Abstract
Purpose :
To evaluate imaging features of novel surgical instrument prototypes for use during real-time intraoperative optical coherence tomography (OCT) and compare with conventional metallic instruments in simulated surgery.
Methods :
OCT-compatible surgical instruments were developed for various surgical needs, based on previous evaluation of potential surgical materials for optical features and physical properties. Instrumentation included membrane scraper, membrane pick and vitreoretinal forceps (Synergetics). Imaging was performed with two intraoperative OCT platforms RESCAN 700 (Carl Zeiss Meditec) and EnFocus (Leica). In vitro imaging was performed with the tip of each instrument submerged in a water-filled petri dish with a tissue simulator lining the bottom. Images were evaluated for visualization of the instrument tip and the underlying materials. Simulated surgical imaging was also performed utilizing human cadaver eyes. Standard 23-gauge vitrectomy was performed. The tip of each instrument was placed in contact with the retina and was imaged with intraoperative OCT. Intraocular maneuvers included compression of the retina and intraocular foreign body removal.
Results :
OCT-compatible instrumentation demonstrated excellent light scattering and reflectivity properties for visualization of the instrument tip. Metallic instruments demonstrated highly variable light scattering properties that often resulted in limited visualization. Shadowing of underlying tissues was significantly reduced with OCT-compatible instrumentation. Surgical manipulations were successfully captured with both intraoperative OCT platforms.
Conclusions :
Prototypes demonstrated improved visualization with intraoperative OCT compared to conventional instrumentation. Further research is needed to evaluate comparative surgical performance of instrumentation. Additionally, instrument tool tracking for intraoperative OCT platforms is also needed to facilitate real-time OCT-guided surgical maneuvers.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.