{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:19:06Z","timestamp":1785507546689,"version":"3.56.0"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the long-term safety and efficacy of the intravitreal dexamethasone implant (DEX-I) as a primary treatment in phakic, treatment-na\u00efve patients with diabetic macular edema (DME) over a five-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective 5-year extension of a prospective cohort included phakic patients with type 2 diabetes receiving pro re nata (PRN) DEX-I as first-line therapy. The primary outcome measure was change in best-corrected visual acuity (BCVA), whereas secondary outcome measures included changes in central subfield macular thickness (CSMT), injection frequency, adverse events, and the need for supplemental\/alternate therapy, if any.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      122\/153 patients originally enrolled for the prospective two-year follow-up study completed 5 years of follow-up and were included in the final analysis. At five years, 59.0% of eyes achieved a\u2009\u2265\u200915-letter gain in BCVA, and 41.1% reached 20\/40 or better. CSMT reduction was significant and sustained throughout the follow-up(\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.013). The mean number of injections over five years was 3.1. Cataract surgery was performed in 54.1% of eyes. Transient ocular hypertension was noted to occur in 20.3% of eyes, with no patient requiring incisional surgery for glaucoma. One patient developed post-injection endophthalmitis that resolved without long-term sequelae. 5.7% of eyes required treatment switch to anti-VEGF agents.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In phakic, treatment-na\u00efve patients with DME, long-term treatment with DEX-I is associated with sustained visual and anatomical improvements, a low injection burden, and an acceptable safety profile over 5 years. These findings support its consideration as a primary treatment option in select patient populations with DME.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721261473033","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:58:17Z","timestamp":1785247097000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Five-Year outcomes of the use of the dexamethasone implant in phakic, treatment-na\u00efve patients with diabetic macular edema"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8403-0853","authenticated-orcid":false,"given":"Alper","family":"Bilgic","sequence":"first","affiliation":[{"name":"OSG Augen-Tagesklinik Wittenberge, Wittenberge, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Kodjikian","sequence":"additional","affiliation":[{"name":"H\u00f4spital de la Croix-Rousse"},{"name":"Laboratoire MATEIS, UMR-CNRS 5510, INSA, Villeurbanne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin S.","family":"Spitzer","sequence":"additional","affiliation":[{"name":"University of Hamburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perfecto","family":"Cagampang","sequence":"additional","affiliation":[{"name":"Manila Doctors\u2019 Hospital, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Sudhalkar","sequence":"additional","affiliation":[{"name":"Retina Department, MS Sudhalkar Research Foundation, Pratapgunj, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8936-5940","authenticated-orcid":false,"given":"Jesus Hernandez","family":"Gonzalez-Cortes","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Autonomous University of Nuevo Leon (UANL), Nuevo Leon, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1418-1872","authenticated-orcid":false,"given":"Thibaud","family":"Mathis","sequence":"additional","affiliation":[{"name":"H\u00f4spital de la Croix-Rousse"},{"name":"Laboratoire MATEIS, UMR-CNRS 5510, INSA, Villeurbanne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2016-310063"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2008.10.001"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-019-00560-z"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000003787"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oret.2019.05.027"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1120672119857511"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-017-0563-7"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2014.04.024"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S79948"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2015-306823"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.02.022"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2021-319070"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-016-3472-1"},{"key":"e_1_3_2_15_2","first-page":"999","article-title":"Management of diabetic macular oedema: new insights and global implications of DRCR protocol V","volume":"34","author":"Cheung N","year":"2020","unstructured":"Cheung N, Cheung CMG, Talks SJ, et al. 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