Which IOL should I choose ?

[ledbrv]

I wonder to know your opinion.
Here is my case.
I am a 43 brazilian male.
I am myopic (OS 3.75, OD 6 or higher), have astigmatism (OS 2, OD 0.5) and glaucoma under control (last IOP on 30/11 was 16 (OS) and 13 (OD)).
The visual field defect (is it the correct expression? I translated from portuguese expression) is negligible.
In the last 5 months I developed an annoying cataract on my OD, so I and my doctor decided that it would be the right moment to remove it and put a IOL.
Due to high OD myopia, my  doctor ask me to do an exame to see if there were any sign of retinal damage that could cause retinal detachment, and no, there are no sign of retinal damage.
My doctor also suggested that I had my eyes biometry measured with IOL Master, due to it great accuracy.
Although I user computers a lot (I work with computers) and love to read, I don`t care to use glasses.
In fact, if have no doubt that I want the best long distant vision possible to drive and watch tv/movies.
Also, mainly because of glaucoma and high myopia, I want the option with the minimum surgery risks possible.
I will discuss the IOL options with my doctor, but after reading a few posts here, I am considering a monofocal IOL like Alcon SN60WF (IOL Master suggested this lens beside others).
I know I would need glasses for astigmatism and presbyopia (I'm in doubt if a toric IOL would be a good choice, as it could rotate).
Also I will need glasses for distant view, because the surgery will be  on OD only.
But as I said, using glasses is  ok.
Is SN60WF a good IOL choice ?
Should I consider other options ?
What else should I pay attention ?

Thanks in advance for any tip.

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

aneisometrophia just means that there is a differende of more than 1.5 diopters between the refractive error of one eye over the other. It makes glasses hard to adjust to and the eyes have trouble working together.
JCH MD

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

Your surgeon seems very thorough.  The SN60WF is a good IOL.  After surgery, assuming you get a very good result and your left eye is "plano" (not need glasses RE) your RX will be 0.00 RE and -3.75 LE. Normally this would create a problem with glasses (aneisometrophia) but you now have 2.25 diopters of aneisometrophia so it may not bother you as much but you should discuss this with your surgeon.  The amount of astigmatism you have in the RE is negligible.

Also cataract surgery generally HELPS glaucoma and the IOP often goes down 5-10% after cataract surgery.  

JCH MD

[ledbrv]

Dr. John, Thank you very much for such  a fast answer.

Yes, my doctor is very careful, but he is not the surgeon.
This is not a problem, they work together for some time now.

I didn't know this "aneisometrophia" problem.
If I understood right your explanation, this problem is due to power differences from LE to RE, right ?
Does it can cause some serious problem ? Or it is just an annoying thing ?
Anyway, as you said, I already have this right now, and I were not aware of it, If fact, right now I think it is more like 4.25, not 2.25, as cataract made my RE power increase from 6 to 8 !
I am also glad to know that cataract surgery can also help control my glaucoma.
In fact, you are confirming what my doctor said.
The fact that post-surgery drops can increase IOPs for a few days, will not cause serious damaged if carefully followed by my doctor and if I strictly follow the instructions, right ?

By the way, I forget to mention that I am using Xalatan at night and Alcon Azorga (brinzolamide 1%, timolol 0.5%) at night and in the morning.
I tried Cosopt before start using Azorga, but IOP was still a little high (18 or 19) and it was difficult to adapt to Cosopt.
Cosopt made my eyes "burn" a little for 1 or 2 minutes, so my eys was "washing" Cosopt with my tears, and I have no control of my tears.
With Azorga I feel almost nothing, for me Azorga is much less annoying and my last IOP was lower (LE 16, RE 13).

Again, thank you very much for your help.