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Purpose: To evaluate the safety and efficacy of intravitreal dexamethasone (IVD) implants in eyes with diabeticmacular edema that did not respond to previous treatment. Methods: We included 46 eyes of 46 patients in this retrospective study. Each month, we recorded patient visualacuity with logarithm of the minimum angle of resolution using the Early Treatment Diabetic RetinopathyStudy chart, central macular thickness measurements with optical coherence tomography, intraocular pressure(IOP), and posttreatment complication occurrence. Results: The mean follow-up time was 8.95 ± 1.33 months (range, 6 to 12). Best-corrected visual acuity improvedsignificantly in the first 4 months after IVD, but no statistically significant change was observed over the following2 months. Although a statistically significant decrease in central macular thickness was observed in thefirst 3 months, the change was not statistically significant in the following 3 months. There was a statisticallysignificant increase in IOP in the first 2 months, but no statistically significant change was observed in the followingmonths. IOP was controlled with medication in all patients with elevated IOP. Of the 26 phakic patients,two had cataracts requiring surgery. Conclusions: Cases of refractory diabetic macular edema that did not respond to previous treatment, such asanti-vascular endothelial growth factor injections and laser photocoagulation, exhibited improvements in visualacuity and decreases in retinal thickness after IVD implantation. Both functional and anatomical effects wereobserved in the first 3 months after injection. Repeat injections and frequent examination might be required forcontinued improvement. Side effects, such as cataracts and elevation of IOP, may require medical or surgicaltreatment.

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