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Purpose: To assess the clinical outcomes and postoperative complications of the implantable collamer lens (ICL) with a central port throughout 10 years of follow-up in patients with low and normal vault., Setting: Fernández-Vega Ophthalmological Institute, Oviedo, Spain., Design: Retrospective and comparative case series., Methods: This study included eyes that underwent a V4c ICL implantation with 10 years of follow-up. The eyes were divided into 2 groups according to the vault at 1 year postoperatively: vault <250 μm and between 250 μm and 800 μm. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), vault, complications, and secondary surgeries were analyzed., Results: 37 and 90 eyes were enrolled in the low and normal-vault groups, respectively. No differences in UDVA, CDVA, and refraction were found between the groups over 10 years of follow-up. No cases developed ICL-induced anterior subcapsular opacity over the follow-up period. 2 (5.4%) and 8 (8.9%) eyes in the low and normal-vault groups, respectively, required ICL exchange. 1 (2.8%) and 2 (2.2%) eyes in the low and normal-vault groups, respectively, required excimer laser to correct residual refractive error. The IOP remained stable throughout the 10-year follow-up. The loss in ECD from that preoperatively to 10 years postoperatively was 3.8% and 4.5% in the low and normal-vault groups, respectively ( P = .4). No pigment dispersion glaucoma or other vision-threatening complications were reported., Conclusions: This study shows good long-term outcomes of the V4c ICL, supporting that the central hole provides safety to the procedure and prevents the potential risk associated with low vault., (Copyright © 2023 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Purpose: To assess the clinical and aberrometric outcomes of a new Implantable Collamer Lens (EVO Viva ICL; STAAR Surgical) to correct moderate to high myopia and presbyopia., Methods: The study included 80 eyes of 40 patients who had bilateral EVO Viva ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, presbyopic add power, binocular through-focus visual acuity, total ocular spherical aberration (SA), coma aberration, and root mean square of ocular higher order aberrations (RMS HOAs) (i-Trace Aberrometer; Tracey Technologies) for a 4.5-mm pupil size were evaluated., Results: The mean binocular postoperative UDVA and CDVA were 0.09 ± 0.19 and 0.02 ± 0.03 logMAR, respectively. The postoperative spherical equivalent was -0.61 ± 0.54 diopters (D). The presbyopic add power reduced from +1.31 ± 0.74 D preoperatively to +0.44 ± 0.58 D after surgery ( P < .0001). The mean visual acuity was 0.1 logMAR or better (20/25 or better) across the vergence range from +0.50 to -1.50 D, better than 0.2 logMAR (20/32 or better) up to the vergence of -2.00 D, and remained better than 0.3 logMAR (20/40 or better) up to the vergence of -2.50 D. The total ocular aberrations induced by EVO Viva ICL were -0.34 ± 0.09 µm of SA, 0.24 ± 0.18 µm of coma, and 0.26 ± 0.12 µm of RMS HOAs., Conclusions: The outcomes support that the new ICL might be a good alternative for myopia and presbyopia correction in patients aged between 45 and 55 years. Further studies are needed to evaluate the threshold lens misalignment from which the patient´s visual quality would be affected. [ J Refract Surg . 2023;39(9):589-596.] .

Purpose: To assess the effect of prior myopic ablations on the optical performance of a trifocal diffractive intraocular lens (IOL) and a novel extended depth of focus (EDOF) diffractive design., Methods: The novel XACT Mono-EDOF ME4 diffractive IOL (Santen Pharmaceutical) and the trifocal diffractive FineVision IOL (PhysIOL) were analyzed standing alone and combined with a simulated myopic corneal ablation. The optical quality of the IOLs in both situations was evaluated with the PMTF optical bench (LAMBDA-X). The through-focus modulation transfer function (MTF) curves and the MTF at three different focal points (+0.50, 0.00, and -0.50 diopters [D]) were recorded., Results: The through-focus MTF curves showed three differentiated peaks for the trifocal IOL and two overlapped peaks for the EDOF IOL. The presence of simulated myopic corneal ablations induces a -0.50 D shift on the overall through-focus curves and softens the multifocal properties of both lenses by decreasing the variations through focus of the MTF. For the analysis of the lenses standing alone, the highest MTF values were obtained for an object vergence of 0.00 D. For a simulated myopic corneal ablation, both IOLs showed better optical quality results at -0.50 D., Conclusions: The trifocal IOL provides better optical quality at far and near distances when analyzed alone. The EDOF IOL optical properties are more stable when a myopic ablation is introduced. Preoperative calculations of both lenses should consider that prior myopic corneal ablations induce a -0.50 D shift on their far peak quality. [J Refract Surg. 2020;36(7):435-441.]., (Copyright 2020, SLACK Incorporated.)

Objective: To assess the intrarater repeatability of the measurements of tear meniscus height (TMH), noninvasive keratograph tear break-up time (NIKBUTs), and ocular redness measurements obtained with the Keratograph 5M (K5M) in a sample of soft silicone hydrogel contact lens (CL) wearers over 15 days., Methods: Prospective study over two consecutive weeks. Three measurements of TMH, NIKBUTs (NIKBUT first and NIKBUT average), and ocular redness were obtained in different sessions; the first day (baseline, at 8 hr of wear, and after lens removal) and the last day of wear-15th day (at 8 hr of wear and after lens removal). The repeatability of measurements were assessed by two intraclass correlation coefficient (ICC) forms; single measurement [ICC (2,1)] and multiple measurements (k=3) [ICC (2, k)]., Results: Sixty-four eyes were analyzed. The repeatability of baseline TMH [ICC (2,1) greater than 0.90; coefficient of repeatability (CR)=0.06 mm] and after and during CL wear [ICC (2,k) greater than 0.90; CR≤0.07 mm] were excellent. The repeatability of baseline NIKBUT average [ICC (2,k)=0.89 (0.82-0.93); CR=6.07 sec] was maintained after CL removal but was poorer during CL wear. The repeatability of baseline NIKBUT first [ICC (2,k) =0.80 (0.69-0.87); CR=8.74 sec] was maintained after CL removal and during CL wear at moderate-good level., Conclusions: Intrarater repeatability of TMH, NIKBUTs, and ocular redness performed by K5M after CL wear remains stable when three measurements are performed. However, intrarater repeatability during CL wear decreased only for NIKBUT average and was not affected by time of use (15 days).

Background: To evaluate the impact on the ocular surface of a daily disposable hydrogel contact lens with high water content compared with two silicone hydrogel daily disposable lenses of lower water content., Methods: The hydrogel lens assessed was made from nesofilcon A and the silicone hydrogel lenses were made of delefilcon A and stenfilcon A. Contact lens thickness was measured to assess material stability during daily wear, and ocular surface parameters such as tear film osmolarity, tear meniscus area and central corneal thickness were also assessed. Optical quality was analysed for all cases by means of wavefront aberrometry., Results: The nesofilcon A was shown to be the thinnest lens (p < 0.001), while no differences in lens thickness were found between the two silicone hydrogel lenses (p = 0.495). No significant differences were found in tear film osmolarity, tear meniscus area, central corneal thickness or corneal aberrations, either as a function of the lens measured or time of use (p > 0.05)., Conclusion: In spite of having the thinnest lens and the highest water content, the hydrogel does not significantly impact on tear film and corneal swelling after one day of use in first-time wearers., (© 2017 Optometry Australia.)

Aims: To assess and compare the optical quality of the myopic and hyperopic implantable collamer lens (ICL) from its wavefront aberrations for different powers and pupil diameters., Settings and Design: Prospective study., Material and Methods: The wavefront aberrations of two myopic (-3 and -6 diopters (D)) and two hyperopic V4b ICLs (+3 and +6D) were measured in vitro. To assess and compare the optical quality of different powers of ICLs, we analyzed the root mean square (RMS) of total higher order aberrations (HOAs), trefoil, coma, tetrafoil, secondary astigmatism, and spherical aberration at 3- and 4.5-mm pupil. In addition, the point spread functions (PSFs) of each ICL evaluated were calculated from the wavefront aberrations at 3- and 4.5-mm pupil., Statistical Analysis: A Student's t-test for unpaired data was used for comparison between myopic and hyperopic ICLs., Results: Myopic ICLs showed negative spherical aberration, in contrast hyperopic ICLs showed positive spherical aberration, which increases when the ICL power increases, due to the innate optical properties of the lens. All ICLs evaluated had negligible amounts of other aberrations. We did not find statistical significant differences in any Zernike coefficient RMS values analyzed between myopic and hyperopic ICLs at 3- and 4.5-mm pupil (P > 0.05)., Conclusions: Myopic and hyperopic ICLs provide good and comparable optical quality for low to moderate refractive error. The ICLs evaluated showed values of wavefront aberrations clinically negligible to affect the visual quality after implantation.

Purpose: To compare the visual quality of implantable collamer lens (ICL) with and without central hole (Hole ICL and conventional ICL) at different degrees of decentering., Methods: An adaptive optics visual simulator (crx1, Imagine Eyes, Orsay, France) was used to simulate the -3, -6 and -12 dioptres (D) conventional and Hole ICLs in three conditions: centred and decentred 0.3 and 0.6 mm. Visual acuity (VA) at high-contrast, medium-contrast and low-contrast and contrast sensitivity (CS) were measured in 15 observers for 3 and 4.5 mm pupils., Results: No statistically significant differences in VA and CS were found between conventional and Hole ICLs for any ICL powers and pupil sizes evaluated (p>0.05). Regarding the effect of the ICL decentration on visual performance, we did not find statistically significant differences in VA and CS between centred, 0.3 and 0.6 mm decentred (p>0.05). Moreover, the ICL decentration affected the same manner on the conventional and Hole ICLs., Conclusions: The outcomes showed that conventional and Hole ICLs provided good and comparable visual performance for all powers and pupil sizes evaluated. Besides, ICL decentering affects the same manner both ICL models evaluated. The ICL decentering did not have any effect on the visual performance.

Purpose: To assess the differences in visual performance between orthokeratology (ortho-k) and laser in situ keratomileusis (LASIK) for the treatment of low-to-moderate myopia., Methods: An adaptive optics visual simulator (Imagine Eyes) was used to simulate the wavefront aberration patterns induced by ortho-k and LASIK for low and moderate myopia on 10 healthy eyes. Visual acuity (VA) at 100%, 50%, and 10% contrast levels and contrast sensitivity (CS) at 10, 20 and 25 cycles per degree (cpd) were then measured for 3- and 6-mm pupil sizes., Results: Differences in VA for 3-mm pupil diameter were not found between ortho-k and LASIK. For 6-mm pupil size, LASIK provided significantly better VA values than ortho-k at 50% and 10% contrast levels for low myopia correction (P = 0.002 and P = 0.001, respectively) and at all contrast levels for moderate myopia correction (P = 0.04 at 100%, P < 0.0001 for 50% and 10% contrast levels). For 3-mm pupil size, differences in CS were not significant between both techniques for low myopia correction and were only significant at 25 cpd (P = 0.03) for moderate myopia correction. For 6-mm pupil diameter, LASIK provided better CS than ortho-k for 20 and 25 cpd for low myopia (P = 0.02 and P = 0.01, respectively) and at all spatial frequencies for moderate myopia (P = 0.02 for 10 cpd and P < 0.0001 for 20 and 25 cpd)., Conclusions: The results in this study suggest that LASIK provides better visual quality outcomes than ortho-k for the treatment of low-to-moderate myopia.

Purpose: The purpose of this study is to compare the visual performance provided by different daily disposable contact lenses and to analyze its variation over time., Methods: Visual performance was evaluated in terms of visual acuity (VA) and contrast sensitivity (CS) in 15 myopic subjects (-0.50 to -4.00 diopters) who had been previously fitted with each one of the following seven types of soft contact lenses: DAILIES TOTAL1 (Alcon, Forth Worth, TX), DAILIES AquaComfort Plus (Alcon), 1-DAY ACUVUE TruEye (Johnson & Johnson Vision Care, Jacksonville, FL), 1-DAY ACUVUE MOIST (Johnson & Johnson Vision Care), SofLens daily disposable (Bausch & Lomb, Rochester, NY), Proclear 1 Day (CooperVision, Fairport, NY), and Clariti 1-Day (Sauflon, Twickenham, United Kingdom). We measured VA at three contrast levels (10%, 50%, and 100%) and CS for three spatial frequencies (10, 20, and 25 cycles/degree). These measurements were performed at 2-hr intervals during a 12-hr period of continuous wearing. Measurements were also performed with ophthalmic lenses before contact lens fitting., Results: Two-way analysis of variance (ANOVA) results revealed significant differences across the lens types and over time for low-contrast VA only. For high- and medium-contrast VA, ophthalmic lens performed better than the contact lenses after 12 hr of use (without statistical differences among the contact lenses). Contrast sensitivity values also showed differences across lenses for the three spatial frequencies under analysis. For each particular lens type, no CS variations were observed with wearing time. Although some of the differences were not statistically significant, we found that, for many of the VA and CS measures, ophthalmic lens and DAILIES TOTAL1 yielded better values than the 1-DAY ACUVUE TruEye and Clariti 1-Day., Conclusions: Assessing VA at different contrasts and CS measurements allowed us to perform a visual function evaluation. Contact lens characteristics such as material and water content, among others, may be the cause of the differences in visual performance that emerged from this study. Our findings provide useful information for contact lens practitioners.

Purpose: To evaluate the efficacy, predictability, safety, and stability of a new-model posterior chamber Implantable Collamer Lens phakic intraocular lens (pIOL) (V4c Visian) to correct myopia., Setting: Private practice, Oviedo, Spain., Design: Case series., Methods: This study enrolled patients who had implantation of a new pIOL design with a central hole for more natural aqueous flow, eliminating the need for neodymium:YAG iridotomy or peripheral iridectomy. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refractive error, intraocular pressure (IOP), endothelial cell count, central vault, and adverse events were evaluated 6 months postoperatively., Results: The study enrolled 138 eyes (70 patients). The mean spherical equivalent decreased from -8.73 diopters (D) ± 2.54 (SD) preoperatively to -0.03 ± 0.19 D 6 months postoperatively; 98.5% of eyes were within ±0.50 D and 100% of eyes were within ±1.00 D. The mean UDVA and CDVA were 20/20 or better in 92.1% and 95.0% of eyes, respectively, at 6 months. The safety and efficacy indices were 1.01 and 1.00, respectively. Postoperatively, the IOP remained stable over time. No significant rises in IOP (including pupillary block) and no secondary cataract were found. After 6 months, the mean vault was 482.7 ± 210.5 μm (range 90 to 970 μm) and the mean endothelial cell loss was 8.5%., Conclusions: Implantation of the pIOL was effective, predictable, safe, and stable for the correction of moderate to high myopic errors. This design, which avoids iridotomy or iridectomy, provided good IOP outcomes., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To compare the optical and visual quality of a simulated Toric Implantable Collamer Lens (TICL) and a bioptics technique to treat high myopic astigmatism., Methods: An adaptive optics visual simulator was used to simulate the vision after TICL implantation and a bioptics procedure from the wavefront aberration pattern for moderate and high-myopic astigmatism. Visual acuity (VA) at different contrasts and contrast sensitivity (CS) at 10, 20 and 25 cycles degree(-1) were measured for 3 and 5-mm pupils. Modulation Transfer Function (MTF) and Point Spread Function (PSF) were calculated for a 5-mm pupil., Results: At a 3-mm pupil we only found statistically significant differences in VA between the two simulated surgeries at low-contrast for moderate- and high-myopic astigmatism (p < 0.05). Statistically significant differences were found in CS at 3-mm pupil between both procedures at the highest spatial frequency for moderate-myopic astigmatism and at all frequencies for high-myopic astigmatism (p < 0.05). At a 5-mm pupil we found statistically significant differences in VA and CS between both simulated surgeries at all contrasts and frequencies evaluated for both groups (p < 0.05). In all cases VA and CS were better with the TICL than with the bioptics technique. MTFs for the bioptics technique were worse than those computed for the TICL. The TICL showed less spread out of the PSF than the bioptics procedure., Conclusions: Simulated TICL and bioptics procedures provided good optical and visual quality, although TICL implantation provided slightly better outcomes than the bioptics procedure, especially when the pupil diameter was increased., (Ophthalmic & Physiological Optics © 2013 The College of Optometrists.)

Aims: To evaluate the visual performance of an aberration-free intraocular lens (IOL) in patients with different corneal profiles using adaptive optics visual simulation., Methods: A crx1 adaptive optics visual simulator was used to simulate the aberration pattern of an aberration-free IOL combined with five corneal profiles: virgin corneas and corneas with low and high myopic ablations and low and high hyperopic ablations. Ten eyes of 10 subjects were evaluated, and monocular distance visual acuity (VA) at 100%, 50% and 10% of contrast was measured., Results: At 100% of contrast, no differences were found in VA values among virgin corneas, low and high myopic ablations and low hyperopic ablation groups (p=0.06). All these groups achieved better results than the high hyperopic ablation group (p<0.001). At 50% and 10%, the best values of VA were obtained for the virgin corneas and for the low myopic and low hyperopic ablation groups (p>0.1, for both levels of contrast). Significant differences were found between these three corneal profiles and the other two corneal profiles (p<0.002 for high myopic and p<0.001 for high hyperopic, for both levels of contrasts)., Conclusions: The results suggest that the aberration-free IOL design gives an excellent visual performance for a range of corneal spherical aberrations that could correspond to patients with virgin corneas and patients in which the corneal spherical aberration has been slightly modified by a hyperopic or myopic laser ablation.

Purpose: To evaluate visual quality differences between intraocular lenses (IOLs) in patients with previous myopic laser ablations and assess the impact of IOL decentration and tilt on visual quality., Setting: University of Valencia, Burjassot, Spain., Design: Cohort study., Methods: An adaptive optics visual simulator was used to simulate the wavefront aberration pattern of 1 aberration-correcting IOL (Acrysof IQ SN60WF), 1 aberration-free IOL (Akreos Adapt AO), and 1 spherical IOL (Triplato) under 5 IOL situations: centered, 0.2 mm and 0.4 mm decentered, and 2 degrees and 4 degrees tilted in eyes with simulated low or high myopic laser corneal ablations. Monocular distance visual acuity at 100%, 50%, and 10% contrast were measured., Results: Ten eyes of 10 patients were evaluated. When the IOLs were centered, the aberration-correcting IOL provided the best visual quality results in both groups. When the IOLs were misaligned, there was a decrease of visual quality with all simulated IOLs except the aberration-free IOL in the high myopia group. In the misaligned situations, all simulated IOLs obtained comparable visual quality results in both groups., Conclusions: The results suggest that in patients with previous myopic laser corneal ablation, aberration-correcting IOLs should be implanted. The decrease in visual quality when these IOLs are decentered or tilted demonstrates the importance of accurate implantation of these IOLs., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To assess the safety, efficacy, stability, and predictability after implantation of a toric intraocular copolymer (Collamer) lens (pIOL) to correct high myopic astigmatism., Setting: Fernández-Vega Ophthalmological Institute, Oviedo, Spain., Methods: This study evaluated eyes that had implantation of a toric pIOL. Outcome measures were the uncorrected (UDVA) and corrected (CDVA) distance visual acuities (Snellen decimal), refraction, and postoperative complications., Results: The study included 15 eyes of 12 patients (9 women). Preoperatively, the mean manifest spherical refraction was -1.98 diopters (D) +/- 1.32 (SD) (range -0.50 to -5.50 D) and the mean refractive cylinder, -4.85 +/- 0.83 D (range -6.50 to -4.00 D). At 12 months, the mean refractive cylinder was -0.55 +/- 0.52 D (range -1.50 to 0.00 D), with 93.3% of eyes having less than 1.00 D of cylinder. The mean spherical equivalent was -0.31 +/- 0.42 (range -1.00 to 0.75 D), with more than 70% of eyes within +/-0.50 D of the target. For the astigmatic components, 93.3% of eyes were within +/-1.00 D of J0 (r(2) = 0.98) and all eyes were within +/-1.00 D of J45 (r(2) = 0.98). The mean UDVA was 0.70 +/- 0.20 and the mean CDVA, 0.83 +/- 0.12. The overall efficacy index was 0.90. Postoperatively, all eyes had unchanged CDVA or gained 1 or more lines., Conclusion: The refractive outcomes and improvement in UDVA and CDVA were rapidly achieved and remained fairly consistent throughout the follow-up period, supporting the use of toric pIOLs in eyes with high astigmatism., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To asses visual quality after bilateral implantation of the Acri.LISA 366D intraocular lens (IOL) (Carl Zeiss Meditec) in patients with high and low-moderate myopia., Methods: A total of 304 eyes of 152 patients had bilateral implantation of the Acri.LISA 366D IOL. The patients were divided into 2 groups: low-moderate myopia (IOL power from 15 to 20.5 D) and high myopia (IOL power from 0 to 14.5 D). Monocular and binocular best-corrected distance visual acuity (BCVA) and best distance-corrected near visual acuity (BCNVA), binocular best distance-corrected intermediate visual acuity (BCIVA), and distance contrast sensitivity (CS) under photopic (85 cd/m2) and mesopic (5 cd/m2) conditions were determined., Results: At the 6-month postoperative visit, there were no statistically significant differences in monocular and binocular BCVA (p=0.13 and p=0.22, respectively). Monocular and binocular BCNVA was comparable between the groups (p=0.26 and p=0.09, respectively). The mean binocular BCIVA changed significantly as a function of the distance of the test (p<0.01) in both groups, and there were no statistically significant differences between groups at any distance. Monocular and binocular CS under photopic and mesopic conditions was similar between both groups (p>0.01)., Conclusions: Bilateral implantation of the Acri.LISA 366D in high myopic eyes provides a satisfactory full range of vision comparable to that obtained in low-moderate myopic eyes.

Purpose: To evaluate the optical and visual quality in eyes with diffractive intraocular lenses (IOLs) after myopic laser in situ keratomileusis (LASIK)., Setting: Fernández-Vega Ophthalmological Institute, Oviedo, Spain., Methods: The best corrected visual acuity (BCVA [distance]) at 12.5%, 25.0%, and 100% contrasts under photopic and mesopic conditions; best distance-corrected near acuity; corneal total higher-order aberrations (HOAs); and optical quality by modulation transfer function (MTF) were measured after myopic LASIK in eyes with a spherical AcrySof ReSTOR SN60D3 IOL or an aspheric Acri.LISA 366D IOL and phakic eyes (control)., Results: Under photopic conditions at 100% contrast, the BCVA was 0.1 logMAR or better in all groups. At 25.0% and 12.5% contrasts, there were no statistically significant differences between the aspheric IOL group and the spherical IOL or control group (P >.01). The control group had better BCVA than the spherical IOL group (P = .0002, 25.0%; P<.0001, 12.5%). Under mesopic conditions, the aspheric IOL group had better BCVA than the spherical IOL group at all contrasts (P<.01). There was no statistically significant difference between the 2 IOL groups in mean best distance-corrected near acuity or between all 3 groups in HOAs (P >.01). With 6.0 mm and 3.0 mm pupils, there were no statistically significant differences in MTF between the aspheric IOL group and the control group; both groups had better MTF than the spherical IOL group with a 6.0 mm pupil (P<.01)., Conclusion: After LASIK, the aspheric IOL provided better visual quality and optical quality than spherical IOL under mesopic conditions (large pupil).

Purpose: To evaluate distance, intermediate, and near visual quality in eyes having diffractive intraocular lens (IOL) implantation after previous myopic laser in situ keratomileusis (LASIK)., Setting: Fernández-Vega Ophthalmological Institute, Oviedo, Spain., Methods: Best corrected distance visual acuity at 12.5%, 25%, and 100% contrasts under photopic and mesopic conditions, best distance-corrected near visual acuity, defocus curve, and corneal higher-order aberrations (HOAs) were measured in eyes with a spherical AcrySof ReSTOR SNA60D3 IOL or aspherical Acri.LISA 366D IOL after myopic LASIK and in phakic eyes after myopic LASIK (control group)., Results: Under photopic conditions at 100% contrast, best corrected distance acuity was 0.1 logMAR or better in all groups. At 25% and 12.5%, there were no statistically significant differences between the Acri.LISA and AcrySof ReSTOR groups or the Acri.LISA and control groups (P >.01). The control group had better best corrected distance acuity than the AcrySof ReSTOR group (P = .0002 and P < .0001 at 25% and 12.5%, respectively). Under mesopic conditions, the Acri.LISA group had better best corrected distance acuity than the AcrySof ReSTOR group at all contrasts (P > .01). The best distance-corrected near acuity was comparable in the 2 IOL groups (P < .01). Intermediate visual acuity was statistically significantly better in the Acri.LISA group than in the AcrySof ReSTOR group (P < .01). There were no statistically significant differences in HOAs between the 3 groups (P > .01)., Conclusions: Both multifocal IOLs provided good and comparable visual acuity at distance and near. However, the aspherical Acri.LISA IOL gave better intermediate visual acuity than the spherical AcrySof ReSTOR IOL.