PURPOSETo evaluate visual function of three types of multifocal intraocular lenses (IOLs) and one monofocal IOL (as the control group) after cataract surgery. METHODSOne hundred fourteen patients participated in a prospective, randomized, controlled clinical study and received monofocal Tecnis Z9000 (AMO) (n=24, 48 eyes); symmetric diffractive multifocal Tecnis ZM900 (AMO) (n=26, 52 eyes); zonal refractive multifocal ReZoom (AMO) (n=32, 64 eyes); and asymmetric diffractive multifocal TwinSet (Acri.Tec) (n=32, 64 eyes) IOLs. RESULTSMean binocular distance best spectacle-corrected visual acuity (BSCVA) (logMAR) was 0.05 for controls, 0.08 for ZM900, 0.07 for ReZoom, and 0.11 for TwinSet, with mean binocular distance BSCVA at near of 0.49, 0.06, 0.22, and 0.11, respectively. Mean contrast sensitivity was better for the monofocal IOL group than for the multifocal IOLs. Patients assigned to TwinSet had less favorable contrast sensitivity scores. Patients with monofocal IOLs had more frequently recommended near addition (74%) than those with multi-focal IOLs. Patients with refractive ReZoom had also recommended near addition more frequently than the two diffractive groups. The percentage of dysphotopsia phenomena was 81% in patients with diffractive multifocal ZM900 compared with 48% in patients with monofocal IOLs, 53% with refractive ReZoom, and 47% with diffractive TwinSet. CONCLUSIONSThe monofocal IOL showed better visual function and lesser photic phenomena than multifocal IOLs but patients were spectacle dependent. ReZoom provided better distance BSCVA than the TwinSet diffractive model. Patients with Tecnis and TwinSet diffractive multifocal IOLs were more spectacle independent than patients with ReZoom. Patients with TwinSet had the worst visual function. Patients implanted with the Tecnis diffractive ZM900 were those reporting more photic phenomena. [J Refract Surg. 2008;24:257-264.] ABOUT THE AUTHORS From the Department of Ophthalmology, Hospital Universitario del Mar and Hospital de la Esperanza, Memorial Cristóbal Garrigosa, Autonomous University of Barcelona, Barcelona, Spain. The authors have no financial interest in the materials presented herein. The authors thank Marta Pulido, MD, for editing the manuscript and editorial assistance. Correspondence: Ana Martínez Palmer, MD, PhD, Anterior Segment Unit, Dept of Ophthalmology, Hospital de la Esperanza, San José de la Montaña 12, E-08024 Barcelona, Spain. Tel: 34 93 3674100; Fax: 34 93 3674266; E-mail: 28653amp@comb.es Received: July 5, 2006 Accepted: January 25, 2007