Dose Relationship of Alpha Chymotrypsin in Production of Glaucoma After Cataract Extraction

In previous communications1,2it has been shown that a transient, occasionally severe glaucoma occurred in 72% of eyes in which α-chymotrypsin was used for enzymatic zonulolysis, while a transient but never severe tension elevation was observed in only 23% of the control group. The clinical characteristics and course of this "enzyme glaucoma" were described and evidence was adduced to support the possibility that this transient glaucoma may be the initiating factor leading to imperfect wound healing after cataract extraction with the enzyme. Acers3,4has confirmed the occurrence of this glaucoma, noting it in 66% of the eyes operated on by him with the use of α-chymotrypsin. On the other hand Barraquer5has denied the existence of this complication. While the number of cases studied by Barraquer was small, it was learned that he used only 0.5 cc of α-chymotrypsin (1:5,000 dilution), whereas in my own studies 2