Abstract: Refractive shift following pediatric cataract surgery is a significant clinical challenge, and intraocular lens (IOL) power calculation formulas play a crucial role in influencing the postoperative refractive shift. Direct application of adult IOL power calculation formulas results in considerable inaccuracy, making the selection of pediatric-specific formulas particularly important. This article systematically reviews the current status of traditional formulas, modern optimized formulas, and novel predictive models. Studies indicate that when performing primary IOL implantation, using at least two formulas to calculate IOL power based on axial length and the method of IOL optic capture in the posterior capsule helps reduce postoperative refractive shift. For secondary in-the-bag IOL implantation, the Barrett Universal II (BUII) formula demonstrates unique advantages in predictive accuracy and stability, whereas for secondary sulcus IOL implantation, targeted adjustments to IOL power or optimization of formula constants are required to improve calculation accuracy. The choice of IOL calculation formula for pediatric eyes should be individualized according to age, axial length, implantation site, and surgical technique, with emphasis on optimizing IOL power formulas to achieve more stable refractive outcomes.

Key words: Pediatric cataract, Intraocular lens power calculation