Is night vis better with monofocal IOL or Toric IOL? is 1 better than the other?

[bm10]

I have a schedule for cataract and migs hudrus surgery. (both eyes,  separately)I am Hyperopic ( +4 AND +3)with negative -(3.5 and -2.75 Cyl) astigmatism.and have used progressive no line glasses for 30 years. Very comfortable with glasses and it's not an important objective of my cataract surgery to eliminate that.
I  believe monofocal distant IOL both eyes is best for me. (aviation) I am trying to evaluate the choice between monofocal aspherical IOL and toric IOL for my case. (Acrysof.IQ and Acrysof.IQ Toric for example

[John C Hagan III, MD, FACS, FAAO]

First read this article carefully:  LINK
https://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You--2019-2020-Update

Now that you have read that article, your surgery is a little more complicated as you are having glaucoma surgery also.  So you want to choose a very experiences, highly skilled surgeon to do 2 things different than the standard cataract surgery  1. glaucoma surgery  2. toric IOL

Recall that the toric IOL comes with a 1-4% chance of having to be repositioned.  If you want your best possible vision without glasses you would need a toric IOL.

[bm10]

Dr Hagan, thank you for your attention with my question and all the others you help on this forum.. Admirable!  I have read your CA options document and appreciate your comment clarity. In my case,as a pilot, mini monovision is a non starter for dept perception and gov. regulation.
It is difficult to establish "highly skilled surgeon" for my needs since all sources I research lack meaningful information on that question.
Some additional questions I pose are:
1.  My Ophthalmologist / surgeon is Board Certified and tells me he has done 15 to 20 hydrus patients. Perhaps not many, but the device is only recently certified by FDA. Can you offer any comment  or hint on this?

2. Apart from the astigmatism correction and rotation/ axis alignment issues , is there any other difference between monovision  aspheric IOL and toric IOl? My Doctor recommends the Toric , still I understand and agree with the "upselling consideration.. Is Glare or light scatter more problematic  with either?

3 How desirable / advantageous is it to correct astigmatism at time of cataract surgery. (item 8 in your C. all options paper)

4. Since I have well adjusted to continuous wearing of progressive glasses for many years with correction for both eyes, my tendency is to choose modern aspheric IOL and  reduce some risk or toric rotation and treat astigmatism with glasses. Any comment?

5. Still, it is not done yet and now is my time to insure I have all information and facts clear for my final decision.

Again, thank you for your work!

[John C Hagan III, MD, FACS, FAAO]

First of all I understand aviation. My father was a commercial pilot and a charter member of the Missouri Pilots Association, I was in the USAF and there are several still flying pilots in our family.

1.  I can't make any judgements about your surgeon.  That is a relatively large number of devices so he seems experienced.
2. The primary difference between the two is that with the toric IOL your vision WITHOUT glasses should be much better; with glasses they should be about the same.  I'm not aware of any studies comparing glare and scatter with toric vs monofocal IOLS
3  Look at #2     If you get a monofocal and are unhappy with your uncorrected vision it is possible to go back after surgery and correct residual astigmatism with corneal laser refractive surgery. Of course that is quite a bit more expensive.
4   No your call
5  Agree, this forum is full of people that did not do the proper research before surgery.

Best of luck

[bm10]

Many thanks for your consideration and your reply.
You have been most helpful to me in this mission.

I wish you a safe and happy new Year!

[John C Hagan III, MD, FACS, FAAO]

You are welcome and have a good flight and safe landing.