Effect of COVID-19 on glaucoma surgical practice in India: The challenges faced and the outcomes

Purpose: To report the effect of COVID-19 pandemic on the glaucoma surgical practice in India. Methods: A retrospective chart review of the hospital database of cases that underwent glaucoma surgery during March 2020–September 2020 was compared to surgeries done during the same months in 2017–2018 and 2019–2021. The clinical diagnosis, demographic details, type of surgeries, clinical details (intraocular pressure [IOP] at the time of surgery and IOP at 1 month of surgery, medications, and time from advice to date of surgery) at the time of surgery, and time from surgery-last hospital visit were compared between pre-COVID and post-COVID times. Results: Of a total of 8296 glaucoma surgeries during the study period, secondary glaucoma formed the majority of type of glaucoma requiring surgery (62.5%) during COVID. Of all surgeries, trabeculectomy and bleb-related procedures were the most common surgeries during all study periods, including the COVID times (42.6% in pre-COVID, 30% in COVID 39.8% in post-COVID period, respectively). Minimally invasive glaucoma surgeries (MIGS) increased during the post-COVID period with reduced trabeculectomy procedures paralleled with an increase in the number of implant procedures during COVID time 11.7% (pre-COVID), 15% (COVID), and 10.8% (post-COVID) study periods, correlating with increase in secondary glaucoma. The surgical outcomes were similar in pre-COVID and post-COVID times. Conclusion: COVID-19 provided a fresh direction to glaucoma surgical practice toward increasing implants and MIGS in the post-COVID phase. Despite changes in the surgical trend, there were similar overall surgical outcomes in glaucoma patients undergoing surgery, this provided similar overall surgical outcome in glaucoma patients undergoing surgery during or immediately after active COVID phase compared to pre-COVID times.