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PURPOSE To compare clinical performance of TECNIS Synergy intraocular lens (IOL), model ZFR00V, versus TECNIS IOL, model ZCB00, in cataract patients. SETTING Multicenter clinical setting. DESIGN Prospective, randomized, subject/evaluator-masked clinical trial. METHODS Cataract patients aged ≥22 years were randomly assigned 1:1 to bilateral implantation with ZFR00V or ZCB00. Key endpoints at 6 months post-surgery included monocular and binocular visual acuities at 4 m, 66 cm, 33 cm, and/or 40 cm, binocular distance-corrected defocus testing, patient-reported outcomes, and safety. RESULTS 272 patients were implanted with ZFR00V (135) or ZCB00 (137). At 6 months, 83/131 (63.4%) ZFR00V patients demonstrated 20/25 or better combined monocular distance-corrected vision at far, intermediate, or near, compared with 5/130 (3.8%) ZCB00 patients. ZFR00V demonstrated excellent binocular uncorrected vision at intermediate (0.022 LogMAR) and distance-corrected vision at 40 cm (0.047 LogMAR). Strong ZFR00V performance persisted under mesopic conditions (0.244 LogMAR or ∼20/32 Snellen), where improvement over ZCB00 with distance-corrected vision at near was 3.5 lines. ZFR00V provided a broad range of functional vision (20/32 or better) through -3.5 D of defocus (29 cm). The majority of ZFR00V patients reported no spectacle wear overall (93.1%) or at all four viewing distances combined (87.8%), and 55.7% qualified as completely spectacle independent. Relatively low proportions of ZFR00V patients reported being very/extremely bothered by halos (13.7%), starbursts (11.5%), or night glare (8.4%). The safety profile was similar between IOL groups. CONCLUSIONS TECNIS Synergy ZFR00V demonstrated improved intermediate and near vision, increased range of vision, and greater spectacle independence versus TECNIS monofocal ZCB00.