PURPOSE: this study evaluates the long-term safety and efficacy of Nd:YAG vitreolysis for symptomatic vitreous floaters, as it remains a controversial procedure due to the lack of robust evidence in the literature for its maintenance of the results and absence of adverse effects. METHODS: this is an observational extension to the previously presented prospective, randomized, double-blind clinical trial study. Eight of thirteen subjects who underwent vitreolysis with YAG laser returned for a late reevaluation, 18 months after the procedure, to evaluate the efficacy and safety of the procedure.RESULTS: all patients maintained the improvement in symptomatology noted after the procedure, with 25% showing complete improvement, and a similar proportion (37.5%) reporting significant or partial improvement. Objective improvement in opacity was similar to that found at 6 months follow-up. The NEI-VFQ 25 quality of life questionnaire showed no statistically significant difference in responses between the sixth and eighteenth month. No adverse effects were noted on clinical examination or reported by patients.CONCLUSION: vitreolysis efficacy observed at 6 months of follow-up was maintained until the eighteenth month, with all patients reporting improvement from the pre-procedure state. No late adverse effects were noted. A larger randomized clinical trial is needed to confirm the safety of the procedure.
