After decades of modest innovation, the options for glaucoma surgery have grown at a rapid pace. This expansion of the glaucoma surgical armamentarium hides an uncomfortable truth: we have so many surgical options because none deliver consistent results across the broad range of presenting clinical scenarios. The ultimate innovation would be a surgery that achieves excellent intraocular pressure (IOP) lowering, with highly consistent results and a low risk profile. This goal was artfully phrased as “10-10-10” by Professor Peng Khaw of Moorfields Eye Hospital, who framed the ideal surgical intervention as one that would reduce IOP to 10 mmHg in a 10-minute procedure that lasts 10 years.