The excimer laser treatment to correct myopic astigmatism can be accomplished by broad beam and Scanning laser technology. The development of active tracking technology associated with scanning laser encouraged manufactures to work on flexible pattern ablation software. Myopic astigmatism correction should be measured under tropicamide cycloplegia and modified by a nomogram to obtain the best result. Customized ablations use topographic maps, refraction numbers or total aberration data (high order and low order) to construct a table in the topograph computer. This table is recorded in a digital media and finally read by the laser computer. In order to avoid ectasia, the corneal bed or residual thickness of the cornea should measure at least 250 microns after cutting the flap and performing the stromal ablation. Achieved correction after surgery should be calculated by vectorial analysis using pre and postoperative refraction. On the first post operative check-up, manual keratometry provides an objective evaluation of surgery. Our personal experience with the Schwind MULTISCAN and ESIRIS using the Carriazo Pendular microkeratome on 301 eyes of 153 patients shows similar outcome in safety, efficacy and predictability.