### Purpose
To determine the rate and risk factors for new persistent opioid use after ophthalmic surgery in the United States (US).
### Design
Retrospective claims-based cohort analysis.
### Participants
Opioid-naive patients aged 13 years and older who underwent incisional ophthalmic surgery between January 1, 2012 to June 30, 2017 in Optum’s de-identified Clinformatics® DataMart Database.
### Methods
New persistent opioid use was defined as fulfillment of an opioid prescription both in the 90 day and the 91-180-day periods following the surgical procedure. The primary explanatory variable was an initial perioperative opioid prescription fill. The rate of new persistent opioid use was calculated, and multivariable logistic regression models were used to identify variables that increased the risk of new persistent use and refill of an opioid prescription after the initial perioperative opioid prescription in the 30 days after surgery.
### Conclusions
Exposure to opioids in the perioperative period is associated with new persistent use in patients who were previously opioid-naïve. This suggests that this exposure to opioids is an independent risk factor for persistent use in patients undergoing incisional ophthalmic surgery. Surgeons should be aware of those risks to identify at-risk patients in the current national opioid crisis and minimize prescribing opioids when possible.
