To evaluate the outcomes of implantation of an accommodating intraocular lens (IOL) in pseudophakic presbyopic eyes. Setting Ophthalmology Department, Benha Medical School, Benha, Egypt. Methods In this prospective controlled trial, near and distance visual acuities, the manifest refraction spherical equivalent, and patient satisfaction were evaluated in presbyopic eyes that had phacoemulsification cataract removal and implantation of a Crystalens AT-45 IOL accommodating IOL. The difference between preoperative and postoperative mean values was compared using the Student t and paired-sample t tests. Comparison between postoperative follow-up visits was by analysis of variance. Results The study comprised 25 eyes (23 patients; 13 men). The mean IOL power was 21.80 diopters (D) ± 1.45 (SD) (range 19.00 to 24.00 D). At 6 months, 23 eyes (92%) had an uncorrected distance visual acuity (UDVA) of 6/12 or better; all eyes had a corrected distance visual acuity (CDVA) of 6/12 or better (P = .000). The difference in CDVA and UDVA between 1 month and 6 months postoperatively was not statistically significant. The mean distance-corrected near visual acuity (DCNVA) was J5 at 1 month and 6 months; from 1 month on, the DCNVA was J3 or better in more than 60% of eyes. There was a statistically significant difference in DCNVA between preoperatively and 6 months postoperatively (P = .021). Conclusions Initial experience indicates that the accommodating IOL provides functional near and distance visual acuity for daily tasks. Surgeon experience and refinement of IOL calculations are required to improve outcomes.