Purpose: To report target z-axis optimized LASIK treating for two eyes from two pa-tients with decentered ablation.Methods: The LaserSight AstraPro2.2 Z software is a topography-guided custom ellip-soid ablation platform. LASIK with target z-axis optimization was performed to restore pre-operative visual axis using a LaserSight SLX excimer laser (version 5.3,300 Hz).Results: During preoperative examination, the uncorrected visual acuity (UCVA) was 0.5 in both eyes, and the best spectacle-corrected visual acuity(BSCVA) was 1.0 and 0.8. The decentered ablation zones were diagnosed with LaserSight AstraMax topogra phy. Following target z-axis microtranslation, fifteen and eight μm of central corneal tissues were preserved in the two eyes respectively,the UCVA was 1.2 in both eyes,and secondary ablation zones were both centered on the visual axis.Topography maps and UCVA were stable in both eyes at the time of final follow-up.Conclusions: Using target z-axis optimized LASIK with the LaserSight AstraPro Plan-ner 2.2 Z customized ablation software was an effective method to modify decentered ablation and restore the visual axis.