Non- and poorly-dilating pupils can pose a challenge during and after cataract surgery. In milder cases, a careful surgical approach and application of intracameral phenylephrine might suffice. However, moderate and severe cases require a pupil expander.

In this part of the Complex Cases, Simplified series, Paul Ursell, MBBS, MD, FRCOphth, explains his view of the management of small pupils, comparing iris hooks with pupil expansion rings (Malyugin Ring). He also touches on the thought process behind adopting new surgical techniques. You can also check out some of the practical tips Mr. Ursell shared in one of our webinars (watch Mr…

Safer attitudes to surgical adjuncts

Surgical adjuncts are not commonly used during routine cataract procedures. However, if complexity exists or complications occur intraoperatively, they can become a surgeon’s best friend. The need for these specialized tools and instruments should always be considered as part of surgical pre-planning to simplify the case and increase safety through avoiding complications. So why are we so reluctant to use them?

In this part of the Complex Cases, Simplified series, Dr. David Lockington addresses the attitudes toward adjuncts and makes a compelling case for the use of the Malyugin Ring 2.0. To get more details on the cases Dr. …


Trabectome — Helping to reduce IOP on a wide patient spectrum

Trabectome® (MicroSurgical Technology) is an easy-to-use, proven irrigating goniectomy device that has shown a sustained IOP reduction.[1]

In this part of the Complex Cases, Simplified series, Dr. Tomas M. Grippo discusses his experience using Trabectome. He describes the technique, the device, and its features and discusses his key learnings with it.

Tomas M. Grippo, MD. Founder, Grippo Glaucoma & Cataract Center, Buenos Aires, Argentina; Assistant Professor (Adjunct) of Ophthalmology & Visual Science, Yale School of Medicine


I started performing irrigating goniectomy using Trabectome during my fellowship in California back in 2010. …

Part VII

Micro Instruments That Facilitate Fibrorhexis Technique and Late IOL Explantation

In this seventh part of the Complex Cases, Simplified series, Dr. Amzallag shares his experience with the fibrorhexis technique and how to simplify it by using micro instrumentation.

Thierry Amzallag, MD. Institut Ophtalmique Somain (France), president-elect of the French Society of Cataract and Refractive Surgery (SAFIR), co-opted member of the Board of the European Society of Cataract and Refractive Surgery (ESCRS).

The Role of Micro Instruments

In my private practice in Northern France, patient outcomes are excellent, and I attribute, in part, these results to my choice of micro instruments. I have been using the MicroSurgical Technology (MST) micro instruments for many years and find…

Part VI

MST’s New Scleral IOL Fixation Solutions Kit Standardizes the Yamane Technique

The new Scleral IOL Fixation Solutions Pack from MicroSurgical Technology (MST), provides every instrument required to fixate an intraocular lens (IOL) based on the Yamane approach.

In this sixth part of the MST Educational Series, Dr. Jason Jones discloses his experience as he uses the new MST Scleral IOL Fixation Solutions Pack with the Yamane double-needle procedure.

Jason Jones, MD, Jones Eye Clinic and Surgery Center, Sioux City, Iowa.

MST’s Scleral Fixation Solutions pack

The original concept behind the MST Scleral IOL Fixation Solutions Pack (SFP) evolved from a specific need for a better quality disposable hypodermic needle. …

Part V

Reliability and confidence in complex cases.

In this fifth part of the Complex Cases, Simplified series, Dr. José Luis Güell shares his experience and tips for capsulorhexis in microincision cataract surgery.

José Luis Güell, MD, PhD. Founding member of IMO (Instituto de Microcirugía Ocular) in Barcelona and coordinator of the Corneal and Refractive Surgery department. Founding member and past president of the EuCornea (European Society of Cornea Specialists). Dr. Jose Luis Güell holds a PhD in Ophthalmology from Barcelona University and he is a Master Professor at IMO, Spain.


Small incisions and an atraumatic approach require micro-instrumentation for best patient outcomes. MicroSurgical Technology (MST) micro-instruments help…

Part 4

Simplifying MIGS Micro Stent Revision Surgery

In the fourth part of this series, a world-renowned surgeon, Dr. John Berdahl, shares his experience using the latest addition to MicroSurgical Technology’s micro-instrumentation family, the 19g Ahmed Micro Stent cutter. Dr. Berdahl describes the key considerations for the CyPass revision surgery, the surgical steps involved, and summarizes the key learnings with his preferred approach.

Part 3

No Zonules? No problem

In this third part of the ‘Complex Cases, Simplified’ series, Dr Brandon Ayres, MD, shares his experience using the MST Capsule Retractors, Chang Modification to manage complicated cataract cases with zonulopathy.

Part 2

The Malyugin Ring 2.0 plays an expanding role in small pupil surgery

In this second article of the ‘Complex Cases, Simplified’ series, Dr. Boris Malyugin, M.D., the inventor of the Malyugin Ring (Figure 1), describes the device in complex small pupil cases and provides an overview of his surgical steps in cases requiring the use of the ring.

Part 1

MST instruments ease IOL explantation — transforming complexity, ensuring simplicity

This first article in the Complex Cases, Simplified series features a case study by Dr Nicole Fram, M.D., in which three MicroSurgical Technology [MST] instruments are used: Packer/Chang IOL Cutters, Hoffman/Ahmed Micro-Scissors, and Micro-Holding Forceps. These small and powerful micro instruments ease the explantation of an IOL, making the whole procedure more manageable for the surgeon and more comfortable for the patient.

MicroSurgical Technology — MST

MST’s philosophy statement is “We make great products that people love”, which guides us in the way we choose and design our products.

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store