Cataract prevention, Cataract Drops: N-acetylcarnosine (NAC) & the controversy

Many are searching for a drop that will remove or “dissolve” a cataract.
The best review I found online to summarize the problems with N-acetylcarnosine (NAC) is below.

The facts are:
1. No randomized, double blinded, prospective studies on N-acetylcarnosine (NAC).
2. The vast majority of studies are sponsored by the company who has a vested interest. 

Babizhayev MA

  • 1Innovative Vision Products, New Castle, Delaware, USA.
  • 3. While it likely does not harm patients, there is no proof that NAC is more effective compared to just increasing antioxidant intake through natural foods.
Until there are good studies, most EyeMDs will be very cautious to recommend this. Amazon does sell it & it received ok reviews but a few said it did not help and some said it made vision worse.
Likely best advice till we have better data:
Put your money in a great pair of wrap around glasses & eat more anti-oxidants.

Cataract Drops

Q: Can N-acetylcarnosine eye drops dissolve cataracts, as marketers say?
A: Some animal studies and a few human trials suggest the drops may help reverse lens cloudiness, the hallmark feature of cataracts—but claims that they are a cataract cure are overstated, at best. The Food and Drug Administration (FDA) has not approved any form of carnosine for the treatment of cataracts. (Carnosine is also sold as a dietary supplement, promoted foreye health and many other disorders.)
Various carnosine-related compounds, including N-acetylcarnosine (NAC), occur naturally in the body. When applied in eye drops, NAC makes its way to the interior of the eye, where it may have antioxidant effects. Oxidation of lipids in the lens of the eye is thought to contribute to cataracts. NAC may also help prevent “cross-linking” of proteins, another factor behind cataracts.
In a study published in Clinical Interventions in Aging in 2009, people with cataracts who used NAC drops for nine months appeared to have an improvement in visual acuity and sensitivity to glare (a problem with cataracts), compared to those using placebo drops. But as with prior studies, this one was relatively small—and there are no data on long-term use.
Moreover, nearly all of the research has been done by a Russian scientist who developed and holds a patent for a brand of NAC eye drops, called Can-C. Larger, better—and independent—studies are needed. According to the Royal College of Ophthalmologists in England, the evidence so far does not support the claims or establish safety of NAC drops.
The best ways to reduce the risk of cataracts are to get plenty of antioxidants from fruits and vegetables, wear sunglasses and a hat to protect your eyes from ultraviolet light and not smoke. Studies on antioxidant supplements have mostly had disappointing results. The only sure cataract cure is surgical removal and replacement of the lens. Still, if you want to try the drops for mild cataracts, talk to your eye-care professional first.
 2009 Nov-Dec;16(6):517-33. doi: 10.1097/MJT.0b013e318195e327.

N-acetylcarnosine lubricant eyedrops possess all-in-one universal antioxidant protective effects of L-carnosine in aqueous and lipid membrane environments, aldehyde scavenging, and transglycation activities inherent to cataracts: a clinical study of the new vision-saving drug N-acetylcarnosine eyedrop therapy in a database population of over 50,500 patients.

Author information

  • 1Innovative Vision Products, New Castle, Delaware, USA.


The antioxidant activity of L-carnosine (beta-alanyl-L-histidine, bioactivated in ocular tissues) versus N-acetylcarnosine (N-acetyl-beta-alanyl-L-histidine, ocular-targeted small dipeptide molecules) was studied in aqueous solution and in a lipid environment, employing liposomes as a model of lipid membranes. Reactive oxygen species (ROS) were generated by an iron/ascorbate promoter system for induction of lipid peroxidation (LPO). L-carnosine, which is stabilized from enzymatic hydrolysis, operates as a universal aldehyde and ROS scavenger in both aqueous and lipid environments and is effective at preventing ROS-induced damage to biomolecules. Second-generation carnosine analogs bearing the histidyl-hydrazide moiety were synthesized and tested versus L-carnosine for their ability to reverse the glycation process, also known as the Maillard reaction, and reverse the stable intermolecular cross-links, monitored in the glucose-ethylamine Schiff base model, ultimately resulting in the formation of the advanced glycation end products (AGEs) from nonenzymatic glycation, accumulating in numerous body tissues and fluids. The obtained data demonstrate the transglycation properties of the ophthalmically stabilized L-carnosine and L-carnosine histidyl-hydrazide derivatives tested and can be used to decrease or predict the occurrence of long-term complications of AGE formation and improve therapeutically the quality of vision and length of life for diabetes mellitus patients and survivors with early aging. Scientists at Innovative Vision Products, Inc. (IVP), developed lubricant eyedrops designed as a sustained-release 1% N-acetylcarnosine prodrug of L-carnosine. The eyedrops contain a mucoadhesive cellulose-based compound combined with corneal absorption promoters and glycerine in a drug-delivery system. Anti-aging therapeutics with the ophthalmic drug eyedrop formula including N-acetylcarnosine showed efficacy in the nonsurgical treatment of age-related cataracts for enrolled participants in the prospective, randomized, double-masked, placebo-controlled crossover clinical trial after controlling for age, gender, and daily activities. In a cohort in excess of 50,500 various patients seeking cutting-edge medical care, the N-acetylcarnosine topical eyedrops target therapy was demonstrated to have significant efficacy, safety, and good tolerability for the prevention and treatment of visual impairment in this older population with relatively stable patterns of causes for blindness and visual impairment. Overall, accumulated study data demonstrate that the IVP-designed new vision-saving drugs, including N-acetylcarnosine eyedrops, promote health vision and prevent vision disability from senile cataracts, primary open-angle glaucoma, age-related macular degeneration, diabetic retinopathy, and aging. N-acetylcarnosine eyedrop therapy is the crown jewel of the anti-aging medical movement and revolutionizes early detection, treatment, and rejuvenation of aging-related eye-disabling disorders. N-acetylcarnosine, as an innovative medical science tool and component of the home medicine and alternative medicine approaches, has the potential to alleviate visual impairment and its associated social, economic, and political woes for an aging population.

Efficacy of N-acetylcarnosine in the treatment of cataracts.

Author information

  • 1Innovative Vision Products, Inc., County of Newcastle, Delaware, USA.



To evaluate the effects of 1% N-acetylcarnosine (NAC) solution on lens clarity over 6 and 24 months in patients with cataracts.


Randomised, placebo-controlled study.


49 subjects (76 affected eyes) with an average age of 65.3 +/- 7.0 years with a diagnosis of senile cataract with minimum to advanced opacification in various lens layers.


26 patients (41 eyes) were allocated to topical NAC 1% eyedrops twice daily. The control group consisted of 13 patients (21 eyes) who received placebo eyedrops and 10 patients (14 eyes) who did not receive eyedrops.


All patients were evaluated at entry and followed up every 2 months for a 6-month period (trial 1), or at 6-month intervals for a 2-year period (trial 2), for best-corrected visual acuity and glare testing. In addition, cataract was measured using stereocinematographic slit-images and retro-illumination examination of the lens. Digital analysis of lens images displayed light scattering and absorbing centres in two- and three-dimensional scales.


The overall intra-reader reproducibility of cataract measurements (image analysis) was 0.830, and glare testing 0.998. After 6 months, 90% of NAC-treated eyes showed improvement in best corrected visual acuity (7 to 100%) and 88.9% showed a 27 to 100% improvement in glare sensitivity. Topographic studies indicated fewer areas of posterior subcapsular lens opacity and 41.5% of treated eyes had improvement in image analysis characteristics. The overall ratios of image analysis characteristics at 6 months compared with baseline measures were 1.04 and 0.86 for the control and NAC-treated group, respectively (p < 0.001). The apparent benefits of treatment were sustained after 24 months’ treatment. No treated eyes demonstrated worsening of vision. The overall visual outcome in the control group showed significant worsening after 24 months in comparison with both baseline and the 6-month follow-up examination. The overall clinical results observed in the NAC-treated group by the 24-month period of examination differed significantly (p < 0.001) from the control group in the eyes with cortical, posterior subcapsular, nuclear or combined lens opacities. Tolerability of NAC eyedrops was good in almost all patients, with no reports of ocular or systemic adverse effects.


Topical NAC shows potential for the treatment and prevention of cataracts.
From AMAZON site:

Important Information

Glycerin (lubricant) 1.0% Carboxymethylcellulose sodium (lubricant) 0.3% N-Acetyl-Carnosine (NAC) 1.0% (approved by IVP) Potassium Bicarbonate Boric Acid Purified Benzyl Alcohol (Preservative) 0.3% Sterile Water (Ophthalmic Grade Isotonic Solution, pH 6.3 to 6.5)

Lean your head back and look up. Instill “one drop” then slowly and gently close the eye. Do not blink or reopen for 60 seconds. Repeat this procedure, if a second drop is used. This allows each drop to be absorbed into the eye tissue. Blinking, even one or two times, will pump most of the solution out of the eye. If you have neck problems, lie down or use a tilt-back chair. Store at room temperature up to two months from opening.

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Product Description

Protect your eyes from sun damage, long hours of computer use, damage caused by physical injuries or glycation processes. Our anti-aging eye drops were developed to promote MAXIMUM EYE HEALTH as well as assist with any existing eye conditions. You might be already taking your vitamins and antioxidants that are known to benefit eye health, but you want to move onto the NEXT LEVEL with your eye care regime. Our formula has been SCIENITFICALLY PROVEN in animal/human trials, discover what it can do for you in the comfort of your own home.
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