Mutations in keratoepithelin are associated with blinding ocular diseases, including lattice corneal dystrophy type 1 and granular corneal dystrophy type 2. These diseases are characterized by deposits of amyloid fibrils and/or granular non-amyloid aggregates in the cornea. Removing the deposits in the cornea is important for treatment. Previously, we reported the destruction of amyloid fibrils of  2 -microglobulin K3 fragments and amyloid  by laser irradiation coupled with the binding of an amyloid-specific thioflavin T. Here, we studied the effects of this combination on the amyloid fibrils of two 22-residue fragments of keratoepithelin. The direct observation of individual amyloid fibrils was performed in real time using total internal reflection fluorescence microscopy. Both types of amyloid fibrils were broken up by the laser irradiation, dependent on the laser power. The results suggest the laser-induced destruction of amyloid fibrils to be a useful strategy for the treatment of these corneal dystrophies.A number of proteins and peptides have been found to aggregate into insoluble amyloid fibrils that are involved in various diseases, including Alzheimer's disease, Parkinson's disease, and dialysis-related amyloidosis (1-5). Keratoepithelin is one of the amyloidogenic proteins responsible for blinding corneal dystrophies (6 -9). Although precursor proteins range from native globular proteins to unstructured peptides, the resultant amyloid fibrils have many characteristics in common (1-4). Amyloid fibrils are typically long, unbranched, and often twisted, consisting of several protofilaments. X-ray fiber diffraction experiments have shown that they are commonly constructed from ordered -strands. The basic structure has been considered a cross- structure in which the -strands are located perpendicular to the fibril axis. In addition, amyloid fibrils exhibit specific optical behavior such as green birefringence when bound to the dye Congo red. They also bind to the fluorescence dye thioflavin T (ThT) 3 , resulting in a characteristic fluorescence emission at 482-490 nm with an excitation maximum at 446 -455 nm (10, 11).Hereditary corneal dystrophies are characterized by the abnormal deposition of amyloid fibrils and/or granular aggregation in the cornea (6 -9). Mutations of keratoepithelin, an extracellular matrix protein composed of 683 amino acids, also known as transforming growth factor -induced (TGFI), are responsible for the dystrophies. Population analyses have revealed two hot spots of mutation, Arg-124 and Arg-555, associated with corneal dystrophies (7, 12). Regarding Arg-124, four different mutations are associated with four different phenotypes. The R124C mutation has been linked with lattice corneal dystrophy type 1, R124H with granular corneal dystrophy type 2, R124L with granular corneal dystrophy type 3, and R124S with a variant of granular corneal dystrophy type 1. Despite numerous studies, an effective therapeutic approach for these corneal dystrophies has yet to be established (9).Re...