So, appointment Sep 26 we adjusted my OS (non-dominate) to remove the cylinder. My assessment following that adjustment is that I may have lost a line on distance vision, meaning I had shifted myopic, and also that I had lost some mid vision (say from 2' to 4').

Last week my MR (tested by the tech and the surgeon) was -2.00 and 0 cylinder ... meaning the adjustment worked, BUT had the effect of also increasing myopia - my subjective assessment prior to the objective MR was generally accurate.

There was no indication of increasing PCO, or other ocular surface disease, but the surgeon did think my OD looked dry.

10 Oct 24
Visual Acuity:
OD - 20/15/J7 (was still hoping for better than J7)
OS 20/25/J1+ (I read it all, but would describe the 20/25 as pretty hard to get to)
Refraction:
AR OD +0.25 +0.75; OS -1.25 +0.25
MR Tech (same Tech each time) OD -0.25 +0.75 (some cylinder increase); OS -2.00 0.00 (last adjustment corrected cylinder, but may have increased the sphere)
MR Doc (same Doc each time) OD -0.25 +0.75 (some cylinder increase); OS -2.00 0.00 (last adjustment corrected cylinder, but may have increased the sphere)
As I noted prior to going in, I provided my assessment:
1. OD – a bit shorter (less clear distance) (confirmed – a bit more myopic and some cylinder where was Plano last (no LDD in between)
2. OD – not as good closer as prior to second LDD (same J7 but still less clear closer?)
3. OS – from 15”-40” seems a bit less clear (maybe confirmed since myopia increased from -1.5 to -2.00)
4. OS – lost a bit of distance? (confirmed – decreased from 20/20 to 20/25 (it was a tough to get to 20/25)
OD - Doc thinks some dry eye is affecting the cylinder, so will wait to check for stability next appointment
OS - Doc thinks have some irregular astigmatism, agrees the LDD eliminated cylinder, but affected sphere, wants to wait and if stable then will address sphere by going back towards -1.5
Doc did not see increasing opacification, so waiting on YAG
I think I’ll change eye drops - using Systane Complete PF right now - recommendation?
Doc wanted to wait to do anything further to either eye - another appointment in two weeks. On OS - he said if script is stable he felt confident in dialing back the myopia to -1.50 (hopefully with zero cylinder) and that this should get the slightly longer near back that I lost due to zeroing out the cylinder and hopefully not changing the cylinder. I asked about trialing contact, but he felt since we are only 0.5D apart, it might not be useful. On OD - he was concerned dry eye had affected the MR, so wanted to wait prior to doing anything else.