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A retrospective chart review was performed on patients who underwent trabeculotomy\u00a0combined with phacoemulsification and lens implantation at Asahi General Hospital, with 6\u00a0months of follow-up. The patients treated by trabeculotomy were classified into two groups depending on the surgical procedures: <jats:italic>ab interno<\/jats:italic> with Tanito microhook (TMH) and <jats:italic>ab externo<\/jats:italic> with rigid probe trabeculotome (LOT). The demographics, preoperative and postoperative intraocular pressure (IOP), number of medications (Med), best-corrected visual acuity (BCVA), surgical-induced astigmatism (SIA), and postoperative complications were analyzed at pre-operation, and 1\u00a0week and 1\u20136\u00a0months post-operation. Fifty-two eyes of 38 Japanese patients underwent TMH and 42 eyes of 32 patients underwent LOT<jats:italic>.<\/jats:italic> The decreases in IOP and Med from the baseline were significant at all time points in both groups (p\u2009&lt;\u20090.001), but there were no significant differences between the two groups. BCVA improved significantly in TMH and LOT after the operation (p\u2009&lt;\u20090.001). BCVA and SIA significantly improved, mostly at 1\u00a0week in TMH, compared with LOT (p\u2009=\u20090.02 and 0.003). Hyphema and IOP spike exceeding 30\u00a0mmHg (spike) occurred in 11% and 6% of participants in TMH, and 33% and 26% of participants in LOT, respectively. Hyphema and IOP spike occurred more frequently in the LOT than in the TMH group (p\u2009=\u20090.01 and 0.005). <jats:italic>Ab interno<\/jats:italic> trabeculotomy showed similar IOP-lowering effects as <jats:italic>ab externo<\/jats:italic>, but had less postoperative complications.<\/jats:p>","DOI":"10.1038\/s41598-021-96701-0","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T10:05:29Z","timestamp":1629972329000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Comparison of effectiveness and complications in trabeculotomy with phacoemulsification between ab externo and ab interno using a spatula-shaped microhook"],"prefix":"10.1038","volume":"11","author":[{"given":"Satoru","family":"Kanda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Fujishiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Omoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryosuke","family":"Fujino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Arai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohei","family":"Nomoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Aihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"issue":"12","key":"96701_CR1","doi-asserted-by":"publisher","first-page":"e1221","DOI":"10.1016\/S2214-109X(17)30393-5","volume":"5","author":"SR Flaxman","year":"2017","unstructured":"Flaxman, S. 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