Ocular Biometry: Surgical Implications in Primary Pediatric Cataract

Doi: 10.36351/pjo.v42i4.2420

Abstract

Purpose:  To evaluate ocular biometric characteristics and assess the predictability of refractive outcomes following intraocular lens (IOL) implantation in children.

Study Design:  Retrospective chart review.

Place and Duration of Study:  Tertiary care hospital in Riyadh, Saudi Arabia from 2021 to 2024.

Methods:  This study included children aged 1-6years who underwent cataract surgery with primary or secondary IOL implantation. Demographic, biometric, and refractive data were extracted. Prediction error (PE) was defined as predicted minus actual post-operative spherical equivalent (SE), while absolute prediction error (APE) represented the magnitude of deviation irrespective of direction.

Results:  A total of 359 eyes from 235 patients were analyzed. The mean age at IOL implantation was 2.90±1.25 years. The mean axial length (AL) was 21.58±1.60mm, mean keratometry (K) was 44.22±2.44D and mean post-operative spherical equivalent (SE) was 1.82±3.12D, compared to a predicted SE of +1.80±1.77D. The mean PE was -0.34±3.15D, and the mean APE was 2.40±2.1D, reflecting substantial variability in refractive outcomes.  Myopic shift was observed at ages 2 and 6years, whereas hyperopic trends predominated at ages 1,3,4, and 5years. The highest APE was noted at 2y of age. No statistically significant differences in PE and APE were observed across age groups (p>0.05). A mild positive correlation was found between PE and AL (rho=0.186, p=0.006) and a weak negative correlation was observed between PE and K(rho=-0.150, p=0.03).

Conclusion:  Despite minimal mean prediction error, refractive outcomes following pediatric cataract surgery remain highly variable.