Efficacy of dexamethasone intravitreal implant for the treatment of diabetic macular edema

Purpose: To assess the efficacy of a single dexamethasone intravitreal implant (Dex-I) injection for the treatment of diabetic macular edema (DME). Methods: This was a retrospective chart review of 39 eyes (34 consecutive patients). Best-corrected visual acuity (BCVA), central macular thickness (CMT), and increase in intraocular pressure (IOP) (> 24 mm Hg) were analyzed before treatment and 2 and 4 months after injection. Results: Preoperative mean CMT was 559 +/- 111 mu m and decreased to 338 +/- 84 and 477 +/- 140 mu m 2 and 4 months after injection, respectively. Although all eyes showed a significant decrease in CMT 2 months after injection (p < 0.0001), a recurrence of the macular edema was observed 4 months after injection in 79% of eyes. Mean BCVA improvement (logMAR) was 0.13 +/- 0.18 (p < 0.0001) and 0.07 +/- 0.21 (p = 0.049) 2 and 4 months after injection, respectively, without significant difference between vitrectomized and nonvitrectomized eyes. Eight eyes (21%) developed reversible increase in IOP 2 months after injection. Conclusions: Thirty percent of DME eyes had gained more than 2 logMAR lines 2 months after Dex-I injection and safety was good. Visual acuity gain was maintained 4 months after injection despite a recurrence of edema in most cases.