To perform a prospective study using a rotary epithelial scrubber, a prescrub, and postoperative cooling of the cornea with chilled balanced salt solution (BSS) (4 degrees C to 6 degrees C) and a Nidek EC-5000 excimer laser. The Johannesburg Excimer Laser Eye Centre, South Africa. The first 90 consecutive eyes with myopia from -1.00 to -10.50 diopters (D) and astigmatism up to 3.00 D were treated. Follow-up was from 9 to 22 months (mean 13.85 months). Bilateral photorefractive keratectomy was performed in 40 patients. Bilateral vision with a bandage lens on the day after surgery was 20/30, 20/40, and 20/60 in 20%, 60%, and 100% of patients. Uniocular vision was 20/20, 20/25, 20/40, 20/60, and 20/80 in 2.2%, 4.4%, 35.5%, 71.1%, and 93.3% of eyes, respectively. Uncorrected visual acuity (UCVA) on removal of the contact lens was 20/30, 20/40(-1), and 20/60 in 15.79%, 73.48%, and 100% of eyes. After 6 months (82 eyes), UCVA was 20/20, 20/25, and 20/40 in 75.6%, 93.9%, and 100%. After 12 months (36 eyes), it was 20/20 and 20/25 in 83.3% and 100%. No eye required retreatment. Scanning slit laser treatment after precise removal of the epithelium with a rotary scrubber, prescrub, and postlaser cooling allowed rapid, accurate correction of myopia and astigmatism.