Is it worth $1500 for laser? and mini-monovision vs distance IOL for 2nd eye

I have three main concerns re cataract surgery in my 2nd eye:

1. Is the laser worth it?

2. Choosing between mini-monovision and distance

3. Not doing 2nd eye for years, using contact lense instead?

I had cataract surgery in my R eye 5 weeks ago, and paid $1K extra for the Toric lense and $1500 for the laser, because my surgeon sang the praises of the laser as giving a better outcome and being safer, and he recommended the Toric lense as well. I was told that I was too nearsighted for multi-focal lenses, that I would get lots of glare and shadows.

The surgery went well and I now have excellent distance vision in my R eye. But I’ve since done research online on the femtosecond laser and have found that the consensus seems to be that laser isn’t worth the cost, esp for routine surgery. (I don’t have any complicating issues).

In fact, I haven’t found any experts online who recommend the laser. Some say that not only is it more expensive, it also causes more trauma to the eye (because of the way the eye must be “Locked in” to the laser, and the additional time under anesthesia). I had a very hard time waking up from the surgery, sleeping 30 hours out of the next 48! It was about 5 days before I could see well.

So now I’ve lost some confidence in my surgeon, since I learned that he has a financial interest in the surgical facility where it was done, and I know those laser machines are mighty expensive and they need to use the machine to pay for it. Also, he told me that Light Adjustable Lenses are not yet approved by the FDA, but someone near me is offering them!

Now I need to decide on how to do my L eye, and it feels like a big decision, since vision is so important and I hope to get it right the first time.

I am currently using a contact lense in my L eye for driving and when I go out, so one option is to put off cataract surgery in my L eye until the cataract has gotten worse, and just continue using the contact lense for now. Vision in my R eye could only be corrected to 20/75, and is now 20/20 after surgery—a great success! But my L eye can be corrected to 20/30, so that cataract is not too bad yet.

I’ve only been using the contact lense for two days, and I struggle to remove it, but hopefully that gets easier with practice.

Reasons to delay:

-Medicine is always advancing and they may have better materials or techniques in a few years.

-I do a lot of reading on my phone, and I can currently read my phone with my L eye with no correction. But with the contact lense in, reading requires glasses, so it would be the same with a new IOL.

-I can’t decide between mini-monovision and distance vision. I’d like to hear from others how your made this decision.

Reasons to do it now:

I know a man in the UK who has been told he can get his surgery only if he takes the Covid vaccine. I’m afraid it might come to that in a year or two in the US and it would put me in a terrible predicament, I will not take it.

It’s weird living as I am now: excellent distance vision in one eye and excellent very close vision in the other. Lop-sided.

I’d be interested in hearing your thoughts on these dilemmas, and esp any books or other sources that you’ve found helpful.

Thanks!

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