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To compare the visual outcomes in patients implanted with a diffractive silicone multifocal in one eye and a diffractive acrylic multifocal IOL in their fellow eye.Augenklinik, Bad Hersfeld, Germany.Forty-two eyes of 21 cataract surgery patients were randomized to undergo implantation with either a silicone diffractive multifocal IOL (Tecnis ZM900, Abbott Medical Optics, Santa Ana, CA, USA) or an acrylic diffractive multifocal IOL (Tecnis ZMA00, AMO). The two IOLs share the same design platform. Outcome measurements included uncorrected and best-corrected distance and near visual acuity, spherical equivalent, reading speed and reading acuity, as well as photic phenomena. Patients were followed for 6 months following surgery.The mean spherical equivalent was 0.161 D (acrylic) and 0.065 D (silicone). The mean uncorrected visual acuity was 0.17 logMAR for the acrylic eyes and 0.17 logMAR for the silicone eyes, a difference of 0.01 (p = 0.861). The mean best-corrected visual acuity (BCVA) was 0.08 for the acrylic eyes and 0.10 for the silicone lens, a difference of 0.03 (p = 0.321).Given that the designs of the lenses are identical and that this was a contralateral eye study, it is reasonable to expect that the results between the two eyes and two types of lenses were similar. Both versions of this lens provide excellent visual function.