Etiologic Spectrum and Surgical Epidemiology of Pediatric Cataracts in Kazakhstan: A Three-Year Retrospective Study from Two Tertiary Eye-Care Centers

Background and Objectives: Pediatric cataract comprises a heterogeneous group of disorders with varying etiologies, laterality patterns, age and gender distributions, and contemporary data from Central Asia remain limited. The study aimed to describe the etiologic spectrum, laterality, age, and gender distribution of pediatric cataract from a two-center tertiary cohort from Kazakhstan. Materials and Methods: This retrospective two-center cohort study included all consecutive children aged ≤17 years who underwent cataract surgery between January 2022 and December 2024 at the Astana and Almaty branches of the Kazakh Eye Research Institute. Recorded variables included age at surgery, gender, cataract laterality, and etiology. Etiologies were classified as congenital, traumatic, ectopia lentis-associated, and complicated cataract. No formal hypothesis-testing framework was predefined; analyses were primarily descriptive. Results: A total of 528 children (782 eyes) were included. Median age at surgery was 6.5 years (IQR 4.3–9.9 years). Children were distributed as ≤6 years: 294 (55.68%), 7–11 years: 156 (29.55%), and 12–17 years: 78 (14.77%). Operated eyes were distributed as 466 (59.59%), 216 (27.62%), and 100 (12.79%), respectively. Congenital cataract was the predominant etiology, accounting for 412/528 children (78.03%) and 645/782 eyes (82.48%), and was predominantly bilateral (233/412 children, 56.55%). Traumatic cataract accounted for 68/528 children (12.88%) and was uniformly unilateral, with male predominance (53/68, 77.94%). Ectopia lentis-associated cataract accounted for 24/528 children (4.55%) and was more often bilateral (14/24, 58.33%). Complicated cataracts accounted for 24/528 children (4.55%). Conclusions: Overall, these findings demonstrate that the etiologic profile of pediatric cataract surgery varies substantially by age, gender, and laterality.