Hello and thank you for your question.
It sounds as though your brother has experienced significant regression in his refractive error (need for glasses) after the RK.
In eyes that have had previous corneal refractive surgery performed on them, a thorough evaluation must be performed to determine whether or not LASIK is appropriate for the patient, given their previously altered corneas. In the right setting, a patient with severe myopia and severe astigmatism may indeed be helped by laser refractive surgery such as LASIK, even after RK, but the circumstances have to be right. A good LASIK surgeon will evaluate all of his measurements and take into account his exam to arrive at what is the safest and most beneficial option to help your brother's refractive situation. If you feel like this surgeon does not have your brother's best interests at heart, or you feel uncomfortable with his/her recommendation, it would be wise to seek a second opinion.
As far as the retinal diagnoses, peripheral retinal degeneration and macular degeneration, the retinal degeneration is consistent with a long eye (these eyes that are long are very nearsighted and typically have thin retinas). This can put him at risk for retinal breaks/holes/tears with intraocular surgery, but many people still have surgery with this condition and do just fine. The macular degeneration diagnosis is a bit puzzling because it is quite usually a diagnosis made an elderly person. That being said, however, there are forms of retinal disorders that may mimic macular degeneration that can be seen in younger individuals, and this may be the case with him. However, LASIK will do nothing to help any retinal condition.
As far as his posterior subcapsular cataract, the only thing that can improve this condition is cataract surgery, which can be very beneficial to his vision if the cataract is indeed causing him significant vision problems.
Does this help address your concerns?
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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.