PURPOSE:To compare the quality of vision with an aspheric intraocular lens (IOL) with no aberration and an IOL with negative spherical aberration.SETTING:Bretonneau University Hospital, Tours, France.METHODS:Patients scheduled for cataract surgery were randomly chosen to bilaterally receive a SofPort Advanced Optics IOL with no aberration (no-aberration IOL group) or a Tecnis Z9000 IOL with negative spherical aberration (negative-aberration IOL group). Six-month postoperative outcomes included patient-centered visual disability assessed with the Activities of Daily Vision Scale (ADVS), contrast sensitivity testing, and wavefront aberration analysis.RESULTS:There was no difference in the overall ADVS score between the 2 groups (P = 0.07); however, the negative-aberration IOL group had a better night-driving score (mean 82.7 +/- 15.1 [SD] versus 66.4 +/- 7.6) (P<.001) and the no-aberration IOL group had a better corrected near-vision score (mean 96.5 +/- 6.2 versus 86.2 +/- 13.2) (P<.001). Mesopic contrast sensitivity was significantly better in the negative-aberration IOL group at intermediate and high frequencies; the no-aberration IOL group performed better under photopic conditions at intermediate frequencies. There was significantly higher spherical aberration (mean 0.11 +/- 0.05 microm versus 0.01 +/- 0.06 microm; P = .001) and lower 3rd-order coma (mean 0.09 +/- 0.06 microm versus 0.15 +/- 0.06 microm; P<.001) in the no-aberration IOL group than in the negative-aberration IOL group, which had better MTF.CONCLUSIONS:Bilateral implantation of an IOL with no aberration resulted in better quality of near vision. A negative spherical aberration IOL provided better night-driving vision and improvements in mesopic contrast sensitivity and MTF.