Glaucoma Surgery During Non-Pandemic vs. Pandemic Periods in a Tertiary Center in Romania

Purpose: Evaluation of the results of glaucoma surgery performed by the same surgeon in the non-pandemic period (2019, 2021 and the first 3 months of 2022) vs. the pandemic one (2020). Evaluation of the effects of glaucoma surgery: release of intraocular pressure, intra and postoperative complications, measurement of success rate and postoperative failure rate and its implications. Material and method: Out of a total of 66 patients ad-mitted between November 2019 and March 2022, 45 patients met the inclusion and ex-clusion criteria and were included in the study. All underwent glaucoma surgery per-formed by the same surgeon using the same technique (trabeculectomy ± iridectomy, ± mitomycin C). Clinical parameters evaluated: preoperative and postop-erative, pre-operative IOP and first postoperative day; early / late intraoperative and postoperative complications; postoperative success and failure rates. Results: Most cases of glaucoma were in 2021 (38%). In 2019, cases of pseudoexfoliative glaucoma predominated (41.7%), while in 2020 cases of closed uncle secondary glaucoma pre-dominated (61.1%). In 2019, pseudoexfoliative glaucoma was the most prevalent sub-type (50%), whereas in 2020, neovascular glaucoma predominated (40%). In contrast, in 2021 (45.5%) and 2022 (40%), the most frequent diagnosis was primary open-angle glaucoma. Over years of study, it is found that retrobulbar anesthesia was performed more frequently in 2019. The failure rate was not significantly influenced by complications, age, comorbidities and type of intervention. Conclusions: Glaucoma surgery encountered a number of difficulties during the pandemic vs. non-pandemic period even though they were considered an emergency due to their low addressability. The share of early intraoperative and post-operative complications was reduced, with early intraocular hypotonia predominating in 10 cases. In all study groups, over 80% had qualified success and only 18% failed. According to the AAO and EGS recommendations, glaucoma is an emergency and surgery is urgently needed when IOP is uncontrolled to prevent severe functional loss, regardless of the existing pandemic or non-pandemic situation.