To evaluate the results of the first blue light-filtering photochromic intraocular lens (IOL) and compare them with those of a regular yellow blue light-filtering IOL and a clear ultraviolet-filtering IOL in human eyes under various lighting conditions. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China. Prospective comparative clinical study. This study evaluated eyes that had implantation of 1 of the following 3 IOLs: photochromic Aurium Matrix acrylic, model 400; yellow AF-1 (UY); or clear MC611MI. All eyes were followed for 3 months. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, contrast vision (lighting 400 lux, 30 lux, 5 lux), contrast sensitivity, color vision (Farnsworth-Munsell 100-hue test under 400 lux, 30 lux), and patient questionnaire responses were evaluated. The photochromic IOL group comprised 39 eyes; the yellow IOL group, 41 eyes; and the clear IOL group, 38 eyes. There were no significant differences between the 3 IOLs in UDVA, CDVA, contrast sensitivity, or questionnaire responses. The photochromic group had significantly better color vision than the yellow IOL group at 30 lux and better contrast vision at 5% contrast (P < .05); however, there were no significant differences between the photochromic IOL group and the clear IOL group (P > .05). The photochromic blue light-filtering IOL performed as well as the yellow and clear IOLs under photopic conditions. Under mesopic conditions, the yellow IOL gave poor color vision and contrast sensitivity.