Surgical delays between indication and operating room access in patients undergoing glaucoma filtration surgery

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.