With millions of intra-vitreal injections being performed every year, an iatrogenic rupture of the posterior capsule by the needle is bound to happen. This is a very tricky situation because the pierced posterior capsule can open wide and allow the nucleus to fall into the vitreous cavity. We must certainly avoid hydro-dissection in these cases, otherwise it could result in an immediate dropped nucleus. Dr Tom Oetting has a great presentation about how to deal with this challenging situation. Our guest surgeon does a great job with this case and with the help of 7 tubes of viscoelastic, the anterior hyaloid face remains intact and there is no vitreous prolapse. The IOL is placed securely with the haptics in the sulcus and the optic captured through the capsulorhexis. You WILL encounter this situation in your career (likely multiple times), so learn from this video now.