Abstract

Long anterior zonules (LAZ) are anterior lens  zonules which extend on the anterior surface of the crystalline lens  beyond their usual insertion leading to a small zonule free zone. They present with a spectrum of phenotypes. Non pigmented LAZ may be easily missed on slit lamp examination but may pose a challenge during cataract surgery. This video includes a stepwise approach to identify and manage eyes with LAZ, starting from simple tips and tricks for identifying the spectrum of LAZ on slit lamp examination.  Identification of  clinical features  associated with LAZ like Krukenberg spindle, gonioscopy, pseudoplateau iris, ultrasound biomicroscopic features, peripheral retinal pigmentary changes and choroidal neovascular membranes is shown. Easy hacks to perform a capsulorrhexis during cataract surgery in eyes with various presentations of pigmented, non pigmented, segmental and non segmental LAZ is demonstrated.