Efficacy and safety of intraocular lens removal combined with vitrectomy for acute endophthalmitis in pseudophakic eyes

To evaluate the efficacy and safety of intraocular lens (IOL) removal during vitrectomy in the treatment of primary endophthalmitis in pseudophakic eyes. A comparative retrospective study was conducted on 55 eyes diagnosed with endophthalmitis at the Department of Ophthalmology, Saarland University Medical Center, between the years 2016 and 2020. The study assessed both functional and morphological long-term outcomes in patients undergoing pars plana vitrectomy (PPV) with IOL removal versus those with IOL preserved. Key parameters measured included best corrected visual acuity, duration of hospitalization, and the rate of inpatient and post-discharge complications. The removal of the IOL did not significantly affect treatment outcomes, as there were no notable differences in best corrected visual acuity, hospitalization duration and the postoperative complication rates between both groups. IOL removal does not seem to offer additional advantages in the management of endophthalmitis. Thus, PPV IOL preservation seems to be a safe approach. Retaining the IOL may represent a viable and safe option, avoiding unnecessary surgical intervention in acute settings without significantly compromising patient outcomes. However, larger studies are required to confirm these findings.