COVID-19 has changed surgical preferences

Glaucoma specialists’ procedure of choice has changed as a result of the COVID-19 pandemic, according to the lead author of a recent report in the British Journal of Ophthalmology.¹

Lee Joseph Holland, a fellow in the Glaucoma Unit, Manchester Royal Eye Hospital, Manchester, UK, reported that while trabeculectomy remains the preferred procedure, surgeons have begun using alternative treatments because of the need for fewer postoperative visits.

Holland and colleagues senta cross-sectional online survey to all consultant glaucoma specialists in UK and Eire Glaucoma Society contact list to determine their practice preferences.

The participants responded to specific questions about their glaucoma surgical practices and how those preferences did or did not change as a result of the COVID-19 pandemic.

Seventy glaucoma specialists completed the survey, and the results indicated that trabeculectomy was by far the procedure of choice for 87% of surgeons.

Before the pandemic, 51 (73%) respondents reported performing minimally invasive glaucoma surgery procedures, the most frequent of which were implantation of the iStent inject (Glaukos) (51%), XEN 45 (Allergan) (36%), and the Preserflo Microshunt (Santen) (17%).

The questionnaire showed that 43 (61%) surgeons changed their glaucoma surgery practice in response to the pandemic, specifically, 21 (43%) surgeons decreased the number of trabeculectomies they performed; the alternative procedure used was diode laser (both micropulse and conventional trans-scleral cyclodiode), Holland reported.

Other alternatives included the use of glaucoma drainage devices, deep sclerectomy, and implantation of the Preserflo Microshunt.

The reason that surgeons cited for performing alternatives to trabeculectomy was the desire for fewer postoperative visits and procedures required.

Reference

1. Holland LJ, Kirwan JF, Mercieca KJ. Effect of COVID-19 pandemic on glaucoma surgical practices in the UK. Br J Ophthalmol. http://dx.doi.org/10.1136/bjophthalmol-2021-319062