Draft:Graham Barrett (ophthalmologist)

Graham D. Barrett is an Australian ophthalmologist, ophthalmic surgeon, inventor, and academic. Barrett is an ophthalmic surgeon at Sir Charles Gairdner Hospital, and a Clinical Professor at the Centre for Ophthalmology and Visual Science, University of Western Australia. He is the inventor of the Barrett Universal II formula for IOL power calculations, and the first Australian ophthalmologist who won the Binkhorst Medal, the Ridley Medal, the Susruta Award, and the Choyce Award in the same year. In 2016, The Ophthalmologist magazine named him in its top 100 global power list and inducted him into its Ophthalmologist Power List in 2022, 2023. Barrett is the co-founder and president of the Australasian Society of Cataract & Refractive Surgeons (AUSCRS).

Early life and education
Barrett completed his medical training (MBBCh) at the University of Witwatersrand in 1977. He then pursued his ophthalmology training, becoming a Fellow of the Royal Australian College of Ophthalmologists in 1984. Barrett also undertook specialty training in Corneal transplantation, External Eye Disease, and Refractive Surgery at the University of Texas Health Science Center at Houston in 1987.

Insertion of the first foldable IOL (1983)
In in the early eighties (1983 -1985), Barrett and Thomas Mazzocco developed and implanted the first foldable intraocular lens (IOL). This allowed the lens to be inserted through a much smaller incision compared to the rigid lenses used previously. The foldable IOL could be compressed and inserted through a small opening, where it would then unfold into place within the eye. This technique significantly reduced surgical trauma, improved recovery times, and decreased the risk of complications such as induced astigmatism, leading to quicker visual rehabilitation and better overall outcomes for patients undergoing cataract surgery.

The Barrett Formula Suite
The Barrett Formula Suite is a comprehensive set of intraocular lens (IOL) power calculation tools used to enhance the accuracy of cataract surgery outcomes. This suite includes the Barrett Universal II, Barrett True K, and Barrett Toric formulas. These tools account for various ocular measurements and biometric data to improve the prediction of postoperative refractive outcomes, addressing both simple and complex cases, such as eyes with previous refractive surgery or significant astigmatism. The suite has been integrated into devices like the Zeiss IOLMaster 700, further aiding in precise measurements and predictions.

The Barrett Universal II Formula
The Barrett Universal II Formula is a method for calculating intraocular lens (IOL) power based on Gaussian optical principles. It accounts for the shifts in principal planes that occur with different IOL powers, providing more accurate predictions of postoperative refraction. This formula also serves as the basis for the Barrett Toric calculator, which is used for determining the power of toric IOLs to correct astigmatism.

A retrospective case series study, by Eppley et al. (2021), compared the Barrett Universal II formula to the Holladay 2, Hoffer Q, and SRK/T formulas for predicting postoperative refraction in pediatric IOL implantation. The Barrett Universal II formula showed the lowest mean prediction error and stable performance across variables. Despite limitations like small sample size and retrospective design, the study supported the Barrett Universal II formula as a viable option for pediatric lens power calculation.

The Barrett RX Formula
The Barrett RX Formula is an advanced tool used by ophthalmologists to manage refractive surprises following cataract surgery with toric intraocular lenses (IOLs). Developed by Barrett, this formula integrates the Barrett Universal II formula and the Barrett Toric Calculator to provide comprehensive solutions for postoperative refractive errors. The tool is particularly valuable for addressing residual astigmatism and optimizing both spherical and toric IOL powers. It allows surgeons to determine the optimal rotation of the IOL or the necessary adjustments in IOL power to achieve the best possible refractive outcome. The Barrett RX Formula can be used to calculate the appropriate strength for a piggyback IOL in cases of significant refractive errors after initial surgery. The formula is accessible through the ASCRS website, which links to the formula application through the website of the Asia-Pacific Association of Cataract and Refractive Surgeons.

On vision, innovation, and RayOne EMV IOL
Barrett has worked with Rayner to produce the RayOne EMV IOL. In a 2022 interview with Karl Stonecipher, Barrett discussed the development and advantages of the Rayner EMV lens, emphasizing its ability to provide extended depth of focus without compromising the quality of vision, unlike traditional multifocal lenses. He explained the lens's positive spherical aberration, which synergizes with myopia to enhance vision across distances without significant trade-offs. Barrett also touched on his contributions to biometry and the evolution of his formulas, which have significantly improved outcomes in cataract surgery. He highlighted the lens's suitability for a wide range of patients, including those with previous refractive surgeries, underscoring its robustness and tolerance.

The toriCAM
The toriCAM app is a tool designed by Barrett to assist in the precise alignment of IOLs during cataract surgery. The app helps surgeons mark the corneal axis accurately, which is crucial for the effective placement of toric IOLs to correct astigmatism. The accuracy provided by toriCAM reduces the likelihood of alignment errors, which can significantly improve surgical outcomes and patient satisfaction by minimizing postoperative residual astigmatism.

Journal articles

 * Barrett, Graham D. "An improved universal theoretical formula for intraocular lens power prediction." Journal of Cataract & Refractive Surgery 19, no. 6 (1993): 713-720.
 * Allan, B. D., Perry Short, Geoffrey J. Crawford, G. D. Barrett, and Ian J. Constable. "Pterygium excision with conjunctival autografting: an effective and safe technique." British journal of ophthalmology 77, no. 11 (1993): 698-701.
 * Abulafia, Adi, Graham D. Barrett, Michael Rotenberg, Guy Kleinmann, Adi Levy, Olga Reitblat, Douglas D. Koch, Li Wang, and Ehud I. Assia. "Intraocular lens power calculation for eyes with an axial length greater than 26.0 mm: comparison of formulas and methods." Journal of Cataract & Refractive Surgery 41, no. 3 (2015): 548-556.
 * Abulafia, Adi, Warren E. Hill, Douglas D. Koch, Li Wang, and Graham D. Barrett. "Accuracy of the Barrett True-K formula for intraocular lens power prediction after laser in situ keratomileusis or photorefractive keratectomy for myopia." Journal of Cataract & Refractive Surgery 42, no. 3 (2016): 363-369.

Books

 * Zhang, Fuxiang, Alan Sugar, and Graham D. Barrett. Pseudophakic monovision: a clinical guide. Georg Thieme Verlag, 2019.

Medals

 * The Binkhorst Medal
 * The Ridley Medal
 * The RANZCO Norman Gregg Medal

Awards

 * The Susruta Award
 * The Choyce Award
 * The Hawaiian Eye Foundation's International Award for Excellence (2010)

Honors and fellowships

 * Member of the Order of Australia (AM)
 * Fellow of the Royal Australasian College of Surgeons (FRACS)
 * Fellow of the Royal Australian and New Zealand College of Ophthalmologists (FRANZCO)

Personal life
Barrett lives and practices in Perth, Western Australia. He is astronomy hobbyist.