Background: Jurisdictions worldwide ramped down ophthalmic surgeries to mitigate the effects of coronavirus disease 2019 (COVID-19), creating a global surgical backlog . We sought to predict the long-term impact of COVID-19 on ophthalmology surgical care delivery .
Methods: This is a population-based study and a microsimulation model for predicting future outcomes . Provincial administrative data from January 2019 to November 2020 was used to estimate the decline in surgical volumes during the COVID-19 pandemic . For the post-pandemic recovery phase, we estimated the resources required to clear the backlog of patients accumulated on the waitlist since the pandemic . Results: A total of 56,923 patients were on the waitlist in the province of Ontario awaiting non-emergency ophthalmic surgery as of March 15 , 2020 . The number of non-emergency surgeries performed in the province decreased by 45-98% between March to May 2020 compared to the same months in 2019 . By 2 years and 3 years, the overall estimated number of patients awaiting surgery grew by 125% and 148%, respectively . The mean wait time for patients for all subspecialty surgeries increased to 198.49 days (SD 81.38) in March 2021 compared to 94.41 days (SD 97.42) in 2019 . The provincial monthly additional resources required to clear the backlog by March 2023 was estimated to be 126% (3,538 additional surgeries).
Discussion: The magnitude of the ophthalmic surgical backlog from COVID-19 has important implications for the recovery phase . The estimates from the surgical database and microsimulation modelling can be adapted to other jurisdictions to assist with recovery planning.