Can prescription eye drops like lanosterol (Can-C eye drops) help ease cataract symptoms?

No Prescription Eye Drops Are Proven to Ease Cataract Symptoms

There are currently no FDA-approved or guideline-recommended prescription eye drops that can reverse or ease cataract symptoms—surgery remains the only established treatment. 1

Current Standard of Care

The American Academy of Ophthalmology's 2022 guidelines definitively state that once visual acuity and function decline from cataracts, the disease progresses with no chance of reversal through medical therapy. 1 The only proven treatment is surgical removal of the cataractous lens. 1

Why Lanosterol Eye Drops (Can-C) Are Not Recommended

Despite initial excitement about lanosterol and similar oxysterols as potential cataract treatments, the evidence does not support their clinical use:

Failed Clinical Evidence

• A 2019 study directly contradicted the premise that lanosterol can dissolve cataracts, showing that 15 mM lanosterol liposomes failed to reverse lens opacities in rat lenses or prevent progression to nuclear cataracts. 2
• The same study found that lanosterol (0.20 mM) and 25-hydroxycholesterol (0.25-0.50 mM) failed to increase soluble lens proteins or decrease insoluble proteins in human lenses aged 47-60 years. 2
• Molecular binding studies confirmed that both oxysterols failed to reach acceptable threshold binding scores to αB-crystallin proteins compared to ATP, undermining the proposed mechanism of action. 2

Lack of Genetic Support

• A 2024 genetic association study of 45,449 cataract cases found no statistically significant associations between lanosterol-related genetic variants and cataract risk, providing no evidence for lanosterol's protective properties. 3
• The authors concluded their results do not support lanosterol's potential role in treating cataracts. 3

Conflicting Laboratory Data

• While a 2018 study showed lanosterol and 25-hydroxycholesterol could dissociate crystallin aggregates isolated from human cataractous lenses ex vivo with EC50 values at ten micromolar levels, 4 this contradicts the 2019 failure to demonstrate similar effects in intact human lenses. 2
• A 2024 mechanistic study suggested lanosterol may work through lipid metabolism pathways in lens epithelial cells, 5 but this remains purely experimental without clinical validation.

Critical Clinical Pitfalls

• Patients may delay necessary cataract surgery while attempting unproven eye drop treatments, risking further visual deterioration and increased surgical complications from mature cataracts. 1
• No anti-cataract drugs have been approved for clinical use despite decades of research targeting oxidative stress, aldose reductase, and protein aggregation. 6
• The American Academy of Ophthalmology emphasizes that cataract surgery has a substantial positive impact on vision-dependent functioning, with up to 90% of patients noting improvement in functional status and satisfaction. 1

What Actually Works

Cataract surgery is the only proven intervention that:

• Improves visual function and quality of life consistently across well-designed studies 1
• Reduces risk of traffic accidents, falls, and fractures 1
• Allows improved visualization and management of coexisting ocular diseases like glaucoma, macular degeneration, or diabetic retinopathy 1

Prevention Strategies (Not Treatment)

While no drops treat existing cataracts, risk reduction includes:

• UV protection with UV-B blocking sunglasses and brimmed hats 7
• Smoking cessation 7
• Management of diabetes, hypertension, and obesity 7
• Minimizing long-term corticosteroid use when possible 7