As you are likely aware, the Australian federal government announced that all non-urgent elective surgery has been suspended from midnight on March 26th due to the coronavirus. The idea behind the suspension is to preserve resources, including personal protective equipment (PPE), and help prepare the health system for a potential future influx of patients in the coming weeks and months. These regulations have been put in place for all public and private hospitals across the nation.
What does this mean for someone scheduled for eye surgery?
We have had many patients contact our office and ask about their upcoming eye surgery. Only category 1 and urgent category 2 elective procedures will be allowed at the present time. The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) has created recommendations to help guide both patients and doctors to make the safest decision about any planned procedures and surgical interventions.
Cataract
Patients suffering from cataract with reduced vision may be considered highly urgent if the cataract is causing high intractable intraocular pressure. Cataract surgery is considered moderately urgent if the cataract causes significant visual morbidity (corrected vision less than 6/60 in both eyes) or if one eye has already had cataract surgery and this causes visual imbalance (anisometropia) if the second eye has not had cataract surgery. Elective cataract surgery that does not meet these criteria should otherwise be deferred.
Corneal Surgery
Patients suffering from corneal disease requiring corneal surgery may be considered highly urgent if there is a perforation requiring a tectonic keratoplasty (corneal transplant to seal a leak). Keratoplasty in the setting of bullous keratopathy (with a hight risk of infection or pain) is considered moderate urgency as is keratoplasy in a patient with less than 6/60 vision in both eyes. Corneal cross linking (CXL) for progressive ectasia (keratoconus) that is rapid or in the setting of a very thin cornea is also considered moderately urgent. Other elective corneal procedures should be delayed at the present time.
Medical Retina Procedures
Patients requiring intravtireal injections for exudative age related macular degeneration (neovascular or wet AMD), diabetic macular oedema, retinal vein occlusion, or causes of macular oedema or choroidal neovascularisation are considered highly urgent. These patients should follow-up and have their treatments as planned. The injections should be given under a treat and extend protocol to minimise the number of injections and visits for each patient. Laser procedures for active proliferative diabetic retinopathy is also considered highly urgent.
Laser Refractive Surgery
All patients who are candidates for laser refractive surgery should have their surgery delayed at the present time.
Surgery with Dr Ross MacIntyre
Dr Ross MacIntyre is still seeing new and review patients that require face to face consultations, but is also available for telehealth consultation (either video or phone consultation). Conditions requiring urgent surgery will be scheduled as normal, while elective cases will be placed on hold for the moment.
If you have any questions about your upcoming procedures, whether it is in the office, at a private hospital, public hospital, or day procedure unit, do not hesitate to contact the office.
Dr Ross MacIntyre - Melbourne Cataract, Cornea & Laser Eye Surgeon 