Abstract:AIM: To investigate the association of axial length (AL), lens thickness (LT), and lens vault (LV) with postoperative anterior chamber angle metrics after laser peripheral iridotomy (LPI). METHODS: Prospective observational study of 69 patients (97 eyes) were diagnosed as primary angle-closure suspect (PACS), primary angle closure (PAC) or primary angle-closure glaucoma (PACG). AL, LT, anterior central chamber depth (ACD), angle opening distance (AOD), trabecular iris angle (TIA), and angle recess area (ARA) were measured before and 1wk after LPI. The association between AL, LT, LV with ACD, AOD, TIA, ARA were analyzed by comparing the differences between preoperative and postoperative measurements for anterior segment biometric parameters. RESULTS: ACD, AOD, TIA, and ARA were significantly increased after LPI (all P<0.05). Greater LT was significantly associated with greater postoperative increases in ACD, AOD, TIA, and ARA (all P<0.05). AL was not significantly associated with changes of anterior segment biometric parameters. Greater LV was significantly associated with greater postoperative increases in ACD, AOD, and TIA (all P<0.05), but was not significantly associated with changes of ARA. CONCLUSION: Greater baseline LT and LV measurements are associated with greater increases in anterior segment biometric parameters after laser peripheral iridotomy. AL are not associated with the change of anterior segment biometric parameters.