EyeWorld India June 2021 Issue

FEATURE 14 EWAP JUNE 2021 Ophthalmic surgery practice in the Asia-Pacific amid COVID-19 T he COVID-19 pandemic has disrupted life as we had known it for decades such that people all over the world have—to varying degrees depending on numerous factors ranging from preexisting social and economic standards to how well governments have managed the pandemic in their respective countries—adopted numerous, often fundamental changes to the way they go about their daily lives. How have ophthalmology practices in the Asia-Pacific adapted to the many challenges posed by the pandemic? Following on a similar survey published in the March 2021 issue of EyeWorld Magazine (“How has COVID-19 changed your practice?” EyeWorld March 2021, Vol. 26 No. 1, pp. 110–112), EyeWorld Asia-Pacific reached out to some doctors in the region and asked them to answer two questions regarding changes to the workflow, operating procedures, techniques, and/ or technologies used in their respective practices: 1. What are some things that you have had to adopt in response to the pandemic? 2. What are some things in your practice that you used to do or use that the pandemic has led you to abandon and that you will never go back to again, even after the pandemic? The doctors’ responses are presented here without further commentary but have been lightly edited for clarity. Q1: Adopting changes Lee Mun Wai, MD LEC Eye Centre Ipoh, Malaysia “COVID-19 has made it challenging for my practice from a business point of view as I am part owner of a group practice ASC. We have had to adopt lean management practices, and in order to sustain the practice, we have had to drill down to cost control and improve efficiency of our practice to minimize waste.” Hiroko Bissen-Miyajima, MD Tokyo Dental College Suidobashi Hospital Tokyo, Japan “I only changed the workflow inside the operating room, but did not change any surgical techniques in response to the pandemic. A new implementation with the spread of the novel coronavirus is that patients are now also required to keep their masks at all times. This means that patients also have their mask on during the procedure. After several trials, we decided that the mask of the patient should be moved under the nose during the surgery for two reasons. One is for the sake of the patient’s breathing. Some patients complained having trouble breathing when their nose is covered by both the mask and the surgical drape. Another one is to expose the skin to be able to disinfect before the surgery. The distance between the eye and the mask becomes sufficient when the mask is set under the nose. Hence, this step of adjusting the patient’s mask was added to the workflow. Outside the operating room, we now require patients to keep a safe distance from each other and limit the number of people who come along to appointments. “We often have the visitors to observe the surgeries from other clinic and hospitals. During the pandemic, we have declined all such requests.” Dr. Bissen Miyajima further clarified their hospital procedure as follows: “The patient comes into the OR and sits down on the surgical reclining chair. “At this time, the patient has her or his mask at the original position. “The reclining chair moves to the flat position for the surgery. “Then, the nurse pulls the patient’s mask down below the patient’s nose. “The surgeon sterilizes around the eye and puts the drape over the patient’s face. “So, the surgical drape remains above the nose.” Sheetal Brar, MD Nethradhama Superspeciality Eye Hospital Bangalore, India “The COVID-19 pandemic is continuing to severely affect and influence patient and practice management in our institute, with staff and patient safety being the greatest challenges faced. Contact information Bissen-Miyajima: bissen@tdc.ac.jp Brar: brar_sheetal@yahoo.co.in Chung: c0000c83@naver.com Lee DH: eyedr0823@hotmail.com Lee MW: munwai_lee@lec.com.my Wong: edmund.wong.y.m@singhealth.com.sg