Objective: To assess the safety and efficacy of excimer laser treatmen
t of myopic astigmatism and to compare this with the excimer laser tre
atment of myopia. Design: A prospective, open study of consecutive pat
ients having excimer laser treatment of myopic astigmatism or myopia.
Settings: Patients were recruited from 18 private ophthalmic practices
. Patients: Fifty-four eyes received treatment for astigmatism and 66
eyes for myopia. One patient was lost to follow-up, and another underw
ent an ineffective ablation. Interventions: A VISX Twenty/Twenty excim
er laser was used to perform either photoastigmatic refractive keratec
tomy or photorefractive keratectomy. Main Outcome Measures: Refraction
and visual acuity with and without correction were assessed preoperat
ively and postoperatively. Results: At 6 months, 17 (85%) of the 20 pa
tients receiving photoastigmatic refractive keratectomy were within 1
diopter of piano refraction, and 19 (95%) of 20 had uncorrected visual
acuity of 6/12 (20/40) or better. For patients receiving photorefract
ive keratectomy, these figures were 28 (88%) of 32 patients and 28 (88
%) of 32 patients, respectively. Conclusions: Excimer laser surgery of
fers an effective option in the treatment of myopic astigmatism.