To evaluate the binocular visual function and depth of focus after staged implantation of diffractive multifocal intraocular lenses (MIOLs) with 3 different add powers following cataract removal.

Prospective comparative case series.

Setting: Institutional. Study Population: Both eyes of 56 patients that underwent staged implantation of bifocal IOLs. Intervention: In the first eye, MIOLs with a +4.0-diopter (D) add power were implanted. Based on outcomes at 1 week postoperatively and patient preference for near vision, 1 of 3 near add powers—+4.0 D (group MM), +3.25 D (group ML), or +2.75 D (group MK)—was implanted in the fellow eye. Main Outcome Measure(s): Three months postoperatively, the binocular uncorrected and distance-corrected visual acuities (BUCVA and BDCVA, respectively) at 5.0, 1.0, 0.5, 0.4, and 0.3 meters; binocular defocus curves; contrast sensitivity; and near stereopsis were measured.

The MM, ML, and MK groups included 21, 18, and 17 patients, respectively. The mean BUCVA in the MM group was significantly (P = .003) worse than that in the MK group at 0.5 meter. The BDCVAs at 0.5 meter in the ML and MK groups were significantly (P < .02) better than that in the MM group. The defocus curves with the -2.0 D refraction differed significantly (P < .001) between the MM and MK groups. The binocular contrast sensitivity and stereopsis values did not differ significantly.

Staged implantation of different add powers obtained better binocular intermediate visual acuity without degradation of visual function.