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Cohort studyAmerican journal of ophthalmology · 2026

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

Enze Liu, Xuanqiao Lin, Kaiyi Zhu … Dexi Zhu

OphthalmologyCohort study

A model predicts which children will develop high myopia after cataract surgery

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

Enze Liu … Dexi Zhu

American journal of ophthalmology · 2026

Purpose

To identify risk factors associated with the development of high myopia following congenital cataract surgery and to establish a robust predictive model.

Methods

The model was externally validated in an independent cohort of 72 patients with a mean follow-up of 7.83 years.

n = 72 patients

Results

0.711

model correctly ranked risk about 71% of the time

n = 72 patients

More results

An initial postoperative refraction of <+0.75D, and a higher IOL Power to Axial length Ratio (IOL/AL ratio) were identified as significant risk factors for the development of postoperative high myopia.

The area under the receiver operating characteristic curve (AUC) values for predicting high myopia at 5 and 10 years were 0.858 and 0.745, respectively.

More results

In external validation, the model achieved a C-index of 0.825, 5-year AUC of 0.833, and 10-year AUC of 0.713.

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Conclusion · 1 of 3

Our analysis established that initial postoperative refraction <+0.75D, and an elevated IOL/AL ratio are key determinants of high myopia risk following surgery.

Conclusion · 2 of 3

Shorter preoperative axial length was associated with a greater magnitude of postoperative myopic shift.

Conclusion · 3 of 3

This predictive framework provides clinicians with a practical tool to optimize preoperative IOL selection and identify high-risk infants who require vigilant myopia prevention and balanced amblyopia management.

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

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