Intraoperative optical coherence tomography-compatible surgical instruments for real-time image-guided ophthalmic surgery.

Intraoperative optical coherence tomography (OCT) is a potentially transformational technology that is now commercially available to ophthalmic surgeons. Currently, the use of the technology is primarily limited to a 'stop and image' approach due to the lack of OCT compatibility with surgical instrumentation. In this report, we describe multiple OCT-compatible surgical instruments that were developed for various surgical needs, based on previous evaluation of potential surgical materials for optical features and physical properties. OCT-compatible instrumentation included two membrane scrapers, a surgical pick and vitreoretinal forceps. Imaging during in vitro and ex vivo-simulated surgical procedures demonstrated excellent visualisation of the instrument tip and of the tissue-instrument interaction. These OCT-compatible instruments may be a key component to the feasibility of real-time image-guided surgery with intraoperative OCT.