Abstract Background To evaluate factors influencing best corrected visual acuity (BCVA) in paediatric patients with bilateral congenital cataracts (CC) after cataract extraction and intraocular lens (IOL) implantation, as well as develop a robust model for predicting long-term visual acuity. Methods This retrospective study followed 194 paediatric patients with bilateral CC from January 2008 to December 2021. The endpoint event was defined as a final BCVA