Persistent Opioid Use after Ophthalmic Surgery in Opioid-Naive Patients and Associated Risk Factors

Area of Science:

• Ophthalmology
• Pain Management
• Public Health

Background:

• New persistent opioid use is a growing concern, particularly after surgical procedures.
• Ophthalmic surgery, while common, can involve perioperative opioid use.
• Understanding risk factors for persistent opioid use is crucial for patient safety and public health.

Purpose of the Study:

• To determine the incidence of new persistent opioid use following ophthalmic surgery in the United States.
• To identify risk factors associated with new persistent opioid use after ophthalmic surgery.
• To inform clinical practice regarding opioid prescribing in ophthalmic surgery.

Main Methods:

• Retrospective cohort analysis of opioid-naive patients undergoing ophthalmic surgery using claims data.
• Defined new persistent opioid use as opioid prescription fills within 90-180 days post-surgery.
• Utilized multivariate logistic regression to identify risk factors for persistent opioid use and prescription refills.

Main Results:

• Out of 327,379 patients, 4.5% received an initial perioperative opioid prescription.
• New persistent opioid use was significantly higher in patients with an initial perioperative fill (3.4%) compared to those without (0.6%).
• Initial perioperative opioid fill was an independent risk factor for new persistent use (aOR, 6.21; P < 0.001).

Conclusions:

• Perioperative opioid exposure is independently associated with new persistent opioid use in opioid-naive patients undergoing ophthalmic surgery.
• Larger initial opioid prescription amounts (≥150 MME) increased the odds of prescription refills.
• Clinicians should exercise caution with opioid prescribing in ophthalmic surgery to minimize risks of persistent use.