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Intraoperative optical coherence tomography-compatible surgical instruments for real-time image-guided ophthalmic surgery
  1. Justis P Ehlers,
  2. Atsuro Uchida,
  3. Sunil K Srivastava
  1. Ophthalmic Imaging Center, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
  1. Correspondence to Dr Justis P Ehlers, Cole Eye Institute, 9500 Euclid Ave i32, Cleveland, Ohio 44195, USA; ehlersj1{at}


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.

  • imaging
  • retina
  • treatment surgery

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  • Contributors All authors contributed to this work. JPE and SKS provided experimental design, instrument design, resources, critical manuscript review and participated in experiment execution. AU participated in experiment execution and drafting of the manuscript. JPE had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding NIH/NEI K23-EY022947-01A1 (JPE); Ohio Department of Development TECH-13-059 (JPE); R01-EY023039-01 (JPE, SKS); Research to Prevent Blindness (Cole Eye Institutional Grant); unrestricted travel grant from Alcon Novartis Hida Memorial Award 2015 funded by Alcon Japan Ltd (AU). Eversight Ohio (provision oftissue, JPE).

  • Competing interests JPE: Bioptigen/Leica (patent, consultant), Synergetics (patent), Zeiss (consultant), Thrombogenics (consultant, research grant); Regeneron (research grant), Genentech (research grant), Santen (consultant), Alcon (consultant);. AU: None. SKS: Allergan (research grant), Bausch and Lomb (consultant), Bioptigen (patent), Zeiss (consultant), Leica (consultant), Santen (consultant), Synergetics (patent).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Additional instrument imaging is available upon request.