Manitoba among worst wait times for eye surgeries
Manitoba lags behind almost every other province when it comes to eye surgery wait times, according to recent data.
The latest report from the Canadian Institute for Health Information (CIHI) presented by Doctors Manitoba at a Zoom conference on Tuesday compared wait times between provinces from April 2020 to September 2021.
The data showed that Manitoba was second to last for cataract surgery wait times, with 39% of those patients having surgery within the 112-day benchmark, compared to 66% national scale. In Alberta, 64% of cataract patients had surgery within 112 days, and 63% of patients in Saskatchewan had surgery within that time. The pre-pandemic national benchmark was 70%.
The time sampled does not include data on the impact of delta, omicron and its subvariant, known as BA.2, on wait times.
Even taking into account the pandemic shutdowns, an eye surgeon at Winnipeg’s Misericordia Health Center said the province is already at the bottom of the scale for the country, and the pandemic has brought that to light.
Staff have struggled to perform eye surgeries during the shutdowns and staff redeployments, with the bulk being cataract surgeries, said eye doctor Dr Jennifer Rahman.
There is a backlog of about 9,300 cataract surgeries in the province — about the same number that are normally performed in a year, Rahman said. Last October, the backlog was 5,000 cataract surgeries.
There were backlogs in Manitoba elective eye surgery before the pandemic, she said, but data shows the pandemic has increased wait times.
“We have the second worst wait times in the country, and that’s not something to be proud of,” she said. “The [CIHI] report showed that there has been some improvement in the numbers, [but] it’s still pretty low.”
The health center runs one to two operating rooms and works on as many urgent and emergent surgeries as possible, Rahman said. This includes scheduling them in the evenings and on weekends.
“We don’t want to wait because it affects patients’ quality of life and overall outcomes,” Rahman said. “The longer we wait, especially for cataracts, the thicker they get and the harder it is to remove them. They can’t drive or work and they become vulnerable to things like falls. We want to preserve independence and people’s quality of life.
Cataract surgeries are classified as elective because they are not immediately life threatening, but they are necessary to save a person’s sight and must be performed in a timely manner.
She said the actual wait time for eye surgery is actually much longer because the data presented is only for the median time for both eyes. What the province really needs to report is the actual wait time for surgery to start, which can be up to one to two years.
“That is what is causing the backlog and it needs to be brought forward,” she said. Other eye surgeries, for conditions such as glaucoma or cancers, are scheduled according to a scale of priority. However, cataracts are almost inevitable for everyone as they age, Rahman said. As the population ages and more people require surgery, it becomes critical to address this sector of the backlog as soon as possible.
Another reason for the backlog is the shortage of ophthalmologists in Manitoba. There are an average of two per 100,000 people, Rahman said. Any solution to the backlog will have to include recruitment and training.
The province announced an expansion of the cataract surgery program at Misericordia last March, but Rahman said she was not given a firm date for when that will happen. The ideal situation would be to allow medical staff to continue treating as many uncapped public sector eye cases so that they can eliminate the backlog themselves.
There is no indication from the province whether ophthalmologists will be able to increase operations beyond their cap to clear the backlog.
The data also showed that Manitoba lags behind most of the country in terms of knee surgeries. From April 2020 to September 2021, CIHI analysis suggests that more than one-third – 38% – of Manitobans on the knee surgery waitlist received the procedure within the national benchmark of six months. Manitoba ranks second in this area, after Saskatchewan, where 30% of surgeries were performed within the six-month benchmark.
Before the pandemic, approximately 70% of patients in Canada had their knees replaced within six months.
There is good news from the analysis of the data from the province. Manitoba was able to maintain its life-saving levels of care throughout the 18 months sampled. In terms of radiation therapy, Manitoba was the only province to maintain a 100% rate of patients starting within the four-week benchmark. In terms of hip fractures, 89% of patients underwent surgery within the benchmark of 48 hours.
Analysis of the data can be viewed on CIHI’s website at https://bit.ly/3N4jhwi and Doctors Manitoba’s conclusions on this data at https://bit.ly/3ypIey4.
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