Near vision monofocal with astigmatism

I agree with you -- both should be toric.

If I were to make what you report he said to make sense, he would assume that you could not swing the extra cost of two torics, and that since you would need glasses for driving and reading, correct the astigmatism in the glasses. But in reality, what you report does not make sense to me.

I like the idea of mini-monovision. I expect to do that when I get my second eye done.

It's been my experience that -1.75D (spherical equivalent -1.5) and even -1.0 gives me all the small print reading vision I need, not tiny but I don't need tiny. I should add that the -1.0 lens has not be validated with a refraction but it does provide me with MUCH more functional vision than the -1.5 lens. For what it's worth, my surgeon recommended that both IOLs be toric. By the way, I do have some depth perception issues even with this slight offset and if I had it to do over again, I'd choose -1.0 for both eyes.

The first issue is that you cannot be sure what your post cataract surgery astigmatism will be based on your eyeglass prescription for cylinder. The reason is that your current cylinder requirements will be the sum of astigmatism in the lens, which may be aggravated by the cataract, plus the astigmatism in the cornea. And they are not purely additive as the angle of each component can be different. So the bottom line is that you will not know what residual astigmatism there will be with the natural lens removed until they have done the detailed eye measurements with instruments like the IOLMaster and Pentacam. You need to ask what the predicted residual will be if you do not get a toric.

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Astigmatism impacts both near and far vision, so that alone can't be a reason not to get a toric. It could be that if measurements have already been taken that your predicted residual cylinder in that eye is less than 0.75 D and a toric is not suitable for that low of an amount. Or, it could be that if you get corrected to -2.25 D you will need glasses anyway. Correcting astigmatism is really only required when you want to be eyeglasses free. Eyeglasses easily correct astigmatism for near and far, and spending money on a toric is kind of a waste if you are going to wear glasses.

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Targeting -2.25 is going to give you very good near vision without glasses IF your predicted astigmatism is less than 0.75 D cylinder. And even if it is larger than 0.75 D vision can be good if you can tolerate some blurriness.

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Do you have any particular activities that you need near vision without glasses? If not, then having -2.25 D near vision may not have much value to you. I was in that range of myopia for 30 years or so, and basically wore progressive from the time I got out of the shower in the morning until the time I went to bed.

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What you need to think about is what vision do you want without glasses on. If it is distance then correct to slight myopia like -0.25 D, and if it is near then correct to -2.25 D.

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Also keep in mind that mini-monovision is not a terrible outcome that cannot be corrected with eyeglasses. It can be perfectly corrected with eyeglasses, just like you would correct both eyes at -2.25, or both eyes at plano. You are not painting yourself into a corner that you cannot get out of. All you are determining is what vision you will have without glasses on. You might be surprised as to how good it is, and spend most of your time without glasses on. The worst case is that you may need glasses. If you target -2.25 D, you WILL require glasses. There is no may about it. And if you target plano in both eyes you WILL need reading glasses or even prescription glasses.

I was quite myopic prior to cataract surgery and had worn eyeglasses for many years . I asked my cataract surgeon to target me for intermediate vision in both eyes and she did. I also had two diopeters of astigmatism that I did not correct with a toric. I expected my new eyeglasses prescription after surgery would fully correct my vision. As it was, I ended up rarely needing eyeglasses at all, but mine was maybe a unique case. That said, I don't see why a cataract surgeon would not heed your wishes for intermediate vision.

You can target near(@Bookwoman here did) and seems happy with it since she spends a lot of time reading and on the computer. Many others target distance and wear eyeglasses to correct for near/intermediate. Toric IOLs are about a $1,000 extra expense for each eye. Or you can go for mini-monovision as Ron suggested. Why did your doctors advise against mini-monovision?