Treatment validation techniques include generating a modified treatment target from an original treatment target using a modification process, and comparing induced aberrations provided by the original and modified treatment targets, so as to verify the modified treatment target or the modification process. In some cases, a modification process may include a deconvolution process, a low pass filter process, a scaling process, or an adjustment process. The induced aberrations may include high order aberrations, such as spherical aberration.

In certain embodiments, ophthalmic laser system includes an auxiliary light system, laser system, imaging system, and computer. The auxiliary light system directs auxiliary light towards a test target according to a planned test pattern to yield one or more actual auxiliary spots of an actual test pattern on the test target. The planned test pattern indicates one or more planned auxiliary spots located relative to a planned laser spot in a predetermined manner. The laser system directs a laser beam to yield an actual laser spot of the actual test pattern on the test target. The imaging system generates a digital image of the actual test pattern. The computer analyzes the digital image to compare the actual to the planned test pattern, detect a deviation of the actual from the planned test pattern, identify an issue indicated by the deviation, and provide output in response to the issue.

Generation of treatment recommendations for topographic-based excimer laser surgical procedures is described that includes generating accurate cylinder compensation and spherical compensation values that are adjusted to compensate for unique characteristics of advanced topographic-based excimer laser surgical systems. Generating treatment recommendations generally includes determining a topographic vector from a topographic corneal map of the eye, determining a posterior astigmatism vector and an anterior astigmatism vector for the eye, and generating an interior astigmatism vector using the topographic vector, the posterior astigmatism vector, the anterior astigmatism vector, and a manifest astigmatism vector. In various embodiments, the cylinder compensation is generated using the interior astigmatism vector and the posterior astigmatism vector, and the spherical compensation is generated using an initial spherical compensation modified by a topographic addback modifier and a cylinder addback modifier.