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Nd:YAG Laser Vitreolysis For Primary Symptomatic Vitreous Floaters : A Systematic Review and Meta-analysis
Abdullah Alnajres1, Shaikhah Alsenani1, Mohammed Almajhadi1
1College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Ophthalmology. Retina
|July 31, 2026
Summary
Nd:YAG laser vitreolysis significantly improves vision-related quality of life and contrast sensitivity for symptomatic vitreous floaters. This less invasive treatment offers a favorable safety profile compared to pars plana vitrectomy.
Area of Science:
- Ophthalmology
- Laser Surgery
- Retinal Diseases
Background:
- Symptomatic vitreous floaters can severely impact daily life and visual function.
- Current treatment options may have limitations or risks.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness and safety of Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) laser vitreolysis for primary symptomatic vitreous floaters.
- To compare Nd:YAG vitreolysis with pars plana vitrectomy (PPV).
Main Methods:
- Systematic review and meta-analysis following PRISMA 2020 guidelines.
- Searched PubMed, Embase, Scopus, and Cochrane Library (Jan 2000-Jul 2025).
- Included adult patients treated with Nd:YAG vitreolysis; primary outcome was subjective visual improvement (NEI VFQ-25).
Main Results:
- Fifteen studies (718 eyes) analyzed; Nd:YAG vitreolysis significantly improved NEI VFQ-25 scores (+18.9 points) and contrast sensitivity.
- Best-corrected visual acuity (BCVA) remained stable.
- Adverse events were infrequent and transient; no permanent vision loss reported.
Conclusions:
- Nd:YAG laser vitreolysis demonstrates significant benefits in visual function and quality of life for vitreous floaters.
- It presents a potentially safer, less invasive alternative to PPV for selected patients.
- Further high-quality randomized controlled trials comparing Nd:YAG vitreolysis with PPV are recommended.
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