Systems and methods for corneal laser ablation for primary vision correction include topographic guided ablation. A laser ablation pattern for removal of astigmatism is derived at least in part from corneal topographic data rather than manifest astigmatism. Laser ablation patterns for treatment of high order aberrations of the cornea may also be based on corneal topographic data. Spherical corrections may be based on manifest refraction, eye models, or wavefront aberrometry.
