Can't find Bss Ophthalmic Solution for your eye surgery? Learn about BSS Plus, Endosol Extra, Navstel, and other alternatives your surgeon may use.
You're about to have eye surgery, and your surgical center can't find Bss Ophthalmic Solution. What now? If your procedure requires a sterile irrigating solution — and virtually every eye surgery does — your surgeon will need an alternative.
The good news is that several FDA-approved alternatives to BSS exist, and your ophthalmologist is trained to choose the right one for your specific procedure. In this article, we'll explain what BSS is, how it works, and walk you through the main alternatives available in 2026.
Bss Ophthalmic Solution — also known as Balanced Salt Solution or BSS — is a sterile, isotonic irrigating solution made by Alcon Laboratories. It's used during eye surgeries like cataract extraction, corneal transplantation, and glaucoma procedures to keep the eye hydrated and protected.
The solution contains a carefully balanced mix of electrolytes — sodium chloride, potassium chloride, calcium chloride, magnesium chloride, sodium acetate, and sodium citrate — in concentrations that closely match the natural fluid inside your eye (aqueous humor). The pH is approximately 7.5, and the osmolality is about 300 mOsm/kg, making it compatible with delicate ocular tissues.
For a comprehensive overview, see our article: What Is Bss Ophthalmic Solution? Uses, Dosage, and What You Need to Know.
During eye surgery, the surgeon needs to keep the eye's internal structures moist and maintain the shape of the eye (especially the anterior chamber). BSS does this by:
For more on the mechanism, visit How Does Bss Ophthalmic Solution Work? Mechanism of Action Explained.
BSS Plus is Alcon's premium irrigating solution, enriched with bicarbonate, dextrose, and glutathione in addition to the standard electrolytes found in regular BSS. It was specifically designed for longer intraocular procedures — surgeries that involve perfusion of the eye for more than 60 minutes.
Key differences from standard BSS:
When it's a good alternative: BSS Plus can be used for any procedure where standard BSS would be used. It's considered the gold standard for longer surgeries and provides equal or better tissue protection for shorter procedures. The main difference is cost — BSS Plus typically runs $35 to $90 per 500 mL bottle compared to less for standard BSS.
Availability: BSS Plus is also made by Alcon, so it may face similar supply constraints. However, because it's a different product line, availability doesn't always track one-to-one with standard BSS.
Endosol Extra is another FDA-approved balanced salt ophthalmic solution that can be used as an intraocular irrigating solution during eye surgery. It provides a similar electrolyte balance to BSS and is designed to protect ocular tissues during surgical procedures.
Key features:
When it's a good alternative: Endosol Extra is a direct substitute for BSS in most procedures. Your surgeon may prefer it when standard BSS and BSS Plus are both unavailable.
Navstel is a balanced salt ophthalmic solution that includes hypromellose, dextrose, and glutathione. It's designed for intraocular irrigation during surgical procedures and offers additional tissue protection through its enriched formula.
Key features:
When it's a good alternative: Navstel is particularly useful for longer or more complex procedures where additional tissue protection is beneficial. It's a solid option when BSS Plus is unavailable.
In rare cases when no FDA-approved ophthalmic irrigating solution is available, some surgeons may use Lactated Ringer's Solution as an emergency substitute. However, this is not ideal for intraocular use because:
Important: Lactated Ringer's should only be used when no approved ophthalmic irrigating solution is available and the surgery cannot be safely postponed. This decision is made by the surgeon based on the clinical situation.
Choosing an alternative to BSS is a medical decision that your ophthalmologist or surgeon will make based on:
You don't need to be an expert on irrigating solutions — that's your surgeon's job. But being informed about the options can help you have a more productive conversation with your care team. If you're looking for a doctor who can guide you through these decisions, see How to Find a Doctor Who Can Prescribe Bss Ophthalmic Solution Near You.
Running into a supply issue with Bss Ophthalmic Solution is frustrating, but it doesn't have to derail your eye surgery. BSS Plus, Endosol Extra, and Navstel are all proven alternatives that your surgeon can use safely.
The most important step? Communicate early with your surgical team. Ask about supply at your pre-op appointment, and make sure your surgeon has a plan in case the preferred product isn't available. And if you need help finding BSS or any of its alternatives in stock, Medfinder can help you search by location and set up availability alerts.
For more about the ongoing supply situation, read our Bss Ophthalmic Solution Shortage Update for 2026.
You focus on staying healthy. We'll handle the rest.
Try Medfinder Concierge FreeMedfinder's mission is to ensure every patient gets access to the medications they need. We believe this begins with trustworthy information. Our core values guide everything we do, including the standards that shape the accuracy, transparency, and quality of our content. We’re committed to delivering information that’s evidence-based, regularly updated, and easy to understand. For more details on our editorial process, see here.
%2C%20Color%3DOriginal.png)
