Image quality with multifocal intraocular lenses and the effect of pupil size

The refractive IOL gave better image quality than the hybrid IOLs at distance and with small pupils. With pupils larger than 3.5 mm, the quality was similar. Hybrid IOLs gave significantly better image quality for near vision with all pupil sizes. AcrySof ReSTOR SN60D3 IOLs give better distance vision than Tecnis ZM900 IOLs; the latter gave better near vision. The reference monofocal IOL provided better distance images than any multifocal IOL with all pupil sizes.