Novel technique of corneal biopsy by using a femtosecond laser in infectious ulcers.

Purpose: To describe femtosecond laser-assisted corneal biopsy and its use in assessing the causative organisms in 2 cases of infectious corneal ulcers.

Methods: A 27-year-old man and a 65-year-old woman, both of whom showed uncertain symptoms, repeated negative test results for infectious organisms, and after no improvement despite empirical therapy, underwent diagnostic corneal biopsy by using a femtosecond laser. A corneal flap depth of 200 microm and a diameter of 3 mm were obtained from each patient.

Results: The biopsy specimen from the male patient showed pseudohyphae, which led to a diagnosis of candidal keratitis. The biopsy specimen from the female patient showed positive Gram stain and no evidence of fungal ulcers and yielded a culture of Streptococcus viridans. No complications occurred during either procedure.

Conclusions: Femtosecond laser-assisted corneal biopsy enabled identification of the infectious pathogen in both patients. This technique is easy, safe, and rapid, and it yields a biopsy specimen with a uniform depth and precise size. Femtosecond laser-assisted corneal biopsy can be used as an accurate diagnostic method in uncertain cases of corneal ulcers.