Efficacy And Safety Of Topical Losartan Drops For Corneal Scars: A Systematic Review Of In Vivo And In Vitro Studies
Published 2026 - 44th Congress of the ESCRS
Reference: PP20.018 | Type: Free paper | DOI: 10.82333/3bb7-9k09
Authors: Dr Hashem Abu Serhan* 1 , Dr Ahmad Alazzam 2 , Dr Ahmad Barakat 2 , Dr Anas Alamoudi 3 , Dr Nagi Ahmed 1 , Dr Naseem Elkhili 4 , Dr Raed Alnutaifi 5
1Department of Ophthalmology,Hamad Medical Corporation,Doha,Qatar, 2Faculty of Medicine,The Hashemite University,Zarqa,Jordan, 3Department of Ophthalmology,Jeddah Eye Hospital,Jeddah,Saudi Arabia, 4Department of Ophthalmology,Tripoli University,Tripoli ,Libya, 5Faculty of Medicine,King Saud University,Riyadh,Saudi Arabia
Purpose
To evaluated the efficacy and safety of topical losartan drops for corneal scars.
Setting
A systematic review.
Methods
Our protocol was registered on PROSPERO (CRD420251035857). We conducted a systematic review following the PRISMA guidelines. Eligible studies included in vivo and in vitro models reporting improved corneal opacity, fibrosis, or related markers. We searched PubMed, Scopus, Web of Science, Embase, Cochrane Library, ClinicalTrials.gov, WHO ICTRP, and Google Scholar for articles published through April 2025. Risk of bias was assessed using the Joanna Briggs Institute checklist for in vitro and clinical studies, and the SYRCLE tool for animal experiments.
Results
We included 14 studies in our systematic review, divided into seven high quality in-vivo studies (15 patients, ages 15–72) with diverse corneal scars treated with topical losartan 0.8 mg/mL for 4–9 months and seven in vitro studies on New Zealand white rabbits tested topical losartan (0.1–40 mg/mL) for corneal fibrosis in varied injury models over 4–6 weeks. Losartan reduced corneal myofibroblasts and fibrosis dose-dependently, improving transparency without impairing healing or causing significant toxicity. In vivo studies showed that both objective assessments and subjective measures consistently demonstrated reduction in corneal scarring and variable improvement in visual outcomes, with a well-tolerated adverse events profile.
Conclusions
Topical losartan demonstrates promising antifibrotic effects in both in vivo animal models and in vitro human corneal fibroblast cultures, with minimal reported toxicity or adverse effects.