Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers

Roberto Dell’Omo; Roberto Dell'Omo; Mariaelena Filippelli; Gianni Virgili; Francesco Bandello; Giuseppe Querques; Paolo Lanzetta; Teresio Avitabile; Francesco Viola; Michele Reibaldi; Francesco Semeraro; Luciano Quaranta; Stanislao Rizzo; Edoardo Midena; Giuseppe Campagna; Ciro Costagliola; Paola Marolo; Carlo Enrico Traverso; Michele Iester; Carlo Alberto Cutolo; Claudio Azzolini; Simone Donati; Elias Premi; Paolo Nucci; Stela Vujosevic; Giovanni Staurenghi; Ferdinando Bottoni; Francesco Romano; Federica Romano; Domenico Grosso; Enrico Borrelli; Riccardo Sacconi; Paolo Milella; Simone Ganci; Mario R. Romano; Gabriella Ricciardelli; Davide Allegrini; Marco Casaluci; Davide Romano; Giorgio Marchini; Francesca Chemello; Camilla Amantea; Carlotta Amantea; Rino Frisina; Elisabetta Pilotto; Raffaele Parrozzani; Daniele Veritti; Valentina Sarao; Tognetto Daniele; Massimo Busin; Francesco Parmeggiani; Katia De Nadai; Luca Furiosi; Rodolfo Mastropasqua; Bruno Battaglia; Matteo Gironi; Marco Gironi; Stefano Gandolfi; Enrico Luciani; Paolo Mora; Costantino Schiavi; Patrizia Bertaccini; Paolo Antonio Bertaccini; Alessandro Finzi; Matilde Roda; Carlo Cagini; Marco Lupidi; Fabrizio Giansanti; Daniela Bacherini; Gianmarco Tosi; Elena De Benedetto; Marco Nardi; Michele Figus; Chiara Posarelli; Cesare Mariotti; Vittorio Pirani; Michele Nicolai; Massimo Nicolai; Stefano Bonini; Marco Coassin; Antonio Di Zazzo; Maria Cristina Savastano; Alfonso Savastano; Gloria Gambini; Umberto De Vico; Leopoldo Spadea; Andrea Iannaccone; Carlo Nucci; Federico Ricci; Francesco Aiello; Gabriele Gallo Afflitto; Leonardo Mastropasqua; Giada D’Onofio; Federica Evangelista; Lorenza Brescia; Pasquale Napolitano; Paolo Polisena; Nicolina Gianfrancesco; Domenico Trivisonno; Francesco Petti; Francesca Simonelli; Settimio Rossi; Antonio Tartaglione; Nicola Rosa; Maddalena De Bernardo; Cristiana Iaculli; Anna Valeria Bux; Giulia Maggiore; Giuseppe Maggiore; Francesco Boscia; Giancarlo Sborgia; Maria Oliva Grassi; Vincenzo Scorcia; Giuseppe Giannaccare; Guglielmo Parisi; Giuseppe Parisi; Salvatore Cillino; Francesco Alaimo; Pasquale Aragona; Alessandro Meduri; Antonio Pinna; Andrea Sollazzo; Enrico Peiretti; Emanuele Siotto

doi:10.1177/11206721211002442

Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers

Roberto Dell’Omo, Roberto Dell'Omo, Mariaelena Filippelli, Gianni Virgili, Francesco Bandello, Giuseppe Querques, Paolo Lanzetta, Teresio Avitabile, Francesco Viola, Michele Reibaldi, Francesco Semeraro, Luciano Quaranta, Stanislao Rizzo, Edoardo Midena, Giuseppe Campagna, Ciro Costagliola, Paola Marolo, Carlo Enrico Traverso, Michele Iester, Carlo Alberto CutoloClaudio Azzolini, Simone Donati, Elias Premi, Paolo Nucci, Stela Vujosevic, Giovanni Staurenghi, Ferdinando Bottoni, Francesco Romano, Federica Romano, Domenico Grosso, Enrico Borrelli, Riccardo Sacconi, Paolo Milella, Simone Ganci, Mario R. Romano, Gabriella Ricciardelli, Davide Allegrini, Marco Casaluci, Davide Romano, Giorgio Marchini, Francesca Chemello, Camilla Amantea, Carlotta Amantea, Rino Frisina, Elisabetta Pilotto, Raffaele Parrozzani, Daniele Veritti, Valentina Sarao, Tognetto Daniele, Massimo Busin, Francesco Parmeggiani, Katia De Nadai, Luca Furiosi, Rodolfo Mastropasqua, Bruno Battaglia, Matteo Gironi, Marco Gironi, Stefano Gandolfi, Enrico Luciani, Paolo Mora, Costantino Schiavi, Patrizia Bertaccini, Paolo Antonio Bertaccini, Alessandro Finzi, Matilde Roda, Carlo Cagini, Marco Lupidi, Fabrizio Giansanti, Daniela Bacherini, Gianmarco Tosi, Elena De Benedetto, Marco Nardi, Michele Figus, Chiara Posarelli, Cesare Mariotti, Vittorio Pirani, Michele Nicolai, Massimo Nicolai, Stefano Bonini, Marco Coassin, Antonio Di Zazzo, Maria Cristina Savastano, Alfonso Savastano, Gloria Gambini, Umberto De Vico, Leopoldo Spadea, Andrea Iannaccone, Carlo Nucci, Federico Ricci, Francesco Aiello, Gabriele Gallo Afflitto, Leonardo Mastropasqua, Giada D’Onofio, Federica Evangelista, Lorenza Brescia, Pasquale Napolitano, Paolo Polisena, Nicolina Gianfrancesco, Domenico Trivisonno, Francesco Petti, Francesca Simonelli, Settimio Rossi, Antonio Tartaglione, Nicola Rosa, Maddalena De Bernardo, Cristiana Iaculli, Anna Valeria Bux, Giulia Maggiore, Giuseppe Maggiore, Francesco Boscia, Giancarlo Sborgia, Maria Oliva Grassi, Vincenzo Scorcia, Giuseppe Giannaccare, Guglielmo Parisi, Giuseppe Parisi, Salvatore Cillino, Francesco Alaimo, Pasquale Aragona, Alessandro Meduri, Antonio Pinna, Andrea Sollazzo, Enrico Peiretti, Emanuele Siotto

Risultato della ricerca: Contributo in rivista › Articolo in rivista

Abstract

Background/objectives: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). Methods: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant. Results: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65–0.80 and 0.61–0.75, respectively, p < 0.001 for both). Conclusion: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.

Lingua originale	English
pagine (da-a)	695-703
Numero di pagine	9
Rivista	European Journal of Ophthalmology
Volume	32
DOI	https://doi.org/10.1177/11206721211002442
Stato di pubblicazione	Pubblicato - 2022

Keywords

Trauma
choroidal neovascular membranes
corneal transplantation
glaucoma
phacoemulsification
retinal detachment
venous occlusive disease

Accesso al documento

10.1177/11206721211002442

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Dell’Omo, R., Dell'Omo, R., Filippelli, M., Virgili, G., Bandello, F., Querques, G., Lanzetta, P., Avitabile, T., Viola, F., Reibaldi, M., Semeraro, F., Quaranta, L., Rizzo, S., Midena, E., Campagna, G., Costagliola, C., Marolo, P., Traverso, C. E., Iester, M., ... Siotto, E. (2022). Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers. European Journal of Ophthalmology, 32, 695-703. https://doi.org/10.1177/11206721211002442

@article{9336e4a7afce4b94a9b11b0faca45ad2,

title = "Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers",

abstract = "Background/objectives: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). Methods: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant. Results: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65–0.80 and 0.61–0.75, respectively, p < 0.001 for both). Conclusion: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.",

keywords = "Trauma, choroidal neovascular membranes, corneal transplantation, glaucoma, phacoemulsification, retinal detachment, venous occlusive disease, Trauma, choroidal neovascular membranes, corneal transplantation, glaucoma, phacoemulsification, retinal detachment, venous occlusive disease",

author = "Roberto Dell{\textquoteright}Omo and Roberto Dell'Omo and Mariaelena Filippelli and Gianni Virgili and Francesco Bandello and Giuseppe Querques and Paolo Lanzetta and Teresio Avitabile and Francesco Viola and Michele Reibaldi and Francesco Semeraro and Luciano Quaranta and Stanislao Rizzo and Edoardo Midena and Giuseppe Campagna and Ciro Costagliola and Paola Marolo and Traverso, {Carlo Enrico} and Michele Iester and Cutolo, {Carlo Alberto} and Claudio Azzolini and Simone Donati and Elias Premi and Paolo Nucci and Stela Vujosevic and Giovanni Staurenghi and Ferdinando Bottoni and Francesco Romano and Federica Romano and Domenico Grosso and Enrico Borrelli and Riccardo Sacconi and Paolo Milella and Simone Ganci and Romano, {Mario R.} and Gabriella Ricciardelli and Davide Allegrini and Marco Casaluci and Davide Romano and Giorgio Marchini and Francesca Chemello and Camilla Amantea and Carlotta Amantea and Rino Frisina and Elisabetta Pilotto and Raffaele Parrozzani and Daniele Veritti and Valentina Sarao and Tognetto Daniele and Massimo Busin and Francesco Parmeggiani and {De Nadai}, Katia and Luca Furiosi and Rodolfo Mastropasqua and Bruno Battaglia and Matteo Gironi and Marco Gironi and Stefano Gandolfi and Enrico Luciani and Paolo Mora and Costantino Schiavi and Patrizia Bertaccini and Bertaccini, {Paolo Antonio} and Alessandro Finzi and Matilde Roda and Carlo Cagini and Marco Lupidi and Fabrizio Giansanti and Daniela Bacherini and Gianmarco Tosi and {De Benedetto}, Elena and Marco Nardi and Michele Figus and Chiara Posarelli and Cesare Mariotti and Vittorio Pirani and Michele Nicolai and Massimo Nicolai and Stefano Bonini and Marco Coassin and {Di Zazzo}, Antonio and Savastano, {Maria Cristina} and Alfonso Savastano and Gloria Gambini and Vico, {Umberto De} and Leopoldo Spadea and Andrea Iannaccone and Carlo Nucci and Federico Ricci and Francesco Aiello and Afflitto, {Gabriele Gallo} and Leonardo Mastropasqua and Giada D{\textquoteright}Onofio and Federica Evangelista and Lorenza Brescia and Pasquale Napolitano and Paolo Polisena and Nicolina Gianfrancesco and Domenico Trivisonno and Francesco Petti and Francesca Simonelli and Settimio Rossi and Antonio Tartaglione and Nicola Rosa and Bernardo, {Maddalena De} and Cristiana Iaculli and {Valeria Bux}, Anna and Giulia Maggiore and Giuseppe Maggiore and Francesco Boscia and Giancarlo Sborgia and Grassi, {Maria Oliva} and Vincenzo Scorcia and Giuseppe Giannaccare and Guglielmo Parisi and Giuseppe Parisi and Salvatore Cillino and Francesco Alaimo and Pasquale Aragona and Alessandro Meduri and Antonio Pinna and Andrea Sollazzo and Enrico Peiretti and Emanuele Siotto",

year = "2022",

doi = "10.1177/11206721211002442",

language = "English",

volume = "32",

pages = "695--703",

journal = "European Journal of Ophthalmology",

issn = "1120-6721",

publisher = "Wichtig Publishing Srl",

}

Dell’Omo, R, Dell'Omo, R, Filippelli, M, Virgili, G, Bandello, F, Querques, G, Lanzetta, P, Avitabile, T, Viola, F, Reibaldi, M, Semeraro, F, Quaranta, L, Rizzo, S, Midena, E, Campagna, G, Costagliola, C, Marolo, P, Traverso, CE, Iester, M, Cutolo, CA, Azzolini, C, Donati, S, Premi, E, Nucci, P, Vujosevic, S, Staurenghi, G, Bottoni, F, Romano, F, Romano, F, Grosso, D, Borrelli, E, Sacconi, R, Milella, P, Ganci, S, Romano, MR, Ricciardelli, G, Allegrini, D, Casaluci, M, Romano, D, Marchini, G, Chemello, F, Amantea, C, Amantea, C, Frisina, R, Pilotto, E, Parrozzani, R, Veritti, D, Sarao, V, Daniele, T, Busin, M, Parmeggiani, F, De Nadai, K, Furiosi, L, Mastropasqua, R, Battaglia, B, Gironi, M, Gironi, M, Gandolfi, S, Luciani, E, Mora, P, Schiavi, C, Bertaccini, P, Bertaccini, PA, Finzi, A, Roda, M, Cagini, C, Lupidi, M, Giansanti, F, Bacherini, D, Tosi, G, De Benedetto, E, Nardi, M, Figus, M, Posarelli, C, Mariotti, C, Pirani, V, Nicolai, M, Nicolai, M, Bonini, S, Coassin, M, Di Zazzo, A, Savastano, MC, Savastano, A, Gambini, G, Vico, UD, Spadea, L, Iannaccone, A, Nucci, C, Ricci, F, Aiello, F, Afflitto, GG, Mastropasqua, L, D’Onofio, G, Evangelista, F, Brescia, L, Napolitano, P, Polisena, P, Gianfrancesco, N, Trivisonno, D, Petti, F, Simonelli, F, Rossi, S, Tartaglione, A, Rosa, N, Bernardo, MD, Iaculli, C, Valeria Bux, A, Maggiore, G, Maggiore, G, Boscia, F, Sborgia, G, Grassi, MO, Scorcia, V, Giannaccare, G, Parisi, G, Parisi, G, Cillino, S, Alaimo, F, Aragona, P, Meduri, A, Pinna, A, Sollazzo, A, Peiretti, E & Siotto, E 2022, 'Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers', European Journal of Ophthalmology, vol. 32, pagg. 695-703. https://doi.org/10.1177/11206721211002442

TY - JOUR

T1 - Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers

AU - Dell’Omo, Roberto

AU - Dell'Omo, Roberto

AU - Filippelli, Mariaelena

AU - Virgili, Gianni

AU - Bandello, Francesco

AU - Querques, Giuseppe

AU - Lanzetta, Paolo

AU - Avitabile, Teresio

AU - Viola, Francesco

AU - Reibaldi, Michele

AU - Semeraro, Francesco

AU - Quaranta, Luciano

AU - Rizzo, Stanislao

AU - Midena, Edoardo

AU - Campagna, Giuseppe

AU - Costagliola, Ciro

AU - Marolo, Paola

AU - Traverso, Carlo Enrico

AU - Iester, Michele

AU - Cutolo, Carlo Alberto

AU - Azzolini, Claudio

AU - Donati, Simone

AU - Premi, Elias

AU - Nucci, Paolo

AU - Vujosevic, Stela

AU - Staurenghi, Giovanni

AU - Bottoni, Ferdinando

AU - Romano, Francesco

AU - Romano, Federica

AU - Grosso, Domenico

AU - Borrelli, Enrico

AU - Sacconi, Riccardo

AU - Milella, Paolo

AU - Ganci, Simone

AU - Romano, Mario R.

AU - Ricciardelli, Gabriella

AU - Allegrini, Davide

AU - Casaluci, Marco

AU - Romano, Davide

AU - Marchini, Giorgio

AU - Chemello, Francesca

AU - Amantea, Camilla

AU - Amantea, Carlotta

AU - Frisina, Rino

AU - Pilotto, Elisabetta

AU - Parrozzani, Raffaele

AU - Veritti, Daniele

AU - Sarao, Valentina

AU - Daniele, Tognetto

AU - Busin, Massimo

AU - Parmeggiani, Francesco

AU - De Nadai, Katia

AU - Furiosi, Luca

AU - Mastropasqua, Rodolfo

AU - Battaglia, Bruno

AU - Gironi, Matteo

AU - Gironi, Marco

AU - Gandolfi, Stefano

AU - Luciani, Enrico

AU - Mora, Paolo

AU - Schiavi, Costantino

AU - Bertaccini, Patrizia

AU - Bertaccini, Paolo Antonio

AU - Finzi, Alessandro

AU - Roda, Matilde

AU - Cagini, Carlo

AU - Lupidi, Marco

AU - Giansanti, Fabrizio

AU - Bacherini, Daniela

AU - Tosi, Gianmarco

AU - De Benedetto, Elena

AU - Nardi, Marco

AU - Figus, Michele

AU - Posarelli, Chiara

AU - Mariotti, Cesare

AU - Pirani, Vittorio

AU - Nicolai, Michele

AU - Nicolai, Massimo

AU - Bonini, Stefano

AU - Coassin, Marco

AU - Di Zazzo, Antonio

AU - Savastano, Maria Cristina

AU - Savastano, Alfonso

AU - Gambini, Gloria

AU - Vico, Umberto De

AU - Spadea, Leopoldo

AU - Iannaccone, Andrea

AU - Nucci, Carlo

AU - Ricci, Federico

AU - Aiello, Francesco

AU - Afflitto, Gabriele Gallo

AU - Mastropasqua, Leonardo

AU - D’Onofio, Giada

AU - Evangelista, Federica

AU - Brescia, Lorenza

AU - Napolitano, Pasquale

AU - Polisena, Paolo

AU - Gianfrancesco, Nicolina

AU - Trivisonno, Domenico

AU - Petti, Francesco

AU - Simonelli, Francesca

AU - Rossi, Settimio

AU - Tartaglione, Antonio

AU - Rosa, Nicola

AU - Bernardo, Maddalena De

AU - Iaculli, Cristiana

AU - Valeria Bux, Anna

AU - Maggiore, Giulia

AU - Maggiore, Giuseppe

AU - Boscia, Francesco

AU - Sborgia, Giancarlo

AU - Grassi, Maria Oliva

AU - Scorcia, Vincenzo

AU - Giannaccare, Giuseppe

AU - Parisi, Guglielmo

AU - Parisi, Giuseppe

AU - Cillino, Salvatore

AU - Alaimo, Francesco

AU - Aragona, Pasquale

AU - Meduri, Alessandro

AU - Pinna, Antonio

AU - Sollazzo, Andrea

AU - Peiretti, Enrico

AU - Siotto, Emanuele

PY - 2022

Y1 - 2022

N2 - Background/objectives: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). Methods: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant. Results: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65–0.80 and 0.61–0.75, respectively, p < 0.001 for both). Conclusion: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.

AB - Background/objectives: To compare the number of eye surgical procedures performed in Italy in the 2 months following the beginning of lockdown (study period) because of COVID-19 epidemic with those performed in the two earlier months of the same year (intra-year control) and in the period of 2019 corresponding to the lockdown (inter-year control). Methods: Retrospective analysis of surgical procedures carried out at 39 Academic hospitals. A distinction was made between elective and urgent procedures. Intravitreal injections were also considered. Percentages for all surgical procedures and incidence rate ratios (IRR) for rhegmatogenous retinal detachment (RRD) events were calculated. A p value <0.05 was considered significant. Results: A total of 20,886 versus 55,259 and 56,640 patients underwent surgery during the lockdown versus intra-and inter-year control periods, respectively. During the lockdown, only 70% of patients for whom an operation/intravitreal injection was recommended, finally underwent surgery; the remaining patients did not attend because afraid of getting infected at the hospital (23%), taking public transportation (6.5%), or unavailable swabs (0.5%). Elective surgeries were reduced by 96.2% and 96.4%, urgent surgeries by 49.7% and 50.2%, and intravitreal injections by 48.5% and 48.6% in the lockdown period in comparison to intra-year and inter-year control periods, respectively. IRRs for RRDs during lockdown dropped significantly in comparison with intra- and inter-year control periods (CI: 0.65–0.80 and 0.61–0.75, respectively, p < 0.001 for both). Conclusion: This study provides a quantitative analysis of the reduction of eye surgical procedures performed in Italy because of the COVID-19 epidemic.

KW - Trauma

KW - choroidal neovascular membranes

KW - corneal transplantation

KW - glaucoma

KW - phacoemulsification

KW - retinal detachment

KW - venous occlusive disease

KW - Trauma

KW - choroidal neovascular membranes

KW - corneal transplantation

KW - glaucoma

KW - phacoemulsification

KW - retinal detachment

KW - venous occlusive disease

UR - http://hdl.handle.net/10807/247397

U2 - 10.1177/11206721211002442

DO - 10.1177/11206721211002442

M3 - Article

SN - 1120-6721

VL - 32

SP - 695

EP - 703

JO - European Journal of Ophthalmology

JF - European Journal of Ophthalmology

ER -

Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers

Abstract

Keywords

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