Rationale for American Society of Retina Specialists Best Practice Recommendations for Conducting Vitreoretinal Surgery during the COVID-19 Era - PubMed (original) (raw)

. 2020 Oct 1;4(5):420-429.

doi: 10.1177/2474126420941707. Epub 2020 Jul 27.

Jayanth Sridhar 2, Ajay E Kuriyan 3, Theodore Leng 4, Brad P Barnett 5, Aaron F Carlin 6, Charles C Wykoff 7, Stephen Gayer 8, Prithvi Mruthyunjaya 4, Yoshihiro Yonekawa 3, Amani A Fawzi 9, Audina M Berrocal 2, Steven Yeh 10, Daniel Ting 11, Yasha Modi 12, David N Zacks 13, Nicholas Yannuzzi 2, Natalie A Afshari 1, Timothy Murray 14

Affiliations

Rationale for American Society of Retina Specialists Best Practice Recommendations for Conducting Vitreoretinal Surgery during the COVID-19 Era

Daniel L Chao et al. J Vitreoretin Dis. 2020.

Abstract

Purpose: To detail the rationale behind recommendations recently published by the American Society of Retina Specialists (ASRS) outlining best practices for safety of vitreoretinal surgeons and staff while performing vitreoretinal surgery during the coronavirus disease (COVID)-19 pandemic.

Methods: The committee for ASRS Best Practices for Retinal Surgery during the COVID-19 Pandemic reviewed existing evidence and information on SARS-CoV-2 transmission, and risk factors during vitreoretinal surgery. Recommendations were based on best available published data, cumulative clinical experiences, and recommendations and policies from other organizations. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the strength of recommendations and confidence in the evidence. These serve as interim recommendations which are routinely updated given gaps of knowledge and lack of high-quality data on this evolving subject.

Results: Relevant existing literature related to methods of transmission, and ocular manifestations of SARS-CoV-2 are summarized. The data and clinical experiences driving recommendations for pre-operative, intraoperative and post-operative surgical considerations, anesthesia choice, as well as considerations for intravitreal injections are provided.

Conclusion: Recommendations are provided with the goal of protecting vitreoretinal surgeons and associated personnel from exposure to SARS-CoV-2 during interventional vitreoretinal procedures. This is a rapidly evolving topic with numerous remaining gaps in our current knowledge. As such, recommendations will evolve and the current manuscript is intended to serve as a foundation for continued dialogue on best practices.

Keywords: ASRS; COVID-19; GRADE; PPE; SARS-CoV-2; evidence; guidelines; recommendations; vitreoretinal surgery.

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Conflict of interest statement

Conflicts of Interests: J.S., C.C.W, Y.Y, A.M.B., T.M. are consultants for Alcon. A.E.K. is a consultant for Bausch and Lomb.

Figures

Figure 1.

Figure 1.

Key elements of the Grading of Recommendations Assessment, Development and Evaluation methodology (reproduced with permission from the U.S. GRADE network).

Figure 2.

Figure 2.

American Society of Retina Specialists recommendations updated May 25, 2020. COVID-19 indicates coronavirus disease 2019; GRADE, Grading of Recommendations Assessment, Development and Evaluation; MAC, monitored anesthesia care; OR, operating room.

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