CLINICAL EVALUATION OF TOPICAL LOSARTAN FOR POSTOPERATIVE CORNEAL HAZE REDUCTION

Losartan, an angiotensin II receptor blocker, inhibits TGF-beta signaling and previous reports suggested topical losartan to reduce corneal scarring after corneal injuries or surgeries.

To evaluate the efficacy and safety of topical losartan as an adjuvant treatment for postoperative corneal haze.

¹ Unidade Local de Saúde Almada Seixal, Almada, Portugal

Patients with central corneal scarring and fibrosis following refractive or corneal surgical procedures. Treatment was initiated with topical losartan (0.8 mg/mL, 6id). Exclusion criteria encompassed active or recent (within three months) ocular infections, uveitis, other inflammatory ocular and systemic conditions which potentially impair corneal healing (diabetes mellitus, autoimmune disorders, or connective tissue diseases). The study protocol included a baseline examination and a follow-up examination four months after baseline, during which Snellen best corrected visual acuity (BCVA), slit lamp biomicroscopy, Goldmann applanation tonometry and corneal Scheimpflug tomography (Pentacam HR; Oculus Optikgeräte GmbH) were measured. The primary outcomes measured in each case were BCVA, subjective visual function and corneal optical densitometry.

This case series included six patients with a mean follow-up time of 132 days. A significant reduction of corneal haze was observed in every patient, both at slit lamp examination and in corneal tomography analyses. Mean BCVA improved from 0.6 to 0.4 logMAR 4 and mean corneal optical densitometry decreased from 32GSU to 19GSU.

Losartan inhibits transforming growth factor-β (TGF-β) signaling and is a promising agent to safely reduce corneal haze. Further clinical studies will emphasize the role and efficiency of losartan in corneal scarring treatment, both in terms of dosage and treatment duration.