PT  - JOURNAL ARTICLE
AU  - Tina Felfeli
AU  - Raphael Ximenes
AU  - David M.J. Naimark
AU  - Philip L. Hooper
AU  - Robert J. Campbell
AU  - Sherif R. El-Defrawy
AU  - Beate Sander
TI  - The ophthalmic surgical backlog associated with the COVID-19 pandemic: a population-based and microsimulation modelling study
AID  - 10.9778/cmajo.20210145
DP  - 2021 Oct 01
TA  - CMAJ Open
PG  - E1063--E1072
VI  - 9
IP  - 4
4099  - http://www.cmajopen.ca/content/9/4/E1063.short
4100  - http://www.cmajopen.ca/content/9/4/E1063.full
SO  - CMAJ2021 Oct 01; 9
AB  - Background: Jurisdictions worldwide ramped down ophthalmic surgeries to mitigate the effects of COVID-19, creating a global surgical backlog. We sought to predict the long-term impact of COVID-19 on the timely delivery of non-emergent ophthalmology sub-specialty surgical care in Ontario.Methods: This is a microsimulation modelling study. We used provincial population-based administrative data from the Wait Time Information System database in Ontario for January 2019 to May 2021 and facility-level data for March 2018 to May 2021 to estimate the backlog size and wait times associated with the COVID-19 pandemic. For the postpandemic recovery phase, we estimated the resources required to clear the backlog of patients accumulated on the wait-list during the pandemic. Outcomes were accrued over a time horizon of 3 years.Results: A total of 56 923 patients were on the wait-list in the province of Ontario awaiting non-emergency ophthalmic surgery as of Mar. 15, 2020. The number of non-emergency surgeries performed in the province decreased by 97% in May 2020 and by 80% in May 2021 compared with the same months in 2019. By 2 years and 3 years since the start of the pandemic, the overall estimated number of patients awaiting surgery grew by 129% and 150%, respectively. The estimated mean wait time for patients for all subspecialty surgeries increased to 282 (standard deviation [SD] 91) days in March 2023 compared with 94 (SD 97) days in 2019. The provincial monthly additional resources required to clear the backlog by March 2023 was estimated to be a 34% escalation from the prepandemic volumes (4626 additional surgeries).Interpretation: The estimates from this microsimulation modelling study suggest that the magnitude of the ophthalmic surgical backlog from the COVID-19 pandemic has important implications for the recovery phase. This model can be adapted to other jurisdictions to assist with recovery planning for vision-saving surgeries.