Vitreoretinal surgical visualization by ophthalmic microscopy is limited in its ability to distinguish
thin translucent tissues from other retinal substructures. Conventional methods for supplementing
poor contrast, such as with increased illumination and application of exogenous contrast agents, have
been limited by the risks of toxicity at the retina. Spectral domain optical coherence tomography
(SDOCT) has demonstrated strong clinical success in retinal imaging, enabling high-resolution,
motion-artifact-free cross-sectional imaging and rapid accumulation of volumetric macular datasets.
Current generation SDOCT systems achieve <5 μm axial resolutions in tissue, and have been used to
obtain high resolution datasets from patients with neovascular AMD, high risk drusen, and
geographic atrophy. Recently, an intraoperative microscope-mounted OCT system (MMOCT) was
presented as a method of augmenting a surgical microscope to concurrently acquire high-resolution,
high-contrast SDOCT volumetric datasets. Here, we demonstrated the utility of intraoperative
MMOCT for the visualization of vitreoretinal surgical procedures. Vitreoretinal surgery was
simulated by performing procedures, through an ophthalmic surgical microscope, on cadaveric
porcine eyes. The datasets acquired with the MMOCT show both instrument-tissue interaction as
well as the ability of OCT to image certain surgical tools, which would directly translate to better
surgical visualization and impact the treatment of ocular diseases.