Alpha-chymotrypsin glaucoma

The postoperative course of 141 eyes in 115 patients undergoing uncomplicated intracapsular cataract extraction was reviewed. Alpha-chymotrypsin as used in our institution did not increase the percentage of eyes developing significant postoperative ocular hypertension. Smaller amounts of enzyme and a shorter waiting period than have heretofore been advocated are adequate for clinically effective zonulysis and appear to be protective against "enzyme glaucoma." Indeed, we found that among non-diabetics, those receiving enzyme experienced a lower incidence of postoperative ocular hypertension than did those not receiving enzyme. The one factor in our series related to an increased percentage of postoperative hypertensive responses was diabetes mellitus.