COVID-19 and cataract surgery backlog in Medicare beneficiaries

Abstract

Purpose: To forecast the volume of cataract surgery in Medicare beneficiaries in the United States in 2020 and to estimate the surgical backlog that may be created due to COVID-19. Design: Epidemiologic modeling Methods: Baseline trends in cataract surgery among Medicare beneficiaries were assessed by querying the Medicare Part B Provider Utilization National Summary data. It was assumed that once the surgical deferment is over, there will be a ramp-up period; this was modeled using a stochastic Monte Carlo simulation. Total surgical backlog 2 years post-suspension was estimated. Sensitivity analyses were used to test model assumptions. Results: Assuming cataract surgeries were to resume in May 2020, it would take 4 months under an optimistic scenario to revert to 90% of the expected pre-COVID forecasted volume. At 2-years post-suspension, the resulting backlog would be between 1.1 and 1.6 million cases. Sensitivity analyses revealed that a substantial surgical backlog would remain despite potentially lower surgical demand in the future. Conclusions: Suspension of elective cataract surgical care during the COVID-19 surge might have a lasting impact on ophthalmology, and will likely result in a cataract surgical patient backlog. This data may aid physicians, payers, and policymakers in planning for post-pandemic recovery.