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Updated: Oct 4, 2025

Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter
Published on: September 16, 2025
Comparison of Barrett and Emmetropia Verifying Optical Toric Calculators
Seth M Pantanelli1, Ashley Sun1, Neal Kansara2
1Department of Ophthalmology, Penn State College of Medicine, Hershey, PA, USA.
Purpose:
The purpose of this study was to compare the Barrett (BTC) and Emmetropia Verifying Optical (EVO) Toric Calculators' performance with regards to prediction of residual post-operative astigmatism after cataract surgery.
Methods:
This was a secondary analysis of de-identified data that was collected as part of a prospective multicenter clinical trial in which 109 eyes from 109 patients were implanted with a monofocal toric intraocular lens (IOL). Post-operative biometry was used to calculate the predicted post-operative residual astigmatism for each eye using the two different calculators. The vector difference between the actual and predicted residual astigmatism was calculated.
Results:
The mean absolute astigmatism prediction errors were 0.59 ± 0.38 D and 0.59 ± 0.36 D for the BTC and EVO calculators, respectively (p = 0.98). The centroid of the prediction errors were 0.18 D @ 89° ± 0.68 D and 0.20 D @ 89° ± 0.66 D, respectively (p = 0.21). The proportion of eyes in which the astigmatism prediction error was ≤0.5 D was 50% for BTC and 46% for EVO (p = 0.28). The proportion of eyes in which the post-operative astigmatism orientation was correctly predicted as being against-the-rule, with-the-rule, or oblique was 81% for BTC and 77% for EVO (p = 0.15).
Conclusion:
The Barrett and Emmetropia Verifying Optical Toric Calculators had similar performance with regards to their astigmatism prediction accuracy.

