Eyeworld

SEPTEMBER 2022 | EYEWORLD | 17 continued on page 18 The four changes are described in Table 1. Aside from these modifications, the surgical and perioperative protocols were identical for the two groups. Postoperative outcomes are described in Table 2. A total of 85,562 cataract surgeries were included in the study, of which 56,551 surgeries were in Group 1, and 29,011 were in Group 2. The study found that 3 eyes (0.005%) in Group 1 and 2 eyes (0.006%) in Group 2 developed postoperative endophthal- mitis (P=0.77). The endophthalmitis rate in this Intraoperative change January–March 2020 (Baseline) (n=56,551) Group 1 May–August 2020 (COVID-19) (n=29,011) Group 2 Change 1 2 to 4 patients in same OR simultaneously Only 1 patient in the OR at a time Change 2 The OR floor is cleaned every 3 hours. The OR table and other surfaces are cleaned with antiseptic at end of day. OR table, floor, and surfaces are cleaned with antiseptic after every case. Change 3 Neither the surgeon nor the scrub nurse changed gowns or gloves in between cases. Alcohol/chlorhexidine was used to clean gloves between cases. Double gloves for both surgeon and scrub nurse. Outer glove is changed after each case. Change 4 Patients wore their own clothing in the OR without wearing gowns. Patients wore masks and laundered gowns over their clothing. Table 1. Surgical protocol at baseline and during COVID-19 Cataract surgery type January–March 2020 Group 1 May–August 2020 Group 2 Difference (95% CI) P value Number of surgeries Number of POE (%) Number of surgeries Number of POE (%) Phaco 27,454 (49%) 1 (0.003%) 15,061 (52%) 0 (0.00%) 0.000036 (–0.000035 to 0.000107) 0.46 MSICS 29,097 (51%) 2 (0.006) 13,950 (48%) 2 (0.014%) 0.00007 (–0.0001874 to 0.00033) 0.45 Total 56,551 3 (0.005) 29,011 2 (0.006%) –0.000015 (–0.00013 to 0.00009) 0.77 Table 2. Comparison of postoperative endophthalmitis (POE) by both group and type of cataract surgery Source (all): Aakriti G. Shukla, MD, and David F. Chang, MD References 1. Eckelman MJ, Sherman J. En- vironmental impacts of the U.S. health care system and effects on public health. PLoS One. 2016;11:e0157014. 2. Freeman W. 2020 Cataract Surgical Equipment Market Report. 2020:55. Table 11. Market Scope. July 2020. Accessed April 15, 2021. staging. market-scope.com/files/prod- ucts/brochures/196/2020%20 Cataract%20Equipment%20 Report%20Brochure.pdf 3. Chang DF, Thiel CL, Ophthal- mic Instrument Cleaning and Sterilization Task Force. Survey of cataract surgeons' and nurses' attitudes toward operating room waste. J Cataract Refract Surg. 2020;46:933–940. 4. Haripriya A, et al. Endophthal- mitis reduction with intracamer- al moxifloxacin in eyes with and without surgical complications: Results from 2 million consecu- tive cataract surgeries. J Cataract Refract Surg. 2019;45:1226–1233. 5. Haripriya A, et al. Complica- tion rates of phacoemulsification and manual small-incision cataract surgery at Aravind Eye Hospital. J Cataract Refract Surg. 2012;38:1360–1369. 6. Thiel CL, et al. Cataract surgery and environmental sus- tainability: Waste and lifecycle assessment of phacoemulsifi- cation at a private healthcare facility. J Cataract Refract Surg. 2017;43:1391–1398.

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