Long Anterior Lens Zonules and Intraocular Pressure

Purpose:To investigate the relation between intraocular pressure ( IOP) and the idiopathic long anterior zonule (LAZ) trait. Methods:Patients presenting for primary eye care were examined for LAZ, identified as radially oriented zonular fiberswith central extension >1.0 mm beyond the normal anterior lensinsertion zone (estimated via slit lampbeam length). Ocular, systemic health, and lifestyle data were collected via comprehensive exam and questionnaire. Multivariate regression was used to assess the relationship between IOP(Goldmann) and LAZ. Results:There were 2169 non-LAZ and 129 LAZ subjects (mean age: 49.8 ± 15.0 vs. 62.6 ± 10.2 years; 63.6% vs. 76.0% female; 83.2% vs. 91.5% African American). Right eyes with >trace LAZ (n = 59 of 110) had higher unadjusted mean IOPthan control eyes (16.4 ± 3.3 vs. 15.0 ± 3.3 mm Hg, P = 0.005), and with control for numerous factors, LAZ eyes had an average IOPof approximately 1.3 ± 0.4 mm Hg higher (P = 0.003) than non-LAZ eyes. Final model covariates included sex (P = 0.001); spherical-equivalent refractive error(D; P high school education (P < 0.001); systolic blood pressure (mm Hg; P < 0.0001); being an ever smoker (P = 0.006); and having history of any site cancer (P = 0.01). Conclusions:The LAZ trait, with potential prevalence near 2%, was associated with a higher IOP. This observation is consistent with the hypothesis that the trait is a marker for underlying mechanisms that elevate glaucoma risk.