Systematic Review of Losartan Eye Drops in Managing Post-Surgical Corneal Haze

Abstract

This study aimed to analyze the effectiveness of losartan eye drops in the treatment of haze corneal secondary to surgical procedures such as Photorefractive Keratectomy (PRK), Laser in Situ Keratomileusis (LASIK), Phototherapeutic Keratectomy (PTK) and crosslinking corneal. For this purpose, this systematic review was carried out based on studies published between 2019 and 2024, selected from databases such as PubMed, Scopus and Web of Science. Inclusion criteria covered clinical trials, observational studies and experiments in animal models that investigated the use of topical losartan in the treatment of haze corneal. Data on haze density, visual acuity, side effects and tolerability were extracted and analyzed. In this way, 20 sources were included, consisting of patients and animal models. Most studies reported a significant reduction of up to 60% in haze density corneal in patients treated with losartan eye drops, with a robust decline in corneal opacity; as well as an efficacy of up to 55% in reducing fibrosis, and with signs of inhibition of myofibroblast generation between 25% and 60%. Regarding visual acuity, there was a reduction of up to 50% in corneal abrasion and a 30% improvement in visual acuity after treatment with losartan when compared to the control group. The most common side effects were mild, including eye irritation and hyperemia, occurring in very few cases. The tolerability of the treatment was considered high, with the majority of patients completing the therapeutic course. That said, topical losartan demonstrated significant efficacy in reducing haze corneal and improving visual acuity, with a favorable safety profile. These findings suggest that losartan eye drops may be a viable and safe alternative for the management of haze corneal secondary to surgical procedures for refractive correction and other corneal pathologies. However, additional studies, especially large-scale randomized clinical trials, are needed to consolidate these results and establish standardized clinical protocols, since one of the limitations found in this study was the scarcity of studies in this field of research, in addition to the low number of studies carried out exclusively on humans.