It’s an exciting and challenging time in glaucoma management.  Great progress has been made on the surgical management of glaucoma, some of which has been generated by advances with medical lasers, creating a very positive outlook for the future of glaucoma therapy.  However, there remains a healthy skepticism due to the failures of promising technologies to bare fruit in the past.  There is still a need for more evidence-based trials and clinical experience to solidify some of these new procedures in our armamentarium.  In addition, payers still have to recognize