Abstract
Purpose :
To investigate the impact of the COVID-19 pandemic on glaucoma procedure volume based on data from the United States Centers for Medicare and Medicaid Services (CMS) Part B beneficiaries population.
Methods :
In this retrospective study, we identified 26 common traditional incisional, laser, and minimally invasive glaucoma surgeries (MIGS) performed over a time period from 2016 to 2021. The period from 2016 to 2019 was treated as the period before the outbreak of the COVID-19 pandemic, 2020 was treated as the onset year of the COVID-19 pandemic, and 2021 was treated as the first year following onset of the pandemic.
Results :
The results of our study are summarized in Table 1. There was a decline in almost all glaucoma procedures in 2020 at the onset of the COVID-19 pandemic when compared to the 2016 to 2019 time period. We found the average glaucoma surgical volume decline for the 26 studied procedures to be 22.60% (range, 7.28% to 90.62%). MIGS procedures were subject to the largest percentage of decline in 2020 compared to the year prior (endocyclophotocoagulation 90.62%, Ab Interno XEN gel stent 33.10%, and iStent 25.16%). While there was a rising trajectory in MIGS procedure volume from 2016 to 2019, there was a 39.96% decrease in 2020 compared to projections. Iridotomy/iridectomy procedures in 2020 decreased by 31.10% compared to 2019. In contrast, traditional incisional surgeries had a milder 8.65% decrease in 2020 (glaucoma drainage implant 10.45% and trabeculectomy 7.28%). Additionally, in 2021, following the onset of the pandemic, all procedures other than traditional incisional surgeries had a negative percent change from projected volume, with MIGS experiencing the sharpest decline (24.16% less than projected). The impact on goniotomy was significant; volume was 56.18% less than projected. Overall, 2021 procedure volumes were 48.87% less than projected.
Conclusions :
The suspension of elective and nonemergent surgical interventions during the COVID-19 pandemic significantly contributed to a decline in the number of glaucoma procedures in the CMS Part B population. It is likely that patient attitudes towards entering hospital and outpatient surgical facilities further contributed to this.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.