BACKGROUND: Intraocular pressure (IOP) after intravitreal triamcinolone acetonide (TA) for diffuse diabetic macular edema will be analyzed. PATIENTS AND METHODS: This prospective, non-randomized interventional case-series study included 69 patients (n=81 eyes) with diffuse diabetic macular edema receiving intravitreal TA (about 20 mg); 4 eyes had re-injection. Follow-up was 7.66+/-7.36 months. RESULTS: IOP increased significantly (p<0.001, Wilcoxon) from mean preoperative 15.4+/-3.2 mmHg to mean maximum postoperative 20.4+/-4.7 mmHg. An increase of >21 mmHg in 31 eyes (38.3%) was noted. In eyes with secondary hypertension, IOP was controlled with antiglaucomatous drops; 6 months after injection IOP was normal without medication. CONCLUSION: After intravitreal TA, secondary ocular hypertension develops in 38.3% in eyes with diabetic diffuse macular edema after 1 month, which can be controlled by antiglaucomatous drops. Diffuse diabetic macular edema may not imply a contraindication for intravitreal TA.