PurposeTo evaluate the real-life safety, morphol., and visual outcomes of the dexamethasone intravitreal implant (Ozurdex) in patients with macular edema (ME) within a low-middle-income country (LMIC) setting.MethodsPatients with ME who received Ozurdex injections between 2012 and 2018 were included.Central retinal thickness (CRT), best-corrected visual acuity (BCVA), lens status, and intraocular pressure (IOP) at baseline and last follow-up were compared.Univariate and multivariate analyses identified factors associated with visual improvement.Results154 patients were enrolled.Diabetic ME was the most common etiol. (32.4%), followed by central retinal vein occlusion (18.8%), branch retinal vein occlusion (14.2%), and uveitis (9.99%).CRT was significantly reduced in all patients except those with uveitis but did not correlate with BCVA improvement.Lower baseline visual acuity (OR=1.67), younger age (OR=1.87), and ME secondary to branch retinal vein occlusion (OR=1.34) were associated with BCVA improvement (p < 0.05).During follow-up, 11 patients (7.14%) developed cataracts, and 22 (14.2%) showed increased IOP; these complications resolved without affecting final BCVA improvement.ConclusionIn an LMIC setting, Ozurdex effectively reduces CRT in diabetic and retinal vein occlusion-related ME but not in uveitis.BCVA improvement depends on factors beyond CRT reductionCataracts and elevated IOP are manageable complications.