Effect of Oral Opioid Prescription on Rates of Postoperative Pain among Ophthalmology Subspecialties: A Large Database Analysis

Purpose To assess whether postoperative opioid prescriptions are associated with reduced pain diagnoses or emergency room (ER) visits after ophthalmic surgery. Design Retrospective cohort study using aggregated electronic health record data (June 2005-June 2025) from the TriNetX collaborative research network. Subjects Patients who underwent ophthalmic procedures across 11 subspecialty categories in the past 20 years, with or without a postoperative opioid prescription. Methods Data were analyzed using the TriNetX integrated analytics platform. Patients with chronic pain syndrome or opioid dependence were excluded. Ophthalmic procedures were identified using CPT codes, and characterized as cataract; major or minor cornea, glaucoma, oculoplastics, trauma; retina; or strabismus. Associations were assessed by calculating absolute risk differences with 95% confidence intervals (CI) and risk ratios (RR). Main Outcome Measures Diagnosis of postprocedural pain or ER visits within 2 weeks after surgery. Results The study included 2,510,984 patients. Absolute rates of postoperative pain diagnoses were low across all subspecialties. Opioid prescriptions were associated with small absolute reductions in postprocedural pain diagnoses in glaucoma major (-1.3%, 95% CI -1.4% to -1.2%, p