-COVID-19 pandemic period. METHODS: This study was conducted at Suddhavej Hospital, Mahasarakham University, Mahasarakham, Thailand, between July 1, 2020, and March 31, 2021. In this two-phase study, we used only a COVID-19-screening questionnaire during the first phase and preoperative nasopharyngeal swab severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing for real-time reverse transcriptase-polymerase chain reaction in the second phase, during Thailand's second COVID-19 wave. Nasopharyngeal swab SARS-CoV-2 nucleic acid testing, SARS-CoV-2 IgG/IgM, or anti-SARS-CoV-2 spike antibody seroconversion was used to detect COVID-19 infection among healthcare workers. We also compared cataract surgical volume and postoperative visual acuity of CS patients between the pre-COVID-19 period and during the COVID-19 pandemic period. RESULTS: A total of 947 patients underwent CS. Thirty-two healthcare workers and 275 patients tested negative for SARS-CoV-2 in the second study phase. CSs increased on average by 50.09% month-to-month when the surgery was resumed. The mean postoperative logMAR best-corrected visual acuity was significantly better in the COVID-19 pandemic period than in the pre-pandemic period (difference, 0.1 [95% CI: 0.00-0.12], p < 0.0001). CONCLUSION: CS could be safely performed under an infection control protocol during the COVID-19 pandemic. The cataract surgical volume, with favorable visual outcomes, has an increasing trend after resuming elective surgeries.

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