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Mejai's at first doesn't look that good for Zilean on paper. His kills per game is very average compared to other characters, but Mejai's just really works on him. You will get an insane amount of assists with him and all of your survivability skills will prevent you from losing stacks. Really solid item here, get it early.
Why Sapphire Crystal over Meki Pendant to start with? Assuming you stay in the lane until level 5 or 6, the Crystal will get you only 2-3 extra timebombs. The Meki Pendant, though, will get you 6-10 extra timebombs (and of course more if you are able to stay even longer than that). Both build into Tears of the Goddess.