A lab across the hall from the operating theatre at the Doheny Eye Institute, USC School of Medicine, Los Angeles, recently acquired machine tools intended to work in offices. The Microsurgical Advanced Design lab now sports an Office Lathe and Office Mill from Haas Automation Inc., Oxnard, Calif. (haascnc.com) to create prototypes — all previously made by hand — for microsurgical instruments. The lathe turns down to 0.005 in. and cross drills with 0.002-in.-diameter tools, says instrument maker Matt McCormick. And the mill handles hard milling as well as conventional milling. Both machines hold tolerances to tenths. McCormick's team makes prototypes out of titanium, 300 series stainless steel, mold steels, hardened tool steel, Delrin plastic, acrylics, and ceramic. For example, a surgeon might request a new type of forceps to pick up a little membrane in the retina. The lab would build a prototype and test the instrument on silicone or pigs' eyes. Instruments of the right classification are used immediately in the OR. Complicated ones may have to go to FDA-certified companies such as Bausch and Lomb for manufacturing.