New model predicts postoperative refractive shifts in pediatric cataract surgery

Target refraction chosen during pediatric cataract surgery significantly impacts the long-term refractive shift, with higher target refractions leading to greater myopic shifts, according to a poster presented at AAO 2024.

The study aimed to develop a predictive model for postoperative refraction and assess how target refraction during cataract surgery influences long-term refractive changes in children. The study included 274 eyes from 1657 refractions in patients aged 2 to 18 years, all of whom underwent intraocular lens (IOL) implantation with primary bag fixation. The median follow-up was 6 years, with some cases extending up to 27 years.

Targeting a higher postoperative refraction led to a more significant myopic shift over time (P < 0.001). This association persisted even when accounting for age at surgery and follow-up duration. Specifically, the target refraction ranged from +3.0 D at age 2 to 0 D for children over 10.

The rate of refractive error change slowed significantly around age 12, according to a splice-point analysis.

Reference
Trivedi RH, et al. A Model to Predict Postoperative Refraction in Children Undergoing Bilateral Cataract Surgery With Primary IOL Implantation. Poster presented at: American Academy of Ophthalmology Annual Meeting; October 2024; Chicago.