OBJECTIVES: The aim of this study was to compare the 18 months Nd:Yag laser incidence rate of two multifocal intra-ocular lenses, ReSTOR® and Acrilisa®, implanted by a single surgeon following his usual practice. METHODS: : This retrospective study was based on all patients implanted with a ReSTOR® or Acrilisa® multi-focal lens since Q3-2004 at one site. All patients with either cataract or clear lens were operated by the same surgeon. Medical data were obtained from patient charts. 18-months post surgical data were obtained from the surgeon’s medical files and from other ophthalmologists, if involved in post-surgical care. Time to Nd:Yag laser analysis was carried out using Kaplan-Meier survival curves. Imbalance on confounding variables was adjusted with a Cox model. RESULTS: Eighty patients (160 eyes) were bilaterally implanted with ReSTOR® and 76 (152 eyes) with Acrilisa®. Patients with ReSTOR® were more often male (52.5% versus 30.7%; P<0.01) and younger (63.1 versus 65.8; P<0.01). After one year of follow-up, 3.6% of the ReSTOR® eyes had Nd:Yag laser versus 6.8% of the Acrilisa® eyes. After 18 months, the incidence rates were 4.6% and 26.0%, respectively (P<0.0001). Age was weakly  associated with Nd:Yag laser (p=0.09). Eyes with Acrilisa® had 5.62 [2.64-14.02; P=0.0002] more chances to have Nd:Yag laser than ReSTOR®. This persisted after adjusting on age  [Hazard Ratio: 6.61; 2.61-16.76; P<0.0001]. CONCLUSIONS: This analysis conducted at 18 months suggested that following usual surgical practice, ReSTOR® eyes had significantly less capsulotomy than those implanted with Acrilisa®.  Young population were slightly more exposed at Nd:Yag laser.  Analyses at two and three years will be required to confirm these findings.