The suspensory ligament of the lens (zonule of Zinn) consists of fine fibrous zonular fibres connecting the ciliary body to the equator of the crystalline lens, maintaining lens position and transmitting ciliary muscle contraction to adjust lens curvature for accommodation.
Maintains the lens in its optical position within the posterior chamber, transmits the relaxation of ciliary muscle contraction to flatten the lens for distance vision, and allows lens thickening for near vision when ciliary muscle contracts and zonular tension is released.
Zonular instability (from Marfan syndrome, pseudoexfoliation, trauma, or homocystinuria) produces lens subluxation (ectopia lentis). Weak zonules complicate cataract surgery — capsular tension rings are used to support the bag during phacoemulsification. Complete zonular rupture produces lens dislocation into the anterior chamber or vitreous.
Lens subluxation from zonular weakness in Marfan syndrome producing visual axis displacement, binocular diplopia, and monocular blur, managed by optical correction or lens extraction with sulcus IOL implantation.
Fibrillar material deposition weakening the zonules in pseudoexfoliation syndrome, creating high-risk conditions for cataract surgery requiring a capsular tension ring for bag support.
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