The 2025 EURACCUR study provides a comprehensive look at glaucoma surgery referral patterns across various European regions. Analyzing data from 300 eyes, researchers investigated how specialists manage surgical timing and selection in modern practice. The results highlight a persistent clinical challenge: many patients only reach the operating room once their disease has reached an advanced stage. This delay significantly impacts the long-term prognosis for vision preservation.

Current Trends in Glaucoma Surgery Referral Patterns

The study found that trabeculectomy remains a primary choice for specialists, accounting for 38.3% of all procedures. However, minimally invasive bleb-forming surgeries (MIBS) are rapidly gaining ground, representing 28.3% of the cases. Additionally, drainage devices were utilized in 11.3% of patients. Interestingly, surgeons combined nearly one-fifth of these surgeries with phacoemulsification to address concurrent cataracts. These findings suggest a shift toward more diverse surgical toolkits, yet the gold standard remains prevalent for severe cases.

Addressing the Challenge of Late Referrals

A concerning 58.7% of referrals were classified as either "later than optimal" or "late." The median mean deviation (MD) was -14.47 dB, which indicates significant visual field loss at the time of intervention. Furthermore, the median retinal nerve fibre layer (RNFL) thickness was only 60 µm. These metrics emphasize that most patients undergo surgery with advanced structural and functional damage. Consequently, the study advocates for a more proactive approach to surgical discussions before end-stage disease develops.

Regional Variations and Clinical Outcomes

Regional differences played a significant role in the findings. Patients in Southern and Eastern Europe often presented with more advanced glaucoma compared to those in Central and Northern regions. Moreover, more severe disease was consistently associated with filtering or drainage device surgery rather than less invasive options. Therefore, improving the timeliness of referrals could potentially allow for a wider range of surgical interventions with better safety profiles.

Frequently Asked Questions

What is the most common surgery for advanced glaucoma according to the study?

Trabeculectomy remains the most prevalent procedure for advanced cases, followed by minimally invasive bleb-forming surgeries (MIBS) and drainage devices.

Why is timely referral for glaucoma surgery critical?

Timely referral is essential because over half of current surgical cases are referred at a late stage, often with irreversible visual field loss that limits the potential benefits of the procedure.

How does disease severity influence the choice of surgery?

The study observed that surgeons typically reserve traditional filtering surgeries and drainage devices for more severe cases, while combined procedures are common when cataracts are also present.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice or a professional relationship. While we strive for accuracy, please consult a qualified healthcare professional for any health concerns or diagnostic information. Refer to the latest local and national guidelines for clinical practice.

References

1. Martinez-de-la-Casa J et al. Referral for glaucoma surgery and types of surgery in different European regions in 2025, the EURACCUR study. Graefes Arch Clin Exp Ophthalmol. 2026 Mar 26. doi: 10.1007/s00417-026-07155-x. PMID: 41886082.


2. Gkaragkani E. Glaucoma Surgery in Europe: Top 7 Trends. American Academy of Ophthalmology. Published November 24, 2025.


3. Market Scope. 2025 Glaucoma Surgical Device Market Report: Global Analysis for 2024 to 2030. Published August 15, 2025.