{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T21:25:10Z","timestamp":1648675510648},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background Primary open-angle glaucoma (POAG) is still one of the most common causes of impaired vision worldwide, despite the further development of therapy options, and can lead to blindness. Micro-invasive glaucoma surgery (MIGS) using stents aims at reducing intraocular pressure (IOP), as it is the main risk factor. With regard to adherence and adverse drug reactions it also aims at reducing the drug burden on patients. The study investigates under everyday conditions the criteria according to which ophthalmologists in Germany select patients for MIGS using stents. In addition, it will be investigated which patients (could) benefit most from the therapy.<\/jats:p><jats:p>\n          Material and Methods In this qualitative study, 11 narrative interviews were conducted between May 2017 and July 2018 with ophthalmologists working in the hospital or in a private practice. They were interviewed on their experiences in the treatment of POAG with microstents. The interviews were analysed by an interdisciplinary team using the qualitative content analysis.<\/jats:p><jats:p>\n          Results The stages of therapy escalation form the frame of reference for patient selection in MIGS using stents. Only if the IOP cannot be sufficiently reduced by drop therapy or when this causes drug-related side effects that are intolerable for the patients, stents are apparently used as the next higher escalation stage. The intensive post-operative medication and the frequent check-up appointments are perceived as barriers by the interviewees, especially for people with or without disabilities, who are dependent on external help and\/or those living in rural areas. The active cooperation of the patients in the demanding aftercare seems to be indispensable for the ophthalmologists. In addition, necessary revisions are sometimes stressful for patients (physical\/psychological) and doctors (work organisation\/therapy). Against the background of the organisational and economic challenges in the outpatient spectrum of tasks, especially physicians in private practice\n\t\t\t\t\tseem to weigh up carefully for which patients microstent therapy would be reasonable.<\/jats:p><jats:p>\n          Conclusion In view of the therapeutic requirements, the current microstent therapy seems to be used in a selected, adherent patient group. Further qualitative and quantitative studies (in other health care regions and structures) are necessary to verify and extend the available results.<\/jats:p>","DOI":"10.1055\/a-1241-4489","type":"journal-article","created":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T00:29:41Z","timestamp":1606782581000},"page":"302-310","source":"Crossref","is-referenced-by-count":0,"title":["Treatment Complexity in Primary Open-Angle Glaucoma (POAG): Perspectives on Patient Selection in Micro-Invasive Glaucoma Surgery (MIGS) Using Stents"],"prefix":"10.1055","volume":"238","author":[{"given":"Christian","family":"Helbig","sequence":"additional","affiliation":[{"name":"Institute of General Medicine, University Medicine Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja","family":"Wollny","sequence":"additional","affiliation":[{"name":"Institute of General Medicine, University Medicine Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Attila","family":"Altiner","sequence":"additional","affiliation":[{"name":"Institute of General Medicine, University Medicine Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette","family":"Diener","sequence":"additional","affiliation":[{"name":"Institute of General Medicine, University Medicine Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliane","family":"Kohlen","sequence":"additional","affiliation":[{"name":"Institute of General Medicine, University Medicine Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Ritzke","sequence":"additional","affiliation":[{"name":"Institute of General Medicine, University Medicine Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefanie","family":"Frech","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Ophthalmology, University Medicine Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudolf F.","family":"Guthoff","sequence":"additional","affiliation":[{"name":"Clinic and Polyclinic for Ophthalmology, University Medicine Rostock, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,11,30]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1136\/bjophthalmol-2011-300539","article-title":"Global estimates of visual impairment: 2010","volume":"96","author":"D Pascolini","year":"2012","journal-title":"Br J Ophthalmol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1136\/bjo.2005.081224","article-title":"The number of people with glaucoma worldwide in 2010 and 2020","volume":"90","author":"H A Quigley","year":"2006","journal-title":"Br J Ophthalmol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1016\/j.ophtha.2014.05.013","article-title":"Global Prevalence of Glaucoma and Projections of Glaucoma Burden through 2040: A Systematic Review and Meta-Analysis","volume":"121","author":"Y C Tham","year":"2014","journal-title":"Ophthalmology"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1007\/s00417-018-4011-z","article-title":"Prevalence of glaucoma in Germany: results from the Gutenberg Health Study","volume":"256","author":"R H\u00f6hn","year":"2018","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"e0191185","DOI":"10.1371\/journal.pone.0191185","article-title":"Pharmacoepidemiological assessment of adherence and influencing co-factors among primary open-angle glaucoma patients \u2013 An observational cohort study","volume":"13","author":"S Frech","year":"2018","journal-title":"PLoS One"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1001\/archopht.120.10.1268","article-title":"Reduction of Intraocular Pressure and Glaucoma Progression: Results From the Early Manifest Glaucoma Trial","volume":"120","author":"A Heijl","year":"2002","journal-title":"Arch Ophthalmol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"271","DOI":"10.7326\/0003-4819-158-4-201302190-00008","article-title":"Comparative Effectiveness of Treatments for Open-Angle Glaucoma: A Systematic Review for the U.\u200aS. 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