Research Article

A Comprehensive Strategy for Laser Corneal Refractive Surgery during the COVID-19 Epidemic in a Tertiary Teaching Hospital in Wenzhou, China

Table 1

Main outpatient procedures and prevention/control measures.

Main processThe basic principlePrecautionsMedical staffPatients and family members

Triage① The entrance criteria of the hospital are strictly controlled: admission on the day of the appointment, health code (Annex 3) green, breathing mask compliance, body temperature <37.3°C, up to one companion, and conduct the epidemiological investigation. To those with no issues, colored signs are put on the clothes. (The colors can be different every day, and the effective time is marked.) The patient firstly goes through the epidemiological investigation and the details are entered in the electronic system of the outpatient clinic when he/she comes to the clinic.
② Refer to Annex 2 for the procedure of isolation and observation of patients with fever.
③ Open windows for ventilation during examination and consultation.
④ One patient, one doctor in one room. A family member can accompany if the patient is under the age of 18.
⑤ Everyone and everything gets sterilized: 75% alcohol cotton ball for the disinfection of instruments and appliances (such as test frames, slit lamp indirect ophthalmoscopy lens) where the patient touched (forehead bar, chin rest, etc.), hands-free disinfection solution to disinfect hands, follow “seven-step handwashing” after contact with tears or conjunctival secretions.
⑥ Guide the patients to remain scattered (keep distances with each other) and the family members to wait in a ventilated place, and set up conspicuous signs on the ground, isolation strips, seats, etc. to remind them to be at least 1.5 meters apart.
⑦ Medical staff scattered to have meals at different times and measure their temperature twice a day to report.
① In the epidemiological survey, a question was added asking “whether the patient or the people close to the patient is overseas Chinese or just returned from abroad.”
② Cotton gauze and respirators with noncompliant valves should be replaced in time.
① Wear a five-piece suit: surgical masks, hats, goggles, gloves, and work clothes.
② Slit lamp microscope shield installed to isolate droplets.
③ Wear a face shield when measuring intraocular pressure.
④ Disinfect the face shield and goggles before and after use. Antifog methods for eye masks include antibacterial hand sanitizer, soap-based detergent, iodophor, and antifogging agent [20].
① Wear a breathing mask (other protective equipment can be provided).
② The waiting area is equipped with disposable hand sanitizer.
Outpatient examination and consultation① All inspections are noncontact (referring to noncontact eye surface). Use a slit lamp indirect ophthalmoscopy lens to exam the fundus instead of a direct ophthalmoscope.
② Strengthened protective measures for noncontact tonometry include installing air barriers with isolation baffles; immediately after the measurement, use 75% alcohol spray to disinfect the air near the tonometer’s air outlet and wipe the air outlet; and extend the measurement interval between patients.
Consulting room schedule an operation