Since Barraquer1 reported the use of an enzyme, α-chymotrypsin, to free the cataractous lens from its zonular attachment in 1958, this procedure has gained considerable favor among ophthalmic surgeons.
In spite of the fact that much has been written on the subject of chemical zonulolysis, it is evident that there is a premature tendency to overemphasize the advantages of this procedure, even to the point of advocating it as a routine technique in cases of cataracts over 20 years of age. It has been stated by many authors that α-chymotrypsin selectively attacks and lyses certain components of the zonule without inducing any damage to the other tissues of the eye. According to extensive research now being carried out, this apparently is not entirely true but, for clinical purposes and if used in the proper way, it seems for the most part to have its action limited to the zonule.
HILL HF. Technique of Cataract Extraction with Alpha-Chymotrypsin. Arch Ophthalmol. 1960;64(4):601–605. doi:10.1001/archopht.1960.01840010603019
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