In patients with both cataract and glaucoma, the ophthalmologist may choose to treat both conditions in the same operative encounter. Combined cataract extraction, IOL implantation, and Hydrus microstent insertion offers the patient visual rehabilitation, better control of glaucoma, and the benefit of not having to return to the OR for a second procedure. The Hydrus microstent (HMS) is a minimally invasive glaucoma surgery (MIGS) that bypasses the trabecular meshwork and provides a scaffold for Schlemm’s canal. By avoiding a filtering procedure, one can also avoid the known serious complications associated with blebs, but in exchange for decreased IOP lowering.