Local, News

Sector welcomes reintroduction of sight-saving elective procedures

Cataract surgery will recommence from Monday 27 April after the Federal Government announced the first phase in a gradual loosening of elective surgery restrictions.

RANZCO has welcomed the move, which was confirmed following a National Cabinet meeting on Tuesday that included Prime Minister Mr Scott Morrison, state premiers and chief ministers.

Heather Mack.

The first wave elective of surgeries that can recommence after the Anzac Day weekend are all Category 2 procedures, and ‘important’ Category 3 surgeries. They include “cataracts and eye procedures”, as well as IVF, joint replacement, breast reconstruction and dental procedures, among others.

It is estimated that the staged reintroduction will see one in four cancelled elective surgery operating lists reopened, with flexibility for states to determine the appropriate levels of surgery within the general framework.

In a statement, RANZCO stated it had been working closely with Federal Health Minister Mr Greg Hunt’s office to ensure Australians can begin receiving sight-saving procedures, such as cataract surgery, once the government deemed the situation appropriate.

“Continuing to adhere to government guidelines, RANZCO Fellows will be able to resume this procedure from 27 April. RANZCO will be updating its COVID-19 guidelines once details of the resumption of surgery is provided by the government,” the college said.

RANZCO president Associate Professor Heather Mack said ophthalmologists were eager to restart surgery now that the government had given the green light.

“Cataract is the most performed surgery in Australia with a growing backlog. It is especially important that vulnerable Australians are able to have their vision restored. We know this sight-saving procedure improves mental and physical health, preventing falls and other injuries.”

Peter Sumich.

Australian Society of Ophthalmologists president Dr Peter Sumich also welcomed a responsible return to elective surgery.

“I think all the private surgeries have played their role in standing down while the emergency was on,” he said.

“We’ve been in discussions with local government groups about how we can help and it turns out that our help at the moment isn’t required because they have capacity to cope. But we are available to step down again if it’s needed.

“This whole restart as premised on the fact we are able to step down if we are required to [again].”

Cataracts a ‘high value’ procedure

Elective surgeries were cancelled on 1 April to free up bed space and resources amid concerns about the strain coronavirus patients could place on the healthcare system.

Earlier this week, Hunt signalled a resumption of elective surgery after Australia received 60 million face masks, with another 100 million more set to arrive at the end of May.

As a result of Australia’s success in flattening the curve, its low rates of COVID-related hospitalisation and new data on personal protection equipment (PPE) stocks, it is now commencing a stage reintroduction of elective surgeries. The arrangement will be reviewed by 11 May to determine if other elective surgeries can recommence and volumes increased.

Andrew Chang.

During the course of the outbreak, RANZCO supported the government’s decision to halt non-urgent surgery. However, with a sustained flattening of the curve, it is now backing a gradual easing of restrictions to ensure Australians can regain access to sight-saving surgery.

Associate Professor Andrew Chang, a RANZCO board director and head of ophthalmology at the Sydney Eye Hospital, told Insight the college welcomed a “staged approach” to the resumption of elective surgery.

He said eye surgeries were effective and life-changing procedures that had a low risk of cross-transmission of infection. In particular, cataract surgery could be among the first to restart because it is considered a high value and high impact procedure that produces predictable outcomes without draining vital PPE supplies and resources.

“If you consider major surgery, which are aerosol generating procedures and general anaesthesia, then full PPE is needed and this is needed by the surgeons, the nursing staff and the anaesthetist. But cataract surgery is performed under local anaesthetic, the drapes cover the mouth and nose, reducing the risk of cross transmission, which is why cataract surgery may be considered for early lifting of the suspension of elective surgery,” he said.

“We also appreciate that access to PPE has been a real concern for the government and an issue for the medical sector as a whole. The disposable equipment that we use is pre-packaged especially for eye surgery, which include drapes and gowns, and this does not reduce the national stockpile of PPE required for COVID patients.”

Chang added that cataract patients could typically be sent home on the same day after surgery, meaning they would not occupy hospital bed space.

PPE used for cataract surgery and other ophthalmic procedures would not impact the national stockpile.

RANZCO has produced its own COVID-19 Triage Guidelines to ensure the safety of patients and ophthalmologists. Chang said eyecare professionals also understood the mandated requirements, which would be observed when any elective surgery recommences.

“Hospitals have made changes to their waiting rooms, staggered patients so they are further apart and have encouraged patients to attend with only one escort, which is helping reduce the number of people entering the facilities,” he said.

Ophthalmologists would also review and update their treatment protocols to minimise the number of face-to-face appointments following surgeries, Chang added.

Morrison said delaying elective surgeries could worsen health outcomes, increase anxiety and reduce social and economic productivity.

“National Cabinet again thanked Australia’s health care professionals for their work to support our COVID-19 response,” he said.

Send this to a friend