Background: A corneal abrasion with pronounced inflammation and erosion after phacoemulsification surgery seems to be a rare event. It causes considerable ocular irritation with a presumably higher risk of postoperative endophthalmitis due to increased intraocular pressure changes and fluid influx through the clear cornea incision. Reports about this constellation and about a conceivable extension of endophthalmitis prophylaxis with topic anaesthetics seem not tobe readily available. Case presentation: A 62-year old patient underwent a standard phakoemulsification. During preparation the desinfection swab had contact with the cornea. A marked keratitis and a corneal erosion set in within hours after surgery. Additional prophylactic measures were adhibited as systemic antibiotics and anesthetic drops. Corneal or intraocular infection, corneal scarring or recurrent erosion did not occur; faced with the risk of delayed onset of endophthalmitis the patient developed posttraumatic stress syndrome. Conclusions: The given case report of an uncommon perioperative complication containsdeliberations unto additional prophylactic measures against endophthalmitis to be taken intoaccount though otherwise deemed uncustomary.