@article{98ac54051d464f2191461ce876f3080d,
title = "Referral for first glaucoma surgery in Europe, the ReF-GS study",
abstract = "Purpose: To analyze the appropriateness of referrals for incisional glaucoma-surgery in Europe. Methods: Referrals for the first open-angle glaucoma surgery between January and October 2017 were analyzed in 18 countries: 8 {"}old{"} European Union, 7 {"}new{"} European Union and 3 non-European Union European countries. Results: Most eyes had primary open-angle or exfoliative glaucoma. The average mean deviation was -13.8 dB with split fixation in 44.3%. No structural progression analysis was made before the referrals. The most common medications were the combination of a prostaglandin analog, timolol and a carbonic anhydrase inhibitor (30.0%), and all other combinations comprising > 3 molecules (33.8%). Laser trabeculoplasty was reported in only 18.4%. Of the 294 referrals, 41.5% were appropriate and timely, 35.0% appropriate but later than optimal, and 17.6% appropriate but too late (minimal vision maintained). The treatment period was significantly longer (median: 7 years) in the {"}old{"} European Union countries than in the other groups (3 and 2 years, respectively). No between-group differences were seen in intraocular pressure and mean deviation, but the non-European Union group referred the patients at significantly lower cup/disk ratio and eye drop usage than the other groups. Split fixation was significantly more common in the {"}old{"} (60.6%) than the {"}new{"} European Union countries (38.7%), and in both EU country-groups than in the non-European Union countries (13.6%). Conclusions: Of 294 European open-angle glaucoma referrals for first glaucoma-surgery, 41.5% were completely satisfactory. The damage was typically advanced, and the care varied considerably among the countries. This suggests that further efforts are necessary to improve glaucoma care in Europe.",
keywords = "Blindness, Europe, European Union, glaucoma surgery, referral, therapy, PROGRESSION",
author = "Gabor Hollo and Doreen Schmidl and Anton Hommer and I. Stalmans and T. Daphne and M. Fichtl and E. Ruzickova and L. Rezkova and Bron, {A. M.} and Hoffmann, {E. M.} and A. Klezlova and C. Erb and N. Zimmermann and P. Kothy and A. Gandolfi and L. Varano and N. Ungaro and Januleviciene and L. Kuzmiene and Beckers, {H. J. M.} and Grabska-Liberek and J. Majszyk-Ionescu and A. Skowyra and A. Plichta and Alina Popa-Cherecheanu and Dorin Chiselita and A. Brezhnev and A. Baranov and N. Babic and A. Miljkovic and Ferkova, {S. L.} and B. Cvenkel and Julian Garcia-Feijoo and {Sanchez Jean}, Ruben and Taube, {Botling A.} and M. Irkec and S. Kocabeyoglu and C. Vass and {ReF-GS Investigators}",
note = "Funding Information: The ReF-GS Study Investigators: Vass C, Department of Ophthalmology and Optometry, Medical University Vienna, Vienna?Austria; Stalmans I, Daphn? T, Department of Ophthalmology, University Hospitals UZ Leuven, Leuven?Belgium; Fichtl M, Ruzickova E, Rezkova L, Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic; Bron AM, Department of Ophthalmology, University Hospital, Dijon?France; Hoffmann EM, Klezlova A, Department of Ophthalmology, University Medical Center Mainz?Germany; Erb C, Zimmermann N, Eye Clinic Wittenbergplatz, Berlin?Germany; Holl? G, K?thy P, Department of Ophthalmology, Semmelweis University, Budapest?Hungary; Gandolfi A, Varano L, Ungaro N, Department of Ophthalmology, University of Parma?Italy; Januleviciene I, Kuzmiene L, Eye Clinic of Lithuanian University of Health Sciences, Kaunas?Lithuania; Beckers HJM, University Eye Clinic, Maastricht University Medical Center?the Netherlands; Grabska-Liberek I, Majszyk-Ionescu J, Skowyra A, Plichta A, Department of Ophthalmology, Medical Center of Postgraduate Education, Warsaw?Poland; Alina Popa-Cherecheanu, Department of Ophthalmology, ?Carol Davila? University of Medicine and Pharmacy, University Emergency Hospital, Bucharest?Romania; Dorin Chiselita, Department of Ophthalmology, ?Gr. T. Popa? University of Medicine and Pharmacy, ?Sf. Spiridon? Emergency County Hospital, Iasi?Romania; Brezhnev A., Baranov V. Department of Ophthalmology, Kursk State Medical University, Kursk?Russia; Babi? N, Miljkovi? A, Eye Clinic KC Vojvodina, Medical faculty, University of Novi Sad?Serbia; Ferkov? S L, Department of Ophthalmology, Comenius University, Bratislava?Slovakia; Cvenkel B, Department of Ophthalmology, University Medical Center, Ljubljana?Slovenia; Julian Garcia-Feijoo, Ruben Sanchez Jean, Department of Ophthalmology, Instituto de Investigaciones Sanitarias Hospital Cl?nico San Carlos. OFTARED, Universidad Complutense, Madrid?Spain; Botling Taube A, St Erik Eye Hospital, Department of Clinical Neuroscience, Karolinska Institute, Stockholm?Sweden; Irkec M, Kocabeyoglu S, Department of Ophthalmology, Hacettepe University Faculty of Medicine, Ankara, Turkey. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: G?bor Holl? received honoraria from Novartis and Santen. Doreen Schmidl reports no financial relationships. Anton Hommer received honoraria from Allergan, Thea, Santen, Aerie. Publisher Copyright: {\textcopyright} The Author(s) 2018.",
year = "2019",
month = jul,
doi = "10.1177/1120672118791937",
language = "English",
volume = "29",
pages = "406--416",
journal = "European Journal of Ophthalmology",
issn = "1120-6721",
publisher = "SAGE Publications Ltd",
number = "4",
}