Yes, for the left eye the axis needs to be rotated to conform with the binasal form. I understand that part. It still requires the horizontal decentration value (x) to have it's sign flipped.
Here's the article from MAFO that outlines the technique. It begins on page 22.
http://en.calameo.com/read/00012606594e0f265a619
I've also seen this formula in "Clinical Optics" page 111 on google books and it has the sign convention a little different. Y is positive in the down direction.
Thanks for the assistance,
Rob
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