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POAG patients were randomly assigned to the penetrating canaloplasty or ab externo canaloplasty group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study enrolled POAG patients who underwent penetrating canaloplasty or ab externo canaloplasty randomly. Surgical success, intraocular pressure (IOP), number of glaucoma medications, and surgical complications were evaluated until 24\u2009months post\u2010operatively. Surgical success was defined as 6\u2009mmHg\u2009\u2264\u2009IOP \u226421\u2009mmHg with an IOP reduction \u226520%, which included qualified success (with or without medications) and complete success (without medications).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 52 eyes (45 patients) were randomly assigned to one of two groups: the penetrating canaloplasty group (PCP, <jats:italic>n<\/jats:italic>\u2009=\u200926) or the ab externo canaloplasty group (CP, <jats:italic>n<\/jats:italic>\u2009=\u200926). The probabilities of qualified success and complete success were 92.3% and 76.9%, respectively, in the PCP group and 64.1% and 52.1%, respectively, in the CP group at 24\u2009months (<jats:italic>p<\/jats:italic>\u2009=\u20090.013, <jats:italic>p<\/jats:italic>\u2009=\u20090.042, log\u2010rank test). The mean IOP decreased from 30.8\u2009\u00b1\u200910.7 and 28.6\u2009\u00b1\u200911.8\u2009mmHg to 14.1\u2009\u00b1\u20093.3\u2009mmHg in the PCP group and 22.1\u2009\u00b1\u200913.6\u2009mmHg in the CP group at year two (<jats:italic>p<\/jats:italic>\u2009=\u20090.007). The PCP group also received fewer medications (0.2\u2009\u00b1\u20090.5) than did the CP group (0.7\u2009\u00b1\u20091.2) at year two (<jats:italic>p<\/jats:italic>\u2009=\u20090.038). Post\u2010operative complications were similar, and the most common complications were transient IOP elevation and hyphema in the PCP group (42.3%, 46.2%) and the CP group (38.5%, 23.1%) (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared to ab externo canaloplasty, penetrating canaloplasty had a greater surgical success rate and better IOP reduction with a comparable rate of complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.16750","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T02:19:06Z","timestamp":1724293146000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy and safety of penetrating canaloplasty versus ab externo canaloplasty for primary open\u2010angle glaucoma: A randomized controlled 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