Effect of the COVID-19 Pandemic on Presentation and Outcomes of Pars Plana Vitrectomy for Complications of Diabetic Retinopathy Within a County System

Purpose: To examine the effects of the pandemic on the presentation and outcomes of patients with complications of proliferative diabetic retinopathy (PDR) treated with pars plana vitrectomy (PPV). Methods: A retrospective chart review of eyes of adult patients who underwent PPV for complications of PDR from March 20, 2018, to March 20, 2022, at 2 county-based safety-net hospitals. March 20, 2020, is the cutoff date separating the pre- and post-COVID periods. Eyes with repeat PPVs and/or eyes without 6 months of follow-up were excluded. The primary outcome was visual acuity (VA) at postoperative month 6. Results: During the pre- and post-COVID periods, 253 and 234 eyes, respectively, had PPVs for PDR and at least 6 months of follow-up. The mean time from evaluation to surgery increased by 18 days. Post-COVID, more eyes presented with tractional retinal detachment (167 eyes [48%] vs 139 eyes [35%]; P = .0009) and macula-involving detachment (91 eyes [26%] vs 77 eyes [19%]; P = .0024), and the mean ± standard error VA was worse at postoperative month 6 (logMAR 1.11 ± 0.05 vs 0.94 ± 0.05; P = .0132). Within 6 months, there was no difference in the incidence of postoperative complications. Conclusions: During the pandemic, patients had more severe PDR complications and delays in surgical care, associated with worse visual outcomes after PPV.