The Guiding Significance of Ocular Biometry in Evaluating the Refractive Status of Preschool Children

INTRODUCTIONS: This study aimed to analyze the correlation between refractive status and ocular biological parameters in preschool-age children (3–6 years old), establish a regression curve, guide the clinical judgment of children’s refractive status, and improve the accuracy of refractive screening for this age group. METHODS: A total of 508 children, aged 3–6 years, were admitted to the hospital, exhibiting symptoms of ametropia and a need for dilation optometry. Among these, 326 children were included in the statistics group, having been examined between August 2021 and October 2022, and 182 children were included in the validation group, having been examined between November 2022 and March 2023. Using IOL Master700, ocular biometry parameters were measured for all participants, including axial length (AL), keratometry readings (K1 and K2), anterior chamber depth (ACD), lens thickness (LT), and central corneal thickness (CCT). One percent atropine sulfate eye gel was administered, and then the spherical equivalent (SE) was calculated by Bennett’s formula. The correlation between SE and other ocular biometrics was analyzed, followed by the establishment of an SE prediction equation. The SE prediction equation was used to calculate the spherical equivalent (SE#) using ocular biometry data from the validation group, and the consistency between SE and SE# was evaluated. RESULTS: SE showed a negative correlation with AL/CR (r = −0.936), AL (r = −0.811), ACD (r = −0.500), age (r = −0.396), and Km (r = −0.213) (p < 0.001), and positive correlation with LT (r = 0.301), LP (r = 0.176) (p < 0.001). A multiple linear regression equation was established for SE using the stepwise selection method, SE = 49.232 – 23.583 × AL/CR + 1.703 × ACD + 0.589 × Km − 0.609 × LP + 1.103 × LT (R(2) = 0.997). Based on the regression equation, the predicted SE# highly correlated with SE after cycloplegia in the validation group (r = 0.998, p < 0.001). CONCLUSION: The main ocular biological factors of ocular diopter in children aged 3–6 years are AL/CR, ACD, Km, LP, and LT, which are jointly influenced by multiple factors. Ocular biometry is a reliable predictor of real refraction among children aged 3–6.