An anonymous on-line survey was sent to 234 intraocular Collamer lens (ICL) (Staar Surgical) surgeons in 21 countries to determine how many of their ICL cases had been complicated by endophthalmitis between January 1998 and December 2006. A second questionnaire about the infection details and treatment outcome was sent to those who reported cases of endophthalmitis. Ninety-five (40%) surgeons responded to the survey. They had implanted 17954 ICLs during the study period. Three surgeons reported 1 case of endophthalmitis each, a rate of 0.0167% (95%) confidence interval 0 to 0.036%) or approximately 1 case of endophthalmitis per 6000 ICL implantations. Follow-up details were available in 2 cases. Staphylococcus epidermidis was cultured in both cases, and both were treated without loss of vision. Endophthalmitis may be less common after ICL implantation than after cataract surgery. Further studies are required to define the rate and prognosis for endophthalmitis after ICL implantation to assist in accurate preoperative patient counseling.