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September 19, 2019

Eye surgeons prescribed more opioids as procedures became less invasive, study finds

Opioid prescriptions for eye surgeries doubled during 14-year stretch

Opioids Addiction
Eye Surgery Opioid Prescriptions Soe Moe Oo/Xinhua/Sipa USA

U.S. doctors prescribed more opioids after eye surgeries, even as procedures became less invasive, according to a Penn Medicine study. Above, a Chinese medical team conducts an eye surgery for a patient in Myanmar.

The rates of opioid prescriptions filled after eye surgeries more than doubled during a recent 14-year stretch, even as procedures became less invasive.

In 2000, about 1.2 percent of eye surgeries prompted filled opioid prescriptions. By 2014, that number had risen to 2.5 percent, according to a study conducted by Penn Medicine.


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"I think it's interesting that most specialties have worked very hard to become less invasive," said Dr. Brian VanderBeek, an assistant ophthalmology professor at the Perelman School of Medicine. "It's really paradoxical that we have this increase despite having, in theory, less invasive and less painful surgeries."

Using an insurer's medical claims database, researchers examined 2.4 million incisional eye surgeries that took place between 2000 and 2016. Of them, 45,776 included an opioid prescription.

Rates began to fall in the final two years of the study – about the time efforts were first being made to curb the use of prescription opioids, VanderBeek said.

The surgeries studied by the researchers crossed six subspecialties. Though the specialties are unrelated, the rate of filled opioid prescriptions rose similarly among each.

The overall rate of filled opioid prescriptions – 1.9 percent during the study period – remains low compared to other medical procedures.

That is partly because cataract surgeries typically are not painful for patients – and they accounted for the bulk of the 2.4 million surgeries.

But when a public health emergency is declared, as with the opioid crisis, VanderBeek said doctors should ensure they're working to mitigate the issue. VanderBeek, who performs retina surgeries, recommends over-the-counter pain medications following the surgery.

"Our rate of giving out opioids is not super high," VanderBeek said. "But any time you can remove fuel from the fire and not contribute to the problem, I think you're obligated to assess your practices."

The study was published Thursday in JAMA Ophthalmology. It was funded by the National Institutes of Health and the University of Pennsylvania's Core Grant for Vision Research.

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