“…In addition, the 2 steep hemimeridians will often have asymmetric power distributions, and there can be more than 3 D of peripheral steepening in corneal grafts. 26,40,43,44,51,52 For all these reasons, many authors have hypothesized that using topography to guide asymmetric placement of relaxing incisions should theoretically produce more predictable results and lower levels of astigmatism compared with simply placing paired incisions at an arbitrary length. 3,22,26,28,36,46,51 This assumes that the patients are carefully screened both to ensure reliable topographic analysis and to avoid including patients with eccentric grafts, which has been missing in many reports.…”