Limited zonulolysis has been found to be a valuable aid in cataract extractions by the tumbling technique in patients from 50 to 70 years of age. The limited application of α-chymotrypsin to the zonules avoids the hazards of total zonulolysis in circumstances where there is little need for it, but at the same time, weakens the zonule below in the 6 o'clock position and facilitates tumbling of the lens. Of course, in the very old, senile type of cataract, the zonule is weak and no enzyme is necessary.
As reported by the author1 in 1961, the proper amount of enzyme to use, which will in no way affect or weaken the zonule in the upper anterior segment, was ascertained by a procedure of staining the enzyme solution with sterile fluorescein strips. It was demonstrated that any amount of enzyme less than six drops and injected below with the technique
HILL HF. Cataract Extraction With Limited Enzymatic Zonulolysis. Arch Ophthalmol. 1966;75(1):89–90. doi:https://doi.org/10.1001/archopht.1966.00970050091018
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