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.]