To describe anterior segment optical coherence tomography (AS-OCT) parameters in phacomorphic angle closure, mature cataract eyes and their fellow eyes, and determine the risk factors for developing phacomorphic angle closure in eyes with mature cataracts.

In this prospective, comparative case series a total of 33 phacomorphic angle-closure subjects and 34 control patients with unilateral mature cataracts enrolled. All patients underwent AS-OCT imaging and A-scan biometry of both eyes. Anterior chamber depth (ACD), anterior chamber area (ACA), iris thickness, iris curvature, lens vault (LV), and angle parameters including angle opening distance and trabecular iris space area were measured

Phacomorphic angle closure eyes had the smallest angle and anterior chamber parameters (ACD, ACA, ACW) and the greatest lens vault among the groups. ACA<18.62mm2, ACD <2.60mm, LV>532.0 µ, and AOD750<0.218mm had the highest odds ratios for distinguishing fellow eyes of phacomorphic angle closure vs. fellow eyes of mature cataracts, with odd ratio values of 9.90, 8.31, 7.91, and 7.91, respectively. Logistic regression showed that ACA<18.62 was the major parameter associated with fellow eyes of phacomorphic angle closure (OR=10.96,p<0.001(

ACD,ACA, angle opening distance , and LV are powerful indicators for determining the risk for developing phacomorphic angle closure when the lens becomes mature.