The performance of multifocals is partly determined by the degree to which contrast at the focussed image is reduced by out of focus images. This paper discusses how optical performance may vary with lens design and includes consideration, with available core study results, of multifocal designs marketed by Iolab, 3M, AMO, Ioptex, Storz and Domilens. For most lenses an acuity of 20/40 and J3 can be achieved unaided in over 70% of best case eyes and J2 with the distance correction in over 80%. However the risk of disappointment tends to prevent a more widespread use of multifocals among surgeons, and an explanation is given as to possible reasons.