astimatism after cataract surgery

I am going for cataract surgery on my right  eye in a few days time. My eyes are about -5.5 and I do have cataracts in both eyes but can still see very well with my left  eye. the right eye is very bad - hence the need for surgery.
   1.  I dont have astimatism at all and wonder if the cataract surgery will lead to astimatism.
   2.  is it wise to ask for a lens implant of - 4.5 or - 4 in my bad eye bearing in mind that my good eye (also has cataract but  can still see well with. it is - 5.5.) Will the difference  be too much. I find reading glasses quite hard to cope with. I tried contact lens and then reading glasses on my good eye and so think I will like to remain shortsighted.
   3.  I wear distance glasses all the time and take them off for reading. Will I am able to do the same after surgery if I go for - 4.5. (or - 4)
   4.  If  - 4.5 is not a good idea, can you tell me what I should ask for? What about  - 4 or  -5? Many thanks.

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

This is a decision that you alone wish to make. However if you want to be able to read without your glasses "forever" as you get older and just wear glasses for distance then you may want to shot for post-op refractive error of -3.00. That would give you good reading and reasonable range. Remember your eyes will not be focused at the same spot the right will be -3.00 and the left will be -5.00. You will have more range with the right and more magnification with the left.  The difference is such that most people would adjust fine. When the left eye goes bad and needs to be done you will have the option of leaving it -5.00 (which few people chose) or going to -1.50 which would be a more popular choice since it will give good vision for shopping and computer monitor and shaving without glasses.

JCH III MD

JCH III MD