Abstract:AIM: To compare the Barrett True-K formula with other formulas integrated in Lenstar 900 to predict intraocular lens (IOL) power after small-incision lenticule extraction (SMILE). METHODS: A theoretical prospective study was performed to predict the ratio of equivalent IOL power before and after SMILE using the SRK/T (Sanders, Retzlaff, Kraff/theoretical), Holladay 1, Haigis, and Barrett True-K formulas and compare the stability of their predictions. The study included 54 eyes (54 cases) with a manifest refraction spherical equivalent (MRSE) of -4.99±1.45 D. They were divided into two groups: 27 eyes with axial length of 24-26 mm in Group A, and 27 eyes with axial length >26 mm in Group B. All subjects enrolled in this study were examined with the Lenstar 900 before and 6mo after SMILE including measurements of axial length, corneal curvature, and anterior chamber depth (ACD). RESULTS: The prediction of equivalent IOL power of the two groups was more stable for the Barrett True-K formula, especially in long axial length eyes (Group B). The respective percentages for the SRK/T, Holladay 1, Haigis, and Barrett True-K formulas were 7.4%, 7.4%, 85.19%, and 88.89% for a margin of error within 0.5 D; 25.92%, 51.84%, 100%, and 100% for a margin of error within 1.0 D in Group A; 33.33%, 40.74%, 44.44%, and 81.48% for a margin of error within 0.5 D; and 44.44%, 59.26%, 66.66%, and 92.59% for a margin of error within 1.0 D in Group B. The respective percentages for Barrett True-K formulas were 100% for a margin of error within 2.0 D in Group B. CONCLUSION: Theoretically, the Barrett True-K formula provides more stable predictions than other formulas for cataract eyes after SMILE.