Femtosecond Laser–Assisted Lamellar Keratectomy in the Treatment of Granular Corneal Dystrophy

PURPOSE: To evaluate visual acuity, refractive outcomes, central corneal thickness (CCT), and safety after femtosecond laser-assisted lamellar keratectomy (FLK) for granular corneal dystrophy (GCD). METHODS: This retrospective study included patients with GCD who underwent FLK between January 2013 and December 2025. FLK was performed using a planned flap thickness of 120 μm and diameter of 7.5 mm, followed by intraoperative mitomycin C 0.02% for 1 minute. Best-corrected visual acuity (BCVA), refractive outcomes, and CCT were analyzed in patients with ≥30 days of follow-up. Linear mixed-effects models were used to account for intereye correlation. RESULTS: Twenty-eight eyes of 18 patients (mean age 51.5 years, 9 female, 9 male) met inclusion criteria. Ten patients underwent bilateral FLK (20 eyes). Mean BCVA improved from 0.37 logMAR preoperatively to 0.27 logMAR postoperatively (P = 3.89 × 10-4). Mean sphere changed from +0.30 ± 2.22 diopters to 0.62 ± 2.24 diopters (P = 0.21), and mean cylinder changed from -1.39 ± 0.90 diopters to -1.04 ± 0.86 diopters (P = 0.10). Mean CCT decreased from 517.5 to 438.4 μm (P = 8.77 × 10-6). No intraoperative or postoperative complications were observed. CONCLUSIONS: FLK for GCD was associated with significant improvement in BCVA, nonsignificant and minimal refractive change, and a mean CCT reduction of 83.9 μm.