Abstract: Background　Patients with lens zonular abnormalities are prone to postoperative complications following cataract surgery. Clinically, zonular abnormalities are relatively common in eyes with shallow anterior chambers, which are typically associated with short axial lengths. However, clinical observations have revealed that certain patients with normal axial length (22 – 24 mm) but concomitant shallow anterior chambers also present with lens zonular abnormalities. Objective　To investigate the association between shallow anterior chamber and lens zonular abnormalities in cataract patients with axial lengths of 22–24 mm, and to evaluate the diagnostic value of combining central anterior chamber depth (ACD) and lens thickness (LT) for zonular abnormalities.Methods　A retrospective analysis was conducted on monocular clinical data from cataract patients who underwent phacoemulsification and intraocular lens implantation at the First Medical Center of Chinese PLA General Hospital between October 2024 and December 2025, with axial lengths ranging from 22.0 to 23.99 mm. Zonular status was assessed via ultrasound biomicroscope (UBM) or intraoperative records. Multivariable logistic regression models were used to evaluate the relationship between shallow anterior chamber and zonular abnormalities. Single, serial, and parallel diagnostic models were established using ACD and LT cut-off values. Diagnostic performance metrics were calculated for each model, and model stability was evaluated using ROC curve analysis.Results　A total of 138 patients (138 eyes) were enrolled, including 73 in the shallow ACD group (28 men and 45 women; mean age of 71.2±9.5 years) and 65 in the control group (28 men and 37 women; mean age of 64.2±11.5 years). No significant difference in gender distribution was observed between the two groups (P＞0.05), but the shallow ACD group were older (P＜0.001). The incidence of zonular abnormalities was significantly higher in the shallow ACD group (94.5%, 69/73) than in the control group (43.1%, 28/65; P＜0.001). Logistic regression analysis demonstrated that ACD (OR=1.28, 95% CI: 1.14 – 1.44, P＜0.001) and LT (OR=1.32, 95% CI: 1.15 – 1.52, P＜0.001) were independently associated with zonular abnormalities. Diagnostic model analysis revealed: the single ACD criterion yielded a sensitivity of 71.1%, specificity of 90.2%, and AUC of 0.807; the single LT criterion yielded a sensitivity of 58.8%, specificity of 87.8%, and AUC of 0.733; the parallel criterion achieved the highest sensitivity (76.3%) and AUC of 0.796, making it suitable for preoperative screening; the serial criterion achieved the highest specificity (95.1%) and positive predictive value (96.3%), with AUC of 0.744, making it suitable for identifying high-risk surgical candidates. Bootstrap internal validation indicated acceptable model stability. Conclusion　 In cataract patients with normal axial length, shallow anterior chamber is a significant indicator of zonular abnormalities. A stratified diagnostic strategy combining ACD and LT can effectively identify the risk of zonular abnormalities and facilitate the development of individualized surgical plans.