In this episode, Tom Samuelson and I discuss trabecular bypass procedures including the currently available & two future models of the iStent, and the Ivantis Hydrus Microstent. There is a tendency for doctors to prescribe third and fourth glaucoma medications even though it is well known that there is such a diminishing return after two medications. These ab-interno devices can serve as a glaucoma-lite procedure, the next step after two medications for those reluctant to proceed with a potentially more effective but more risky trabeculectomy. The use of multiple iStents, next generation devices, or targeting delivery to visualized collector ducts should lead to improvements in ab-interno trabecular bypass procedures in the years ahead.