Postoperative Keratometry Prediction Model in Children Undergoing Bilateral Cataract Surgery With Primary Intraocular Lens Implantation.

Purpose: To develop a model for predicting postoperative keratometry in children undergoing cataract surgery with primary intraocular lens (IOL) implantation.

Methods: The longitudinal retrospective study included all children who underwent bilateral cataract surgery and had available intraoperative and postoperative keratometry data. Variables that could influence postoperative keratometry were analyzed, and a generalized estimating equation regression model was used to predict postoperative keratometry.

Results: One hundred twenty eyes of 60 children were included. The mean age at surgery was 2.95 ± 2.78 years (range: 0.12 to 10.95 years), the mean age at the last follow-up was 7.25 ± 4.61 years (range: 0.50 to 20.41 years), and the mean follow-up was 2.40 ± 2.33 years (range: 0.25 to 10.37 years). Keratometry measurements were obtained in both eyes during 510 postoperative visits. The mean keratometry values before surgery and at the last follow-up were 45.32 ± 2.57 diopters (D) (range: 40.75 to 53.88 D) and 44.62 ± 2.25 D (range: 40.63 to 51.25 D), respectively. Preoperative mean keratometry, age at cataract surgery, and age at follow-up were statistically significant predictors of postoperative keratometry. The model to predict postoperative keratometry = 3.1304 + 0.9388 × (baseline keratometry) + 1.8294 × Log10 (baseline age), -1.1336 × Log10 (age at follow-up), -0.7045 × Log10 (baseline age) × Log10 (age at follow-up) was determined. The correlation between measured and estimated keratometry was R = 0.92. Using this model, a hypothetical patient who had surgery at 1 year of age with a mean keratometry value of 44.00 D would be estimated to have a keratometry value of 42.94 D at 21 years of age.

Conclusions: The model is a good predictor for future keratometry after bilateral pediatric cataract surgery with an IOL implant. [J Refract Surg. 2025;41(3):e207-e212.].