Analysis of factors influencing the efficacy of YAG laser vitreolysis for symptomatic vitreous opacities and prediction of postoperative complication risks: a retrospective cohort study.

OBJECTIVE: To identify factors influencing the efficacy of Yttrium Aluminum Garnet (YAG) laser vitreolysis for symptomatic vitreous opacities and to establish a risk prediction model for postoperative complications. METHODS: This retrospective study included 130 patients with symptomatic vitreous opacities who underwent YAG laser vitreolysis from January 2022 to December 2024. The relationships between patient demographics, clinical characteristics, surgical parameters, and treatment efficacy were analyzed. Multivariate logistic regression was applied to identify independent predictive factors for treatment efficacy. A risk prediction model for complications was constructed and evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS: At 3 months postoperatively, 78 (60.0%), 32 (24.6%), and 20 (15.4%) patients experienced marked, partial, and no improvement, respectively. Multivariate analysis identified age (OR=1.052, 95% CI: 1.012-1.093), disease duration (OR=1.105, 95% CI: 1.032-1.183), degree of vitreous opacity (OR=2.356, 95% CI: 1.325-4.187), and laser energy (OR=1.872, 95% CI: 1.235-2.841) as independent factors influencing efficacy (all P<0.05). Postoperative complications occurred in 70 (53.8%) patients. The prediction model demonstrated good performance, with an area under the curve (AUC) of 0.792, sensitivity of 0.714, and specificity of 0.667. CONCLUSIONS: The efficacy of YAG laser vitreolysis is influenced by multiple factors. The established complication risk prediction model shows good predictive ability and may aid clinical decision-making.