Introduction: Corneal haze after photorefractive keratectomy (PRK) results from subepithelial stromal fibrosis and may reduce visual acuity. Current management options are limited. Losartan, an angiotensin II receptor blocker, has demonstrated antifibrotic properties in preclinical models. Patient and Clinical Findings: 6 patients (6 eyes) presented with decreased uncorrected distance visual acuity (UDVA) and clinically evident subepithelial haze after PRK. Diagnosis was confirmed by slitlamp biomicroscopy and anterior segment optical coherence tomography (OCT), which quantified fibrosis thickness. Diagnosis, Intervention, and Outcomes: All eyes received topical losartan 0.8% for 30 to 90 days. No other ocular medications were modified during treatment. UDVA was recorded in logMAR before and after therapy, and OCT was used to measure stromal fibrosis thickness. The Wilcoxon signed-rank test was applied for paired statistical analysis. Clinical improvement was observed in 4 of 6 eyes, with mean UDVA improving from 0.65 to 0.43 logMAR. 3 eyes achieved a gain of ≥0.20 logMAR, meeting the threshold for clinical significance. OCT documented fibrosis reduction in several cases. Statistical analysis showed a trend toward significance ( P = .100), suggesting a positive clinical effect that could reach significance with a larger sample size. Conclusions: Topical losartan 0.8% may safely improve visual function and reduce stromal fibrosis in eyes with post-PRK corneal haze. Its noninvasive profile and preliminary functional and anatomic benefits suggest potential clinical utility. Larger, randomized controlled studies are warranted to confirm efficacy, establish optimal dosing, and evaluate long-term safety.
Velazco-Casapía et al. (Thu,) studied this question.