A dual mode excimer laser eye surgery system is provided. The eye is first treated for primary corneal defects using a large, fixed spot size, and remaining irregularities are removed using a small fixed spot size. The large size allows for faster treatment, and the small size provided for more precision in the treatment of irregular topographies. The system is preferably implemented in a distributed topography environment. For example, a treatment pattern using a large, fixed spot size is provided to doctors based on visual acuity data, such as the degree of dioptric correction needed. The effect of this treatment is then overlaid on a computer against the patient's actual eye topography. The small fixed spot size is used to remove any remaining irregularities yielding a preferred treatment pattern. This combined treatment pattern is then distributed to an excimer laser eye surgery system that performs the large spot size ablation and then the small spot size ablation.