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Prescription opioid users five times more likely to have intraoperative cataract complications

Yasaira Rodriguez Torres

ORLANDO — Cataract surgery patients who take prescription opioids were five times more likely to have an intraoperative complication and three times more likely to have a postoperative complication, according to authors of a poster presented here at Cataract Surgery: Telling It Like It Is.

The population taking prescription opioids is growing and “requiring a lot more attention given the different comorbidities,” said Yasaira Rodriguez Torres, MD, first author on the poster. Rodriguez Torres told Healio/OSN that the research “started with an observation.”

“There’s little information known of [opioids] modulating effects on the aging eye,” wrote Rodriquez Torres and co-authors, all from Kresge Eye Institute at Wayne State University. And individuals over 65 years of age “are among the populations at risk as the opioid epidemic continues to grow.”

To expand the understanding of cataract surgery and opioid use, researchers conducted a cross-sectional retrospective cohort study that looked at prescription opioid users (n = 26) and nonprescription opioid users (n = 143) who underwent cataract surgery by a single surgeon from Jan. 1, 2017, to April 30, 2018. Researchers compared intraoperative and postoperative complications as well as postoperative pain and visual outcomes.

Cataract surgery patients who take prescription opioids were five times more likely to have an intraoperative complication and three times more likely to have a postoperative complication.

According to the abstract, prescription opioid users had an increased odds ratio (OR = 5.018; 95% CI, 1.250-20.140; P = .013) for intraoperative complications and an increased odds ratio (OR = 3.068; 95% CI, 0.851-11.058) for postoperative complications. Additionally, prescription opioid users had an increased risk for severe intraoperative complications, including retinal tear, retinal detachment and macular edema (P < .026).

“I have not encountered any similar reports in the literature,” Rodriguez Torres said when Healio/OSN asked if her and her colleagues’ poster is a first-of-its-kind observation.

“We recommend preoperative counseling for prescription opioid users planning to undergo cataract surgery given its potential association with increased risk of intraoperative and postoperative complications,” the authors said.

“It is never too soon to start counseling patients” now that this observation has been made, Rodriguez Torres said. “We don’t have any conclusive evidence ... and we are taking the next step, but knowing what I know now, yes, absolutely if I see a patient using a prescription opioid,” the patient should be counseled about the possible risk for complications.

“We want to expand the database,” she said. “Now that we found something, we can enlarge the database and look at patients prospectively and start collecting more data and see why are we seeing this.” – by Joan-Marie Stiglich, ELS

Reference:

Rodriguez Torres Y, et al. Presented at: Cataract Surgery: Telling It Like It Is; Feb. 12-16, 2020; Orlando.

Disclosures: The authors report no relevant financial disclosures. The research was supported by Research to Prevent Blindness.

Yasaira Rodriguez Torres

ORLANDO — Cataract surgery patients who take prescription opioids were five times more likely to have an intraoperative complication and three times more likely to have a postoperative complication, according to authors of a poster presented here at Cataract Surgery: Telling It Like It Is.

The population taking prescription opioids is growing and “requiring a lot more attention given the different comorbidities,” said Yasaira Rodriguez Torres, MD, first author on the poster. Rodriguez Torres told Healio/OSN that the research “started with an observation.”

“There’s little information known of [opioids] modulating effects on the aging eye,” wrote Rodriquez Torres and co-authors, all from Kresge Eye Institute at Wayne State University. And individuals over 65 years of age “are among the populations at risk as the opioid epidemic continues to grow.”

To expand the understanding of cataract surgery and opioid use, researchers conducted a cross-sectional retrospective cohort study that looked at prescription opioid users (n = 26) and nonprescription opioid users (n = 143) who underwent cataract surgery by a single surgeon from Jan. 1, 2017, to April 30, 2018. Researchers compared intraoperative and postoperative complications as well as postoperative pain and visual outcomes.

Cataract surgery patients who take prescription opioids were five times more likely to have an intraoperative complication and three times more likely to have a postoperative complication.

According to the abstract, prescription opioid users had an increased odds ratio (OR = 5.018; 95% CI, 1.250-20.140; P = .013) for intraoperative complications and an increased odds ratio (OR = 3.068; 95% CI, 0.851-11.058) for postoperative complications. Additionally, prescription opioid users had an increased risk for severe intraoperative complications, including retinal tear, retinal detachment and macular edema (P < .026).

“I have not encountered any similar reports in the literature,” Rodriguez Torres said when Healio/OSN asked if her and her colleagues’ poster is a first-of-its-kind observation.

“We recommend preoperative counseling for prescription opioid users planning to undergo cataract surgery given its potential association with increased risk of intraoperative and postoperative complications,” the authors said.

“It is never too soon to start counseling patients” now that this observation has been made, Rodriguez Torres said. “We don’t have any conclusive evidence ... and we are taking the next step, but knowing what I know now, yes, absolutely if I see a patient using a prescription opioid,” the patient should be counseled about the possible risk for complications.

“We want to expand the database,” she said. “Now that we found something, we can enlarge the database and look at patients prospectively and start collecting more data and see why are we seeing this.” – by Joan-Marie Stiglich, ELS

Reference:

Rodriguez Torres Y, et al. Presented at: Cataract Surgery: Telling It Like It Is; Feb. 12-16, 2020; Orlando.

Disclosures: The authors report no relevant financial disclosures. The research was supported by Research to Prevent Blindness.

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