To assess long-term clinical outcomes and factors influencing refractive change after implantation of hydrophilic (Akreos AO) and hydrophobic (Acrysof IQ) acrylic intraocular lens.

After phacoemulsification, intraocular lens was inserted in the bag (Akreos AO for 84 eyes and Acrysof IQ for 19 eyes). Uncorrected visual acuities (UCVA), refraction in both spherical equivalent (SE) and astigmatism were compared longitudinally in more than 2 years follow-up. Factors associated with SE change ≥0.5 diopter (D) after Akreos AO implantation were analyzed with logistic regression.

Although Akreos AO showed hyperopic change mainly within 6 months, UCVA and astigmatism change were not statistically significant during follow up (+0.15 ± 0.43 D, p = 0.027). UCVA, SE, astigmatism were not changed after Acrysof IQ implantation and not significantly different between two groups during follow up. Preoperative anterior chamber depth was a sole factor associated with SE change ≥0.5 D after Akreos AO implantation ( p = 0.006).

Possible hyperopic shift after Akreos AO implantation should be considered in setting target diopter, especially in eye with shallow anterior chamber.