PURPOSE: This study was designed to investigate the safety and efficacy of optical lamellar keratoplasty assisted by microkeratome for the treatment of recurrent granular dystrophy. PATIENTS AND METHODS: lamellar keratoplasty was performed by the use of microkeratome on a series of 10 eyes of 9 patients with recurrent granular corneal dystrophy after phototherapeutic keratectomy(PTK). After the resection of corneal opacities, the residual bed thickness was measured by ultrasonopachymeter. Postoperatively, The transparency of cornea, donor-host interface and the refractive changes were examined by slit-lamp microscopy corneal topography. RESULTS: During a follow-up period of 6-15 months, all grafts appeared to be transparent without recognizable opacity in the interface, and no serious complications were encountered. In all cases visual acuity was improved, 6 eyes (60%) had best corrected visual acuity better than 0.5, 2 eyes reached 0.8. During the follow-up longer than 6 months, the mean corneal refractive power significantly increased 2.12D±1.25D（P=0.016）, and the corneal astigmatism significantly decreased 0.89D±0.91D（P=0.021）. Compared with that of before surgery, the increase of the corneal refractive Power had negative correlation to the thickness of residual bed(r=-0.81，P=0.003). CONCLUSIONS: We believe that optical lamellar keratoplasty assisted by microkeratome offers a simple, safe and repeatable way of restoring visual acuity in the treatment of recurrent granular dystrophy, and represents a good alternative to PKP and PTK, especially for the cases with deep opacities in the stroma.