Purpose: To compare the increase in anterior chamber depth (ACD) after cataract extraction/ lensectomy (CE) vs. laser peripheral iridotomy (LPI) in patients with narrow angles (NA) and narrow angle glaucoma (NAG). Effect on intraocular pressure (IOP) and cost was also evaluated. Materials and methods:The Lenstar was used to measure ACD prior to and after cataract extraction and prior to and after LPI in patients with narrow angles. Fifty-four (54) eyes with narrow angles underwent CE and eighteen (18) eyes underwent LPI. Three (3) eyes had LPI with subsequent CE. Pre-and post-surgical IOP were also measured. Results:The mean ACD in eyes undergoing LPI was 2.74 mm before and 2.81 mm after surgery. Mean ACD in eyes undergoing CE was 2.54 mm before and 4.12 mm after surgery. In patients undergoing LPI and subsequent CE mean ACD measured 2.65 mm before LPI, 2.67mm after LPI and 3.92mm after CE. Mean IOP was 21 mmHg before LPI and 18 mmHg after LPI. Mean IOP was 17 mmHg before CE and 15mmHg after C.E. Conclusion:Mean ACD increases significantly more after CE than LPI and should be considered as a primary treatment for patients with NAG and NA in danger of closure.