Introduction: To report the successful treatment of chronic laser-assisted in situ keratomileusis (LASIK) interface scarring using topical losartan 0.08%, 2 decades after initial surgery. Patient and Clinical Findings: A 54-year-old woman presented with decreased bilateral vision due to central corneal fibrosis and scarring of the LASIK flap interface. The areas of scarring were refractory to prolonged topical corticosteroid treatment. Diagnosis, Intervention, and Outcomes: A diagnosis of chronic, progressive post-LASIK stromal fibrosis was made. Topical losartan 0.08% was initiated 6 times daily. Serial Pentacam densitometry and anterior segment optical coherence tomography confirmed gradual improvement in stromal haze and increased clarity. After 10 months, corrected distance visual acuity improved, and corneal densitometry showed a measurable reduction in opacity. No adverse effects were observed. Conclusions: This case highlights the potential utility of topical losartan in reversing long-standing LASIK interface scarring. Even fibrosis decades after surgery may remain biologically modifiable with targeted antifibrotic therapy.
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