PURPOSE: To leverage a novel Data Integration Centre (DIC) infrastructure and real-world data to analyze pandemic-driven changes in the incidence, demographics, and management of corneal ulceration (H16.0) in a tertiary care setting.

METHODS: We conducted a retrospective single-center analysis of 3029 cases (2016-2024), stratified into pre-pandemic, pandemic, and post-pandemic periods. Data were sourced via the institutional DIC. We employed descriptive statistics and regression models to evaluate temporal trends, age/sex distributions, length of stay (LOS), and surgical interventions.

RESULTS: A significant structural shift from inpatient to outpatient care was observed, with outpatient cases rising by 70% during the pandemic while inpatient numbers declined. A notable demographic shift occurred, with a higher proportion of younger male patients (aged 30-40) affected during and after the pandemic. Mean LOS decreased progressively from 6.27 (pre-pandemic) to 4.13 days (post-pandemic). Despite an overall decline in surgical procedures, the rate of keratoplasties per 1000 patients increased significantly in the post-pandemic phase.

CONCLUSION: The COVID-19 pandemic precipitated a marked restructuring of care for corneal ulcers towards outpatient management and was associated with a distinct demographic shift. The increase in keratoplasty rates for the diagnosis of corneal ulcer after the pandemic could be due to a significantly changed local care structure during the pandemic and the prioritization of follow-up treatment for more difficult cases. This study demonstrates the practical utility of DIC-derived real-world data for health services research, providing robust evidence on evolving care patterns and disease burden.

CLINICAL TRIAL REGISTRATION NUMBER: The study was approved by the Ethics Committee of the Saxony Medical Association under reference number EK-BR-102/23-1 in accordance with the ICH-GCP-Guidelines.