Risk Factors and Predictive Model for Postoperative High Myopia in Children Undergoing Congenital Cataract Surgery...

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Biomedical Engineering

Background:

• Congenital cataract surgery requires careful management to prevent postoperative visual complications.
• High myopia is a significant concern following pediatric cataract surgery, potentially impacting long-term visual outcomes.
• Predictive models are needed to identify infants at risk for developing high myopia post-surgery.

Purpose of the Study:

• To identify risk factors for high myopia development after congenital cataract surgery.
• To develop and validate a predictive model for postoperative high myopia.

Main Methods:

• Retrospective cohort study of 106 pediatric patients with primary IOL implantation.
• Analysis of preoperative and postoperative ocular biometric parameters.
• Cox proportional hazards regression for risk factor identification and model construction.
• Internal validation using bootstrapping and external validation in an independent cohort (n=72).

Main Results:

• Initial postoperative refraction < +0.75D and a higher IOL Power to Axial length (IOL/AL) ratio were significant risk factors.
• Shorter preoperative axial length correlated with a greater postoperative myopic shift.
• The predictive model showed robust performance with C-indices of 0.711 (internal) and 0.825 (external), and AUCs for 5- and 10-year prediction ranging from 0.713 to 0.858.

Conclusions:

• Elevated IOL/AL ratio and initial postoperative refraction < +0.75D are key determinants of high myopia risk.
• The developed predictive framework aids in optimizing IOL selection and identifying high-risk infants.
• This tool supports proactive myopia prevention and amblyopia management strategies in pediatric patients.