LAUSR

Because of the COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the American Academy of Ophthalmology issued a statement on March 18, 2020, urging all ophthalmologists across the country to immediately cease providing any nonurgent treatment. In accordance with this national recommendation, all elective ophthalmic procedures were suspended at the University of Miami Bascom Palmer Eye Institute (BPEI) on March 18, 2020. The state of Florida adopted a 3-phased reopening approach starting with phase I beginning May 18, 2020, which allowed most businesses to reopen to 50% capacity whereas still urging people older than 65 years to stay at home. As a part of Florida’s phase I of reopening, BPEI resumed elective ophthalmic procedures starting May 18, 2020. To provide the safest environment possible, every ophthalmic procedure patient at BPEI, including at the refractive surgery center, was required to pass a symptom screening questionnaire to ensure they were asymptomatic. In addition, all asymptomatic patients were required to undergo a COVID-19 reverse transcription polymerase chain reaction (RT-PCR) nasopharyngeal swab test performed by trained nurses at BPEI and analyzed in the University of Miami Pathology Laboratory within 72 hours of their procedure, and the result has to be negative. Despite alarming increases in COVID-19 infections (eg, Florida reported over 15 000 new cases along with a test positivity rate reaching more than 15% on July 11, 2020), we observed that few of our refractive surgery center patients were testing COVID-19–positive. We report our case series on prevalence of COVID-19, as assessed by a positive COVID19 RT-PCR nasopharyngeal swab test, in asymptomatic patients at our refractive surgery center. This retrospective cross-sectional study was approved by the University of Miami Institutional Review Board and adhered to the tenets in the Declaration of Helsinki. All asymptomatic patients at the BPEI refractive surgery center from June to October 2020 were included. Symptom screening followed guidelines of University of Miami and, thus, evolved over time but consistently contained questions querying COVID-19 history, exposure, symptoms, and travel. After screening asymptomatic, patients were scheduled for COVID-19 RT-PCR nasopharyngeal swab testing within 72 hours of their procedure date. Our main outcome measure was COVID-19 RT-PCR test positivity. Basic demographic and procedure data were also collected. The Miami-Dade county COVID-19 testing and positivity data from June to October 2020 were extracted from the Centers for Disease Control and Prevention database for comparison. Patient demographics and procedures performed are summarized in Table 1. Only 7 (1.7%) of our asymptomatic patients at our refractive surgery center tested positive for COVID-19. As shown in Figure 1, the COVID-19 prevalence ranged from 0% in October to 2.6% in July and August. The Centers for Disease Control and Prevention reported a 7-day average of 22 682 COVID-19 tests administered throughout Miami-Dade County during our study period from June to October 2020, with a positivity