Perioperative corneal injury: An unseen casualty of COVID-19.

Introduction: This study is the first to reveal an increased incidence in perioperative corneal injuries during the COVID era and should alert clinicians to this observation. This study could inform investigations into practice or patient factors that changed as a result of the COVID pandemic. We were aware of several adverse corneal injury reports during COVID and as a result did a formal IRB approved retrospective review to see if corneal injuries were more common during that period.

Methods: This is a retrospective cross-sectional observational study based on the hospital reporting of corneal injuries in the peri-operative time-period during the COVID pandemic. Comparison to known incidence of corneal injuries from the same institution in the pre COVID era were made. The objective was to examine if there were increased peri-operative corneal injuries during the COVID pandemic compared to other time points at our institution.

Results: All corneal injury event reports were aggregated for the time period including January 1, 2015 through April 30, 2021. Data include all patients who underwent anesthesia for any procedure at all sites within the hospital system. Corneal injury rates (in lieu of total number of events) were utilized to account for variation in perioperative volume. Using Poisson regression, corneal injury rates were significantly higher after March 2020 compared to the other time points. Alternatively, RISQ reporting rates were significantly lower after March 2020 compared to other time points.

Conclusions: This study reveals an increased incidence in perioperative corneal injuries during the COVID era and should alert clinicians to this observation. This study may inform investigations and may ultimately drive processes that could mitigate preventable causes of perioperative corneal injury.