Alpha-Chymotrypsin (Quimotrase) in Cataract Surgery

Abstract

Joaquin Barraquer¹ is credited with the discovery of the practical use of α-chymotrypsin, a proteolytic enzyme, in facilitating cataract extraction. He demonstrated, both experimentally and clinically, that the enzyme, marketed under the trade name of Quimotrase, possessed anti-inflammatory properties and had a selective biochemical hydrolytic action on the zonular fibers. He hence introduced the term "enzymatic zonulolysis." Further claims were made that it had become possible to extract a lens regardless of the patient's age and to avoid inherent complications of mechanical zonulotomy resulting from scleral pressure or traction. Extracapsular extraction, lens capsule tears, and vitreous loss occurred to much less extent. The incidence of postoperative morbidity resulting from iridocyclitis and detached retina was also markedly lowered. Stimulated by these encouraging reports, I was able to obtain a quantity of α-chymotrypsin to use on a varied series of cases that required cataract extraction. Chemical Characteristics and Action α-Chymotrypsin is