Abstract:

 The etiology of abnormal lens suspensory ligament laxity includes traumatic suspensory ligament injury, congenital suspensory ligament abnormalities (such as Marfan syndrome) and peripheral retinal degeneration, etc. The suspensory ligament laxity can result in antedisplacement of lens iris diaphragm, shallow anterior chamber, progressive angle closure and peripheral anterior synechia, leading to elevated intraocular pressure and glaucoma similar to primary angle closure glaucoma (PACG). The management of these disorders is critical. Commonly used treatments for PACG, such as pilocarpine eye drops and laser peripheral iridotomy or trabeculectomy, may not work, since the main pathogenic factor is not resolved. In addition, the anterior chamber may sometimes become shallower and in turn, the aqueous misdirection or malignant glaucoma may occur. Zonular abnormalities associated angle closure glaucoma differ from PACG in a number of respects, including age, monocular or bilateral, diopter, axial length, anterior chamber depth, the reaction to mydriatic agents and UBM examination. The treatment regimens are also quite different. Therefore, it is important to differentiate glaucoma secondary to suspensory ligament laxity from PACG. (Ophthalmol CHN, 2018, 27: 4-8)

Key words: lens suspensory ligament, angle-closure glaucoma, secondary