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Publications

Journal Article Ahead of print

PubMed: 41886082 DOI: 10.1007/s00417-026-07155-x

Referral for glaucoma surgery and types of surgery in different European regions in 2025, the EURACCUR study.

Graefes Arch Clin Exp Ophthalmol

Authors: Jose Martinez-de-la-Casa, Ingeborg Stalmans, Luís Abegão-Pinto, Fotis Topouzis, Marta Pazos, Heny Beckers, Ingride Januleviciene, Francesco Oddone, Karl Mercieca, Ana Miguel, Gauti Jóhannesson, Miriam Kolko, Mia Zorić Geber, Barbara Cvenkel, Francis Carbonaro, Nikola Babic, Javier Garcia-Bardera, Mehmed Ikinci, Aurija Kalasauskiene, Gloria Roberti, Jan Henrik Simonsen, Tena Križ, Adrian Mifsud, Constance Liegl, Gábor Holló

Affiliations

  • Ophthalmology Service, Hospital Clinico San Carlos. Complutense University, Madrid, Spain.
  • Institute of Health Research, Hospital Clinico San Carlos (IdISSC), Madrid, Spain.
  • Department of Ophthalmology, University Hospitals, Leuven, Belgium.
  • Research Group Ophthalmology, Department of Neurosciences, KU Leuven, Leuven, Flanders, Belgium.
  • Department of Ophthalmology, Visual Sciences Study Center, ULS Santa Maria. Visual Sciences Study Center, Faculty of Medicine of Lisbon University, Lisbon, Portugal.
  • Department of Ophthalmology, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
  • Institute of Ophthalmology. Hospital Clínic Barcelona, Barcelona University, Institute of Health Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
  • University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands.
  • Eye clinic of Lithuanian University of Health Sciences, Kaunas, Lithuania.
  • IRCCS-Fondazione Bietti, Rome, Italy.
  • University Eye Clinic Bonn, Bonn, Germany.
  • Glaucoma Department, Ophthalmology, Private Hospital of la Baie, Avranches, France.
  • Central University Hospital of Caen, Caen, France.
  • Department of Clinical Sciences, Ophthalmology, Umeå University, Umeå, Sweden.
  • Department of Clinical Neuroscience, Karolinska Institutet, St Eriks Eye Hospital, Stockholm, Sweden.
  • Department of Ophthalmology, University of Iceland, Reykjavik, Iceland.
  • Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark.
  • Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
  • Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark.
  • Eye Hospital Your Eye Doctors, Rungsted Kyst, Denmark.
  • Department of Ophthalmology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
  • Department of Ophthalmology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
  • Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
  • Ophthalmic Department, Mater Dei Hospital, Msida, Malta.
  • Department of Twin Research, King's College, London, UK.
  • Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
  • University Eye Clinic, Clinical Center of Vojvodina, Novi Sad, Serbia.
  • Ophthalmology Service, Hospital Clinico San Carlos. Complutense University, Madrid, Spain.
  • University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands.
  • Solymár. Ophthalmology Center, Tutkimusz Ltd, Budapest, Hungary.
  • Prima Medica Health Center, Budapest, Hungary.

Abstract

PURPOSE

To investigate the characteristics of referral for glaucoma surgery and compare surgical practices in various European regions in 2025.

METHODS

Data of 300 eyes of 300 consecutive patients undergoing glaucoma surgery were analysed using a standardized questionnaire and compared between geographical regions. Glaucoma specialists from one centre per country provided data on demographics, glaucoma types, intraocular pressure (IOP), visual field and structural metrics, types of surgery and referral timeliness (timely, later than optimal, late).

RESULTS

The median (quartiles) age was 72 (64-78) years. Primary open angle glaucoma (52.0%) and pseudoexfoliative glaucoma (23.0%) were the most common glaucoma types. Median disease duration was 75 (28-144) months, preoperative IOP 22 (18-28) mmHg, mean deviation - 14.47 (- 21.60 to - 7.85) dB, and retinal nerve fibre layer thickness 60 (50-75) µm. Trabeculectomy (38.3%), minimally invasive bleb forming surgeries (28.3%), and drainage devices (11.3%) were the predominant procedures; 18.7% of the surgeries were combined with phacoemulsification. More severe disease was associated with filtering or drainage device surgery (p < 0.001). Referral was timely in 34.7%, later than optimal in 35.7%, and late in 29.7%. Late referrals were associated with higher IOP, more advanced MD, and thinner RNFL (p < 0.001). Regional differences were significant for common glaucoma types (p = 0.013) and surgical choice (p < 0.0001). Late and later-than-optimal referrals ranged between 22% and 38.3%, and 30.0% and 41.7% between the regions, respectively. The proportion of timely referrals in the East European region (20%) was significantly lower than that in the South and West European (approximately 40%) and North European (31.7%) regions (p = 0.019).

CONCLUSIONS

Marked differences exist in Europe in glaucoma referral timeliness and surgical practice. Late referral remains frequent and associated with advanced structural and functional damage in Europe.

MeSH

Drainage, Ophthalmology, Glaucoma, Open-Angle, Glaucoma