Opioid Use Duration Should Be Reduced After Ocular Surgery: Anton Kolomeyer, MD, PhD

Anton Kolomeyer, MD, PhD, a retina specialist at NJRetina, spoke with The American Journal of Managed Care^® about his previous research into the use of opioid prescriptions in the ocular surgery space, specifically looking at how frequently opioids were prescribed to patients with different forms of incisional ocular surgery.

The study, which was published in JAMA Ophthalmology in 2019, found that patients were more likely to fill their prescribed opioids after their ocular surgery in 2014, 2015, and 2016 when compared with patients from 2000 to 2001. This indicates, Kolomeyer said, that the duration of opioid treatment is important to monitor as more patients use them for recovery.

He explained that he was interested in this topic due to the papers he read during his fellowship about opioid use in general medicine. Kolomeyer decided to focus specifically on ophthalmology, given the lack of studies in the space that tackled the question of opioid prescription fills and use after surgery, especially as it pertains to different prescribing patterns.

“For some surgeries that are more intense, like scleral buckling that we do in retina surgery or pediatrics or ocular trauma, opioids tend to be prescribed at a little bit higher rate,” he said.

His research aimed to assess how the prescription pattern differed in different subspecialties of ophthalmology and across the different types of surgeries, including cataract, strabismus, and glaucoma surgeries. What they found was that trauma, pediatrics, and extensive ocular surgeries had higher rates of prescription rates for opioids.

“I think we all have heard about opioids in the newscasts, and we try to keep [them] top of mind, and we just don’t want to contribute to a problem that may or may not exist already out there,” Kolomeyer said.

Doctors should look at their own prescribing patterns, as some can fall into doing what they’re used to rather than changing with the times, he said. Keeping the treatment duration short is also vital in ensuring that the medications are used properly, as some patients were seen taking opioids for an extended period of time. Kolomeyer noted that taking opioid medication for 5 to 7 days should be the aim for prescribing patterns.