Topical Losartan Efficacy And Quality Of Life In Corneal Scarring Fibrosis In A Developing Country
Published 2025 - 43rd Congress of the ESCRS
Reference: PO598 | Type: Free paper | DOI: 10.82333/frct-k576
Authors: Timur M. Yildirim* 1 , Lilly Teich 1 , Maximilian Hammer 1 , Maximilian Friedrich 1 , Ramin Khoramnia 2 , Gerd Auffarth 1
1Department of Ophthalmology,University of Heidelberg,Heidelberg,Germany, 2Department of Ophthalmology,University of Heidelberg,Heidelberg,Germany;Department of Ophthalmology,University of Dresden,Dresden,Germany
Purpose
To determine the efficacy and impact on quality of life of topical losartan in corneas with scarring fibrosis in Guatemalan eyes.
Setting
Cornea, Anterior Segment and Refractive Surgery service of a national reference center in Guatemala, Central America.
Methods
9 eyes of patients who attended with diagnosis of corneal scarring fibrosis regardless etiology and opacity duration were enroled. Exclusion criteria: active lesions of the corneal epithelium, failure to show up for check-up appointments. A professional of a compounding laboratory was hired to produce topical losartan with losartan powder and balanced physiological solution pH 7.0. Minimum observation time was 6 months. Corneal optical density was measured by Pentacam HR and epithelial map was examined with Optovue OCT, previously and at 3 and 6 months after initiating Losartan 0.08% 6 times a day. QoL Spanish validatet version of NEI-VFQ25 instrument was performed before and after 6 months of treatment.
Results
6 patients (75% male) of mean age 31 y/o with corneal scaring due to trauma 50% infectious 17% and ocular surface disease 33% were founded. Mean time of leukoma durarion: 56.75 (±51.25) months (min - max 5 - 108 months). BCVA before treatment: 0.54 ± 0.28; after treatment: 0.01 ± 0.17 logMAR (p<0.05). QoL before treatment was lower than that reported in other chronic eye diseases, 58.02 ± 9.1 and after treatment was 79.56 ± 9 (p<0.01). COD & HOA improved in all patients, but it was not statistically significant (p=0.08).
Conclusions
Topical Losartan 0.08% was effective in the treatment of leukomas regardless of the etiology and time of evolution. No side effects were observed during this study. UCVA, BCVA, mean Spherical Equivalent and QoL significantly improved after topical Losartan treatment.
In developing countries, like Guatemala, where access to surgical procedures by the population is limited, this alternative treatment is safe, effective and economically viable. More long term studies with larger population are needed.