A 73-year-old woman with a history of Fuchs dystrophy underwent penetrating keratoplasty. On the first postoperative morning, she reported eye pain. Visual acuity was light perception. There was moderate conjunctival hyperemia. Fibrin and a small hypopyon were present in the anterior chamber. The patient underwent immediate pars plana vitrectomy and intravitreal injections of 1 mg of vancomycin hydrochloride and 400 μg of amikacin sulfate. Frequent topical fortified vancomycin and gentamicin sulfate, as well as topical and oral steroid agents, were used during the early postoperative period. Cultures of the aqueous, the vitreous, and the donor corneal rim yielded vancomycin-resistant (minimum inhibitory concentration >64 μg/mL) Enterococcus faecium. Restriction endonuclease analysis of genomic DNA confirmed that the isolates from the 3 sources were genetically identical. The organism was susceptible to linezolid (minimum inhibitory concentration 1 μg/mL), and 600 mg of linezolid was administered intravenously twice daily. Additional intravitreal injections of 1 mg of vancomycin and 500 μg of ampicillin sodium were given. Signs and symptoms of infection improved steadily. The patient received a 2-week course of oral linezolid after discharge from the hospital. Two years after surgery, visual acuity was 20/80. The graft was thin and clear. There was pallor of the optic nerve and attenuation of the retinal vessels.