Avoid Compromises in the Current Opioid Crisis, Using Cautious but Confident Patient Care

Abstract

cal records that I reviewed and received, involving nearly 20 years of office notes and references from multiple glaucoma specialists, the implanted device was described as being a Molteno implant. I therefore requested copies of the original operative report because there was some concern by Dr Molteno that we may be dealing with a counterfeit device. However, to my surprise, I received 2 operative reports. The first describes a Molteno implant being placed in 1996, and the second operative report describes placement of a Krupin valve in 1998, in the same eye. This was the first time I became aware that the patient had 2 implants in the eye. Ever since I have cared for the patient (ie, since October 2011), his affected cornea has been opaque, and the only implant evident on examination is the one that was removed and labeled as "Molteno Implant Functioning as a Culture Plate" (which should be changed to "Krupin Valve Functioning as Culture Plate" 2 ) in the June 2013 issue. 1 I apologize for this error and for my assumption that this was a Molteno implant. I should have checked the appearance of the implant more closely, and if I would have noted the inconsistencies, I would have investigated this prior to publication.

Impact of Standardized Prescribing Guidelines on Postoperative Opioid Prescriptions after Ophthalmic Surgery

“…It is likely that confronting the topic as a group brought thought and awareness to our practice; some surgeons within the same subspecialty (performing the same surgical procedures) showed wide variations with respect to opioid prescribing that previously were not recognized. Therefore, to assume that little evidence exists of serious adverse events after opioid use for ophthalmic surgery 15,16 and not to assess individual prescribing patterns will perpetuate the opioid crisis that began in the early 1990s. 17 Opioid prescriptions, no matter how minimal, have the potential for diversion, and in certain patients, addiction.…”