Impact of Covid-19 Pandemic on Surgical Volume, Clinical Presentations, and Management of Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis Publisher



Asadigandomani H ; Tahmasebi A ; Jalilzadeh M ; Arab Bafrani M ; Mahmoudi F ; Daneshvar K ; Zonouzi S K ; Riazi Esfahani H ; Khalili Pour E
Source: SAGE Open Medicine Published:2026

Abstract

Purpose: To systematically evaluate the impact of the COVID-19 pandemic, particularly lockdown (LD) periods, on the incidence, clinical presentations, surgical management, and outcomes of rhegmatogenous retinal detachment (RRD). Methods: A systematic literature search was conducted in PubMed, Embase, and Web of Science up to June 2025. Observational studies comparing RRD patients during COVID-19 LDs or pandemic periods with pre-pandemic controls were included. Outcomes assessed included RRD incidence, baseline clinical characteristics, intervals from symptom onset to first visit and surgery, surgical interventions, and anatomical and visual outcomes. Meta-analyses were performed for comparable outcomes using random- or fixed-effects models based on heterogeneity. Results: Twenty-nine observational studies involving more than 116,000 eyes were included. COVID-19–related restrictions were associated with a significant reduction in RRD surgical volume (rate ratio 0.71; 95% CI: 0.60–0.84), although marked regional heterogeneity was observed. Marked heterogeneity across studies appeared to be partly related to differences in LD severity, duration, and regional healthcare system burden. Patients presenting during LD periods were significantly less likely to have macula-on RRD (OR = 0.61; 95% CI: 0.46–0.83) and more likely to exhibit moderate-to-severe proliferative vitreoretinopathy (PVR) (OR = 2.58; 95% CI: 1.37–4.87) compared with pre-LD periods. Time from symptom onset to surgery increased during LD periods, while presentation-to-surgery intervals decreased. Surgical practice shifted toward greater use of pars plana vitrectomy (PPV), often combined with longer-acting gas tamponades or silicone oil. Despite increased disease severity, single-surgery retinal attachment rates and postoperative visual outcomes remained largely unchanged across periods. Conclusions: The COVID-19 pandemic had substantial and region-specific effects on RRD management, influencing patient presentation patterns, disease severity, and surgical strategies. Nevertheless, adaptive healthcare responses helped preserve overall anatomical and visual outcomes. © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).