Femtosecond-assisted diagnostic corneal biopsy (FAB) in keratitis

Background: Femtosecond laser technology (IntraLase, Irvine, CA, USA) has been introduced in corneal surgery, opening a new frontier and providing a new surgical modality. The purpose of this study is to present a series of patients with keratitis after Femtosecond-assisted diagnostic corneal biopsies (FAB). Methods: Four patients with progressive keratitis - despite intensive broad-spectrum topical antimicrobial therapy, or progressive stromal infiltration inaccessible to corneal scrapings - underwent femtosecond-assisted diagnostic corneal biopsy. A corneal specimen was obtained using the Femtosecond laser (IntraLase), including both clinically infected and adjacent non-infected clear corneal tissue. A combination of lamellar and keratoplasty treatment parameters were used. Results: Corneal specimens of 3 mm diameter and 120 to 200 μm thickness were obtained in all patients. No intra- or early post-operative complications related to the procedure were found. In all patients, adequate specimens were submitted for cultures, smears, and permanent section staining. Conclusions: In this small case series of patients with undiagnosed keratitis, femtosecond-assisted diagnostic corneal biopsy (FAB) obtained adequate specimens without intra- or early post-operative complications, related to the procedure.