DOI: 10.1097/ico.0000000000004164 ISSN: 0277-3740

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

Taylor J. Linaburg, Talia Shoshany, Michael Kozlov, Tobin Thuma, Rebecca Stein, Henry D. Perry, Eric D. Donnenfeld
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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.

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