Purpose To compare refractive-error quality of life, and spherical aberration in pseudophakic eyes with an aspherical intraocular lens (AcrySof IQ) vs. a conventional spherical intraocular lens (AcrySof Single-Piece). Methods 65 patients were randomized to implantation of either an aspherical IOL (Alcon AcrySof IQ) (30 eyes) or a spherical IOL (Alcon AcrySof Single-Piece (35 eyes). Three months postoperatively, complete ophthalmologic examinations including uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA), and a wavefront analysis were performed. Patients completed the National Eye Institute Refractive Error Quality of life Instrument (NEI RQL) to evaluate vision-related quality of life. Results The mean postoperative best-corrected visual acuity was 0.09±0.07 logMAR in the aspherical group and 0.12±0.08 in the spherical group, and the difference was not statistically significant. Spherical aberrations were significantly lower in the aspherical group (0.12±0.23 μm), than in the spherical group (0.33±0.20 μm) ( P=0.001). Patients with aspherical AcrySof IQ IOLs implantation also experienced less difficulties driving at night ( P=0.04), but the difference was not significant after Bonferroni correction. Conclusion The NEI RQL instrument is sensitive enough to detect the visual benefit of cataract surgery. The aspherical AcrySof IQ IOL reduces both spherical aberration and total higher-order aberrations, compared with the performance achieved by the spherical AcrySof Single-Piece IOL. Although the difference between the two IOLs is not statistically significant, there is a tendency toward the association of objective optical performance of aspherical AcrySof IQ IOLs with a subjective improvement in patients’ night driving.