surgery caused astigmatism and near sightedness

I have never worn glasses and cataracts were causing deteriorating far vision, especially night far vision. My eye surgeon and I agreed to a mono-vision lens replacement for my cataracts with my right eye to have far vision and my left eye near vision The right eye was done 4 weeks ago and resulted in blurred distance vision with slight astigmatism and fairly good near vision - I can read without glasses. The surgeon decided to then insert a lens so the left eye would have good distance vision. This surgery was done 2 weeks ago. The result was the left eye has a significant astigmatism, so neither eye is capable of distance vision without correction with glasses.
I am very disappointed with these results and wonder how 2 attempts to get a good far vision lens implant could have failed. I have not met with the surgeon since the second surgery yet for an explanation. I believe the surgeon has a very good reputation. One of the options being offered is laser surgery. Should this be an added cost? More importantly, should I be looking for another surgeon, or what I have experienced not uncommon? Thanks

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

There are a number of explanations other than those you posit. In fact moder small incision stitchless cataract surgery rarely causes more than 0.50 diopters of inducted astigmatism and may reduce "against the rule (180 degree)" astigmatism.

1. You may have had corneal astigmatism that was neutralized by lenticular astigmatism. Now that the lens (lenticular) is gone the corneal astigmatism is manifest.
2. Your vision may have been so bad that you could not appreciate pre-existing refractive astigmatism. Now that you are seeing much better you can tell that correction with astigmatic lens makes vision better.

Your astigmatism can be corrected with glasses, contacts, incisional corneal surgery, refractive laser surgery.

JCH MD