# Post-pandemic Rise in Mature Cataracts and Delayed Ophthalmic Care: A Retrospective Analysis From a Tertiary Center in Italy

## TL;DR

A year after the pandemic, more people needed cataract surgery due to delayed care, possibly because of fear of infection or lack of access.

## Contribution

This study identifies a significant rise in mature cataracts post-pandemic and explores reasons for delayed ophthalmic care.

## Key findings

- Mature cataract incidence increased from 0.37% in 2019 to 1.01% in 2023-24.
- 68% of 2023-24 patients reported prior COVID-19 infection.
- Fear of infection and lack of appointments were common reasons for delayed care.

## Abstract

Background and objective

The coronavirus disease 2019 (COVID-19) pandemic led to a worldwide decline in elective medical procedures, including cataract surgeries. This study aimed to assess the incidence of mature cataracts one year after the official end of the pandemic at a tertiary ophthalmology center in Milan, Italy.

Methods

A retrospective analysis was conducted involving patients who underwent cataract surgery at IRCCS MultiMedica Eye Clinic in 2019 and from May 2023 to May 2024. Inclusion criteria encompassed best-corrected visual acuity (BCVA) <20/100 due to mature cataract or surgery via extracapsular cataract extraction (ECCE). Demographic and clinical data were compared across the two periods. Patients from 2023-24 were also surveyed on reasons for delayed care.

Results

The incidence of mature cataracts increased from 10/2681 (0.37%) in 2019 to 27/2660 (1.01%) in 2023-24 (p = 0.0004). The mean patient age was 81.9 ± 5.2 years in 2019 compared with 76.2 ± 8.6 years in 2023-24 (p = 0.057). Sex distribution was comparable between the two periods (5/10 males (50%) vs. 13/27 males (48.1%), p = 1.00). Diabetes prevalence was 4/10 (40%) vs. 12/27 (44.4%) (p = 0.407). ECCE was performed in 4/10 (40%) vs. 13/27 (48.1%) (p = 0.72). Among 2023-24 patients, 17/25 respondents (68.0%) reported prior COVID-19 infection. Reasons for delayed ophthalmic care included fear of infection (10/25, 40.0%), lack of appointment availability (8/25, 32.0%), and underestimation of need (9/25, 36.0%).

Conclusions

A significant increase in mature cataracts was observed one year post-pandemic. These findings describe an observable post-pandemic trend and highlight a relevant public health signal that may inform future planning of ophthalmic services.