Modified Malyugin ring iris expansion technique in small-pupil cataract surgery with posterior capsule defect

We describe a simple technique involving modification of iris expansion with the Malyugin ring (MicroSurgical Technology) in nondilating small-pupil cataract surgery with preexisting posterior capsule defect or intraoperative posterior capsule tear. A 6-0 polyglactin suture is placed in the leading scroll of the Malyugin ring, and the end of the suture is secured at the main port incision. This prevents the iris expander from inadvertently dropping into the vitreous during intraoperative manipulation.