The rate of filled opioid prescriptions is increasing for all types of incisional ocular surgery, according to a study published online Sept. 19 in JAMA Ophthalmology.

Anton M. Kolomeyer, M.D., Ph.D., from the University of Pennsylvania in Philadelphia, and colleagues characterized the rates of filled opioid prescriptions after incisional ocular surgeries from 2000 through 2016. The rate of filled opioid prescriptions was examined for each ophthalmic subspecialty surgery over time.

Data were included for 2,407,962 incisional ocular surgeries, of which 1.90 percent were associated with an opioid prescription. The researchers observed considerable variation in the rate of filled opioid prescriptions over time, with the lowest rate in the 2000-2001 cohort year and the highest in 2014 (1.24 and 2.51 percent, respectively). During the study period, an increasing trend was seen (2000 to 2001, 1.24 percent; 2016, 2.07 percent). In multivariate regression, year of surgery was significantly associated with filling an opioid prescription, with the highest odds in 2014, 2015, and 2016 compared with 2000 to 2001 (odds ratios, 3.71, 3.33, and 3.27, respectively).

"Although we would never argue to deny a patient in pain the help they need, we believe that, given the broader context of the current national opioid crisis, now is the proper time to discuss the role of opioids in postophthalmic surgical management," the authors write. "These results provide a basis for holding such a discussion."

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