OBJECTIVES: To compare the lifetime costs and consequences of liberating patients from spectacles after cataract surgery, by implanting multifocal IOLs (ReSTOR® or ARRAY-SA40®) versus a monofocal IOL. METHODS: A Markov model was created to follow a 69-year old patient cohort from cataract surgery until death. Prevalence rates of patients not needing spectacles after cataract surgery were obtained from a randomized clinical trial (ARRAY-SA40® versus monofocal) pooled with a cohort of ReSTOR® patients. Resource utilization, estimated from a Dutch survey, included surgery, IOLs, spectacles, visits to ophthalmologists and optic centers, transportation, and time lost by patients. Economic perspectives were those of Society and Sick Funds (SF). Dutch mortality rates were introduced into the model. Discount rates were applied. Sensitivity analyses were performed. RESULTS: A total of 86.4% of patients implanted with ReSTOR® were spectacle-free compared to 8.5% with monofocal and 8.1% with ARRAY-SA40®. On average, 1.2 pairs of spectacles were purchased after ReSTOR® implantation, versus 7.6 after ARRAY-SA40® or the monofocal. Surgical costs were €3740 for ReSTOR® and ARRAY-SA40® and €2140 for the monofocal. From the societal perspective, total undiscounted cost estimates were €5514 with ReSTOR® compared to €7568 with ARRAY-SA40® and 6526 with the monofocal. With a 4% discount rate these costs became €5425, €6944 and €5740, respectively. From the SF perspective, total undiscounted cost estimates were €2423 with ReSTOR®, €2616 with ARRAY-SA40 and €2615 with monofocal IOLs. With a 4% discount these costs became €2415, €2556 and €2555, respectively. Costs and intervals between spectacle replacements were the most sensitive parameters. CONCLUSIONS: From both the societal and SF perspectives, discounted and undiscounted savings achieved by liberating patients from spectacles counterbalanced the initially higher cost of ReSTOR® compared to a monofocal; this did not hold true for ARRAY-SA40®. ReSTOR® improves patients’ satisfaction and is a cost saving alternative versus spectacles in patients requiring cataract surgery.