AIM: To evaluate long-term visual performance after Tetraflex accommodative intraocular lens(AIOL) implantation by measuring the visual acuity, pseudophakic accommodation, visual symptoms.METHODS: Case-control study. Forty-three consecutive age-related cataract patients (49 eyes) were enrolled and received routine cataract phacoemulsification with IOL implantation surgery. All the cases were randomly divided into 2 groups: Tetraflex group(21 cases 25 eyes), which received Tetraflex AIOL ( and SA60AT group(22 cases 24 eyes), which received Acrysof SA60AT IOL (3, 6, and 24 months postoperatively, the uncorrected and best-corrected distance visual acuity(UCDVA and BCDVA), uncorrected and best distance-corrected near visual acuity(UCNVA and BCNVA), pseudophakic accommodation, diopter and complications were studied between the two groups. Questionnaire of visual function was used to investigate the visual symptoms. The indexes were analyzed by SPSS13.0 statistics software.RESULTS: There were no statistically significant differences in UCDVA and BCDVA between the two groups 3, 6, and 24 months postoperatively (P>0.05); while there were statistically significant differences in UCNVA and BCNVA (P<0.05 ). Minus lens method was applied to evaluate the pseudophakic accommodation: after 3 months, Tetraflex group was 3.56±1.20D, SA60AT group was -0.25±0.20D; after 6 months, Tetraflex group 3.08±1.30D, SA60AT group -0.20±0.18D; 24 months later, Tetraflex group 2.85±1.22D, SA60AT group -0.15±0.16D. Tetraflex AIOL lens provided excellent pseudophakic accommodation than monofocal IOL(P<0.05), and also in close reading and satisfaction of the curative effects (P<005). CONCLUSION: Compared with monofocal IOL, Tetraflex AIOL provides age-related cataract patients with good distance and near vision, as well as pseudophakic accommodation. Although pseudophakic accommodation of Tetraflex AIOL decreases in long-term, it gradually becomes stable.