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Objective To determine longitudinal changes in angle configuration in eyes of primary angle closure suspects (PACS) treated by laser peripheral iridotomy (LPI) and in untreated fellow eyes.Design Longitudinal cohort study Participants PACS aged 50 to 70 years enrolled in a randomized controlled clinical trial.Methods Each participant was treated by LPI in one randomly selected eye, with the fellow eye serving as a control.Angle width was assessed in a masked fashion using gonioscopy and anterior segment optical coherence tomography (AS-OCT) before and at 2 weeks, 6 months and 18 months after LPI.