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July 1960

Unfavorable Effects of Alpha-Chymotrypsin in Cataract Surgery

Author Affiliations

Professor and Chairman of the Section of Ophthalmology, University of Louisville School of Medicine.

Arch Ophthalmol. 1960;64(1):108-113. doi:10.1001/archopht.1960.01840010110010

Since the introduction by Barraquer of enzymatic zonulolysis using α-chymotrypsin to produce lysis of the zonular fibers and facilitate intracapsular removal of cataract, many reports from all parts of the world have appeared in the literature describing various authors' experiences with the new method. Invariably they extol the enzyme for its fibrinolytic and proteolytic properties which make removal of the lens easier. At least one prominent ophthalmic surgeon is so enthusiastic he uses α-chymotrypsin in all his cataract operations.

Many of the reports mention, without going into details, unfavorable effects such as interference with wound healing and abnormally high incidence of corneal edema, but apparently such unfavorable incidents have not occurred with sufficient frequency or severity to dampen the zeal of the authors for zonulolysis. Very few, among whom are Konstas and Chachamidis,1 give actual figures for complications (delayed reformation of anterior chamber: 38% with α-chymotrypsin, 13% without α-chymotrypsin).