Opioid prescriptions after eye surgery linked to higher mortality, hospitalization, overdose

Patients who filled an opioid prescription following an ophthalmic surgery have higher likelihood of mortality, hospitalization, opioid overdose, and opioid dependence than those who did not fill a prescription, reports a study. 

This retrospective, cross-sectional analysis involved patients undergoing ophthalmic surgery, who were identified using administrative claims data from the OptumLabs Data Warehouse. Three cohorts were formed from 1 January 2016 to 30 June 2022. 

The first cohort consisted of propensity score-matched patients who had undergone eye surgery and had filled and not filled an opioid prescription. The second one consisted of patients who were considered opioid-naïve and had filled an opioid prescription matched to those who had not filled a prescription. The last cohort involved opioid-naïve patients matched across the following morphine milligram equivalent (MME) groups: ≤40, 41–80, and >80. 

A total of 1,577,692 patients underwent ophthalmic surgery, with 312,580 (20 percent) filling an opioid prescription. Filling an opioid prescription after an eye surgery correlated with higher mortality (hazard ratio [HR], 1.28, 95 percent confidence interval [CI], 1.25–1.31; p<0.001), hospitalization (HR, 1.51, 95 percent CI, 1.49–1.53; p<0.001), opioid overdose (HR, 7.31, 95 percent CI, 6.20–8.61; p<0.001), and opioid dependency (HR, 13.05, 95 percent CI, 11.48–14.84; p<0.001) than no opioid prescription. 

In addition, higher MME doses of opioids correlated with increased rates of mortality, hospitalization, and abuse or dependence. 

“Opioid prescriptions continue to carry significant short- and long-term systemic risks, even after ophthalmic surgery,” the authors said.