IOL options, pros & cons, questions

Hello,
I'm 41 and have PSC cataracts in both eyes.  The right is worse than the left.  I met with my ophthalmologist friday, and was given many options.  Honestly, it's a little overwhelming.  
Here's my background.  I've worn glasses since I was 18 months (yes months) old.  I'm farsighted with moderate astigmatism in both eyes.  I also have monocular vision--my eyes don't work together well, so I have sort of permanent double vision that's I've adapted to over the years.  As a kid, I had eye therapies and consultations, and it appears that the problem lies in processing and not in the muscles that align my eyes.  Two years ago I started wearing bifocals because I was having trouble reading.
My Dr. suggested that I consider modified monovision with toric lens in the left fixed for distance (I'm very left dominant), and perhaps crystalens in the right, adjusted for reading and intermediate.  
My priorities are:
1.  Sharp clear vision with no halos, etc.
2.  I MUST be able to drive well at night--I have three young kids and will be the taxi for the forseeable future.
3.  I'm a teaching assistant/tutor, so I need to be able to read obviously, and read at a moderate distance (computer, across a desk, across a classroom), and also see distances clearly (driving, see across a playground).
4.  I'm a stargazer, so my night vision needs to be good.  Did anyone see the Parseid meteor shower? :-)
5.  I've worn glasses for 39 years, so the idea of keeping glasses is no biggie-it would be nice to be able to get rid of them, but I won't be heartbroken if I can't.

This forum has many thoughtful and knowledgeable contributors, so I'm asking you for some advice.  Please share your thoughts and suggestions.

[OldNavy966]

In my humble opinion, stay away from Crystalens.  I was on this site for a while trying to decide on which IOL to select.  Four surgeons later, Crystalens.  All the opthamologist had recommended this lens.  When I would ask about my pupil being to large for this optic, they all had a very clever response.  Now that it has been implanted, my doc told me, "you will always have problems with this lens because your pupils are too large".  
Think twice when an opthamologist recommends a "premium" lens.  We all have jobs to do to make a living and an opthamologist is no different.  They first do what is best for them and second what is best for you.  If the two can be accomplished together, great.  If not, guess which one will win out? All your bullets in your post have pointed to the direction of a standard monofocal lens.  I think you have answered your own question.

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

You can do your own research there are hundreds of discussions of the same problem which you can access using search and archives.

HOWEVER: your point one and two in my mind would eliminate Crystalens, Restor or the terrible ReZoom. I suggest you consider modern aspheric monofocal or toric monofocal IOLs in both eyes with some variation or monovision.
JCH MD

[Domitila]

I'm a 64 year old woman who has worn glasses since the age of 5.  I recently had cataract surgery, and toric implants were placed in my eyes.  I can't begin to tell you the regret I've had since having these implants placed in. I'm experiencing with throbbing, pain, dry eye, etc.  I was told I would be able to see distance since I have astigmatism.  That evening after the surgery, I got up to go to the restroom, and I couldn't see out of the left eye that had the surgery.  Thinking that it was dark, and protective cover was causing the problem, I turned the lights on, and I had a complete black void in my left eye. At 9:00 a.m. I got up, and could see, but not distance.  I went in the doctor's office the following morning, and informed him of the problem, and he told me he no longer uses theses eye drops that would cause this problem. I stupidly allowed the right eye to be operated on as well, and complained of the problems I was having with both eyes.  They completly disregarded my complaints, and now they want to perform piggyback surgery on top of these toric lens.  I've asked them if they could remove them immediately, and they said the toric lens were not the problem.  Can I have these removed safely, and have monofocal lens placed in my eyes instead?  And, if so; what are the consequenses?  Help!

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

Get a second and even third opinion from two different Eye MD ophthalmic surgeons that do cataract/IOL and refractive surgery. Find one near you at www.aao.org   Don't have surgery till you clearly understand all the risks and options.  Every operation inside the eye has some risk.

JCH MD