The return of phacoemulsification after emergency status related to COVID-19: the experience of a tertiary referral center.

Purpose To present a protocol of priority criteria for phacoemulsification after the backlog due to SARSCOV-2 pandemic status. Setting Ophthalmology department of Centro Hospitalar e Universitario do Porto (CHUP), Oporto, Portugal. Design Cross-sectional, non-randomized, retrospective study. Method ology: Data of all patients waiting for cataract surgery were analysed at the beginning of May 2020, after two months without performing elective surgery. The waiting time since surgical inscription was considered an independent and overriding factor. Also, higher priority was given to patients with white or brunescent cataracts and patients with low visual acuity: corrected distance visual acuity (CDVA) ≤20/200 in binocular patients or CDVA ≤20/63 in monocular patients. Criteria of medium priority included patients that remained with anisometropia and patients with glaucoma or low to moderate risk of chronic angle closure. Data of scheduled surgeries in the following months were then analyzed. Results A total of 717 patients were waiting for phacoemulsification in our center. 191 patients (26.64%) had more than 4.5 months on the waiting list; the medium waiting time was 3.51±1.57 months. According to both priority criteria and waiting time, 48.6% (n=348) were categorized as priority cases. A total of 158 patients (22.0%) met the highest priority; 61 patients (8.5%) met the medium priority criteria. In 129 patients (18.0%), priority was considered based solely on higher waiting time. This algorithm allowed us to operate all priority cases within the first three months. Conclusion The presented protocol showed to be effective, providing a timely surgical opportunity for priority cases.