To determine the higher order aberrations following implantation of four foldable intraocular lens (IOL) designs. One hundred twenty-two eyes were randomly assigned to undergo implantation with one of four foldable IOL designs--Collamer (STAAR Surgical, Monrovia, Calif), plate haptic silicone (STAAR Surgical), AcrySof (Alcon, Ft Worth, Tex), or the Sensar (Advanced Medical Optics, Santa Ana, Calif). All enrolled eyes underwent wavefront assessment using the Tracey Visual Function Analyzer (Tracey Technologies, Houston, Tex). Preoperatively, no significant differences were noted in higher order aberrations between the four lens groups. No significant differences were noted among the plate haptic silicone, Sensar, or AcrySof lenses at 1 week or 1 month postoperatively, or among the Collamer, plate haptic silicone, or Sensar lenses, with regard to total higher order aberrations, although differences were observed in individual aberration terms. At 1 week and 1 month postoperatively, the Collamer IOL had significantly less higher order aberrations than the AcrySof lens (P < .01). Significantly less third and fourth order aberrations, coma, trefoil, spherical aberration, and tetrafoil were observed postoperatively with the Collamer than the AcrySof IOL. There were no parameters where the AcrySof had significantly less optical aberrations than the Collamer. The Collamer IOL design is associated with fewer higher order aberrations than the AcrySof lens.