Endophthalmitis due to inadvertent globe penetration during retrobulbar injection of saline solution for laser in situ keratomileusis.

A 31-year-old woman presented with visual acuity of counting fingers and presumed bacterial endophthalmitis in the left eye 10 days after refractive surgery. During the procedure, a retrobulbar injection of balanced salt solution had been performed to assist with globe suction by the microkeratome. A perforation site was identified in the inferonasal retina. Following intravitreal antibiotic injection and surgical intervention, the visual acuity returned to 20/20. Retrobulbar injection to facilitate laser in situ keratomileusis carries risks. Careful monitoring for signs of infection is recommended if globe perforation is recognized.