Risk factors and predictive model for corneal edema in patients undergoing cataract surgery

Purpose To identify the risk factors associated with developing corneal edema in patients undergoing cataract surgery and construct a predictive model based on the patient’s clinical characteristics. Methods In total, 502 patients who underwent cataract surgery at a tertiary hospital between January 2021 and December 2023 were included in this study. Multivariate logistic regression analysis was used to investigate risk factors for corneal edema. A prediction model was constructed, and its performance was evaluated using receiver operating characteristic (ROC) curve analysis. The model’s predictive performance was assessed using the area under the ROC curve (AUC). Results Corneal edema was observed in 393 patients after cataract surgery. Multivariate analysis revealed that advanced age (odds ratio [OR], 1.027; 95% confidence interval [CI]: 1.008–1.048; P = 0.007) was associated with an increased risk of corneal edema. Conversely, preoperative visual acuity ranged from 0.01 to 0.10 (OR: 0.476; 95% CI: 0.239–0.951; P = 0.035) and ≥ 0.10 (OR: 0.249; 95% CI: 0.141–0.437; P < 0.001), and intraoperative use of carbachol (OR: 0.378; 95% CI: 0.229–0.623; P < 0.001) were associated with a reduced risk of corneal edema. These combined factors predicted the risk of postoperative corneal edema in patients with cataract with an AUC of 71.5% (95% CI: 65.8%-77.1%; P < 0.001). Conclusion This study’s findings revealed that a multivariate model based on patient age, preoperative visual acuity, and intraoperative use of carbachol can predict the risk of postoperative corneal edema in patients with cataract, demonstrating a moderate predictive value.