目的：观察地塞米松玻璃体内植入剂(DEX)治疗顽固性糖尿病性黄斑水肿(DME)的疗效。方法：回顾性研究。收集2019-06/2020-01于郑州市第二人民医院确诊为顽固性DME并行玻璃体腔内注射DEX患者30例30眼的临床资料。观察治疗前后最佳矫正视力(BCVA)、眼压、黄斑中心凹厚度(CMT)变化及并发症。结果：治疗后1、2、3、4、6mo BCVA(LogMAR)(0.57±0.53、0.42±0.48、0.43±0.26、0.45±0.66、0.51±0.37)较治疗前(0.86±0.47)显著提高(均P<0.05)； 治疗后1、2、3、4、6mo CMT(412.57±74.55、370.21±23.83、371.53±52.66、373.28±68.49、389.35±95.61μm)较治疗前(495.64±107.23μm)有差异(均P<0.05)。用药后2mo BCVA和CMT临床效果达到最佳，部分患者病情反复，再次出现视力下降及黄斑水肿加重，4眼于术后3mo、5眼于术后4mo及2眼于术后6mo，再次注射DEX。所有患者中4眼出现高眼压(≥22mmHg)，应用降眼压药物后，眼压均控制在正常范围内。1眼出现白内障加重。随访6mo中未发生眼内炎、视网膜脱离等并发症。结论：玻璃体腔注射DEX可以有效提高顽固性DME患者BCVA，减轻黄斑水肿。

AIM: To investigate the efficacy of dexamethasone implant injection in the treatment of persistent diabetic macular edema(DME).METHODS: The clinical data of 30 DME patients(30 eyes)after anti-vascular endothelial growth factor(anti-VEGF)agents from June 2019 to January 2020 were retrospectively analyzed. All patients had underwent intravitreal injection of DEX. Best corrected visual acuity(BCVA), intraocular pressure(IOP), central macular thickness(CMT)and adverse events were recorded.RESULTS:BCVA(LogMAR)was significantly improved from(0.86±0.47)to(0.57±0.53, 0.42±0.48, 0.43±0.26, 0.45±0.66 and 0.51±0.37)at 1, 2, 3, 4 and 6mo after treatment. CMT improved significantly from baseline(495.64±107.23)μm to(412.57±74.55, 370.21±23.83, 371.53±52.66, 373.28±68.49, 389.35±95.61)μm 1, 2, 3, 4 and 6mo post-injection. The drug reached its peak efficacy 2mo after administration. 4 eyes were given repeated injection at 3mo, 5 eyes were given at 5mo and 2 eyes were given at 6mo following the primary injection. Cataract progression was showed in 1 case. 4 patients demonstrated IOP levels above 22mmHg and were mostly controllable by IOP-lowering medications. None of patients showed any adverse events at 6mo of follow-up.CONCLUSION: Dexamethasone implant injection showed significant BCVA and CMT improvement. DEX injection may be utilized as an effective DME therapy for patients who are persistent after anti-VEGF treatment.