Abstract
Surgical delays between indication for surgery and access to the operating room in glaucoma filtration surgery (GFS) are unknown. We reviewed medical charts of the first fifty patients’ undergoing GFS from February 2017, 2019, and 2022 with the aim to: (i) measure waiting times between indication for surgery to pre-surgical workup, pre-surgical workup to surgery, and indication to surgery; (ii) identify factors affecting the pre-surgical path duration, and (iii) evaluate whether waiting times changed in the 2017–2022 quinquennium.
633 patients, in four tertiary-care Italian Centers, were enrolled. At the indication for surgery, the mean deviation (MD) was − 13.4 dB (IQR: -21.2; -6.9), with an advanced glaucoma in 54.6% of cases (MD: -20.3 dB), and a median IOP of 24 mmHg (IQR: 20.0–28.0). Overall, patients waited 44.0 days (IQR: 21.0–72.0) between indication for GFS and surgery, with the interval between indication and pre-surgical workup being the most time consuming step (32.0 days (IQR: 8.0-51.8)). Patients living in South Italy, with primary glaucoma, an IOP less than 20 mmHg, scheduled for a first phaco-combined trabeculectomy, non-monocular, and with systemic comorbidities, waited more. Since glaucoma may continue to progress while waiting, efficient organizational strategies should be adopted to optimize the pre-surgical path duration.
Similar content being viewed by others
Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
References
Gedde, S. J. et al. Primary Open-Angle glaucoma preferred practice patterns. Ophthalmology 128(1), P71–P150. https://doi.org/10.1016/j.ophtha.2020.10.022 (2021).
European Glaucoma Society Terminology and Guidelines for Glaucoma, 5th Edition. Br. J. Ophthalmol. 105(Suppl 1), 1–169. https://doi.org/10.1136/bjophthalmol-2021-egsguidelines (2021).
Virtanen, A. et al. Incidence of glaucoma filtration surgery from disease onset of open-angle glaucoma. Acta Ophthalmol. 102(2), 192–200. https://doi.org/10.1111/aos.16618 (2024).
Diniz-Filho, A. et al. Association between intraocular pressure and rates of retinal nerve fiber layer loss measured by optical coherence tomography. Ophthalmology 123(10), 2058–2065. https://doi.org/10.1111/aos.16618 (2016).
Ahmed, A. et al. Intraocular pressure and rates of macular thinning in glaucoma. Ophthalmol. Glaucoma. 6(5), 457–465 (2023).
Chauhan, B. C. et al. Canadian glaucoma study: 2. Risk factors for the progression of open-angle glaucoma. Arch. Ophthalmol. 126(8), 1030–1036. https://doi.org/10.1016/j.ogla.2023.03.008 (2008).
DeCoster, C. et al. Waiting times for surgical procedures. Med. Care. 37(6 Suppl), JS187–205. https://doi.org/10.1097/00005650-199906001-00016 (1999).
Gimbel, H. V. & Dardzhikova, A. A. Consequences of waiting for cataract surgery. Curr. Opin. Ophthalmol. 22(1), 28–30. https://doi.org/10.1097/ICU.0b013e328341425d (2011).
Keay, L. et al. Vision and driving status of older Australians with cataract: an investigation of public hospital waiting lists. Clin. Exp. Optom. 99(5), 449–455. https://doi.org/10.1111/cxo.12414 (2016).
Conner-Spady, B. et al. A systematic literature review of the evidence on benchmarks for cataract surgery waiting time. Can. J. Ophthalmol. 42(4), 543–551 (2007).
Hodge, W. et al. The consequences of waiting for cataract surgery: a systematic review. CMAJ 176(9), 1285–1290. https://doi.org/10.1503/cmaj.060962 (2007).
Carr, T., Teucher, U. & Casson, A. G. Waiting for scheduled surgery: A complex patient experience. J. Health Psychol. 22(3), 290–301. https://doi.org/10.1503/cmaj.060962 (2017).
Bachelet, V. C., Goyenechea, M. & Carrasco, V. A. Policy strategies to reduce waiting times for elective surgery: A scoping review and evidence synthesis. Int. J. Health Plann. Manage. 34(2), e995–e1015. https://doi.org/10.1002/hpm.2751 (2019).
Ballini, L. et al. Interventions to reduce waiting times for elective procedures. Cochrane Database Syst. Rev. 2015(2), CD005610. https://doi.org/10.1002/14651858.CD005610.pub2 (2015).
Hopkins, R. B. et al. Cost-effectiveness of reducing wait times for cataract surgery in Ontario. Can. J. Ophthalmol. 43(2), 213–217. https://doi.org/10.3129/i08-002 (2008).
Hodge, W. G. et al. An investigation of the relationship between cataract surgery wait times and rates of surgery. Can. J. Ophthalmol. 47, 11–15. https://doi.org/10.3129/i08-002 (2012).
Rathnayake, D., Clarke, M. & Jayasinghe, V. Patient prioritization methods to shorten waiting times for elective surgery: A systematic review of how to improve access for surgery. PLoS One. 16(8), e0256578. https://doi.org/10.1371/journal.pone.0256578 (2021).
Hodapp, E., Parrish, R. K. I. I. & Anderson, D. R. Clinical Decisions in Glaucoma 52–61 (The CV Mosby Co, 1993).
Author information
Authors and Affiliations
Contributions
Luca Agnifili: conception and design of the work, literature search, drafting the work, interpreted data, approved the article. Matteo Sacchi: drafting the article, interpretation of data, literature search, final approval of the article. Michele Figus, Michele Iester, Antonio Pinna, Leonardo Mastropasqua: critical interpretation of results, final approval of the article. Chiara Posarelli: drafting article, critical interpretation of results, final approval of the article. Marta Di Nicola, Annalisa Marotta: data analysis, interpretation of data, final approval of the article. Matteo Fornaro, Luca Virgilio Corboli, Paola Cassottana, Alessandro Palma: acquisition and interpretation of data, final approval of the article. Luca Agnifili and Matteo Sacchi equally contributed to this work and share primary authorship. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Agnifili, L., Sacchi, M., Figus, M. et al. Surgical delays between indication and operating room access in patients undergoing glaucoma filtration surgery. Sci Rep (2026). https://doi.org/10.1038/s41598-026-39121-2
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-39121-2
