Macular hole surgery in times of the COVID-19 pandemic

To assess whether there were any differences in patient presentation, morphological and functional features as well as surgical treatment for full-thickness macular holes (FTMH) during the lockdown periods amidst the COVID-19 pandemic compared to the previous year. A retrospective analysis was conducted on all patients with FTMH who received treatment at a large tertiary center during the lockdown periods from March 16 to June 16, 2020, and December 9, 2020, to June 6, 2021 (35 eyes, mean age 66 years). Corresponding periods from the previous year were chosen as a control group (41 eyes, mean age 71 years). The patients' demographics, preoperative and postoperative best-corrected visual acuity (BCVA), symptom duration, time from presentation to surgical treatment, and surgical technique were determined. The minimal and base diameters of the FTMH were assessed using spectral-domain optical coherence tomography. During the lockdown periods in the COVID-19 pandemic, there were no significant differences in the number of patients, duration of symptoms, time from presentation to surgical treatment, surgical technique, macular hole size, base diameter, closure rate or pre- and postoperative BCVA between the two groups. However, there was a significant increase in the number of patients who presented directly at the clinic on an emergency basis without prior contact with a community-based ophthalmologist. This study suggests that the diagnosis and the provision of timely surgical treatment of FTMH were not affected by the COVID-19 pandemic. However, patients more frequently sought immediate emergency care at the hospital. This could be attributed to challenges in scheduling and obtaining appointments at outpatient clinics during the COVID-19 pandemic.