Glaukos Q3 Earnings Call Highlights

Key Points

• Glaukos reported record Q3 sales of $211 million, up 58% year over year, with non-GAAP gross margin near 88% and non-GAAP EPS of $0.47.
• Strong demand for Epioxa and iDose TR drove growth: corneal-health sales rose 154% to $59 million, while iDose TR generated approximately $76 million in quarterly revenue.
• The company raised its 2026 revenue outlook to $775 million-$785 million and introduced a preliminary $1 billion revenue target for 2027, despite potential Medicare coverage changes affecting iDose TR.

Glaukos NYSE: GKOS reported record third-quarter consolidated net sales of $211 million, up 58% from the year-earlier period, led by growth in its Epioxa corneal health therapy and iDose TR glaucoma treatment. The company raised its full-year 2026 revenue outlook and introduced a preliminary target of $1 billion in revenue for 2027.

Chairman and Chief Executive Officer Tom Burns said the company now expects 2026 net sales of $775 million to $785 million, compared with its prior forecast of $680 million to $700 million. The updated midpoint represents a $90 million increase from the previous midpoint.

Glaukos also reported approximately 88% non-GAAP gross margin in the quarter, nearly 400 basis points higher than a year earlier. The company generated more than $50 million in cash, reported non-GAAP net income of $28.5 million, and posted non-GAAP earnings per share of $0.47.

Epioxa Drives Corneal Health Growth

The company’s corneal health franchise generated a record $59 million in third-quarter sales, an increase of 154% year over year. Epioxa contributed approximately $53 million of that total.

Epioxa is the first and only FDA-approved epithelium-on corneal cross-linking treatment for keratoconus, according to Glaukos. Burns said the company is focused on expanding patient access, improving awareness and referrals, and supporting earlier diagnosis of the disease.

Glaukos said its O2N treatment systems were deployed at locations serving roughly 90% of the U.S. population as of the third quarter, with a pipeline of additional locations expected to extend treatment-center reach beyond 95% of the population. President and Chief Operating Officer Joe Gilliam said the company ended the quarter with more than 200 established sites of care and had contracts for deployments that would expand the network to more than 300 sites.

The company said it had established Epioxa access pathways covering approximately 90% of U.S. commercial lives, including the five largest payers, and more than 80% of Medicaid lives. Following the July 1 effective date of Epioxa’s product-specific J-code, Glaukos said it has been working to refine reimbursement processes with providers and its specialty pharmacy partner.

Gilliam said the company expects prior-authorization processes to become more efficient as payer experience and claim volumes increase. Glaukos is supporting access through its EpioxaCareConnect hub, specialty pharmacy partner and buy-and-bill channels. He said the number of sites using buy-and-bill has been increasing rapidly, particularly over the prior 30 to 60 days.

Glaukos also launched its “Could it be KC?” disease-awareness campaign during the quarter with NBA champion Stephen Curry, who has personal experience with keratoconus. The company plans additional awareness activities in 2027 and said it remains on track to introduce a keratoconus screening device entering 2027. Gilliam said the device is intended to broaden screening through optometrists, who can refer potentially affected patients for diagnosis and treatment.

iDose TR Sales Reach $76 Million

Glaukos’ U.S. glaucoma franchise recorded $118.6 million in third-quarter revenue, rising 47% year over year. iDose TR generated about $76 million in sales during the quarter.

Gilliam said iDose TR growth was supported by contributions from fee-for-service patients in the NGS jurisdiction, Medicare Advantage and commercially insured populations, though summer seasonality affected results. For full-year 2026, the company now expects iDose revenue in the low-$280 million range, up from its earlier expectation of $275 million to $280 million.

The company recently reported positive top-line results from a Phase IV randomized controlled trial of iDose TR used with cataract surgery. According to Burns, the study showed an 11.1 mmHg mean reduction in intraocular pressure and a 3.6 mmHg incremental treatment effect compared with cataract surgery alone at three months.

Management also addressed potential local coverage determinations, or LCDs, related to iDose TR. Gilliam said Medicare Administrative Contractors have until one year from the May draft date to either act on or abandon the proposed LCD, and any final LCD would have a 45-day waiting period before taking effect.

Glaukos said it has considered a range of LCD outcomes in developing its preliminary $1 billion 2027 revenue outlook, including scenarios in which restrictions are implemented near the terms proposed in the draft. Gilliam said the company will provide more detailed franchise assumptions after any final coverage decision is known.

International Growth and Pipeline Programs

International glaucoma sales totaled $33.4 million, up 13% on a reported basis and 15% in constant currency. Burns said growth was broad-based as the company continued to expand its international infrastructure and promote minimally invasive glaucoma surgery as a standard of care.

Glaukos also highlighted development activity across five therapeutic platforms. The company is advancing iDose TREX in Phase IIb/III and iDose TRIO in Phase IIIb, with FDA approval for iDose TRIO targeted by the end of 2027. It has completed enrollment for pivotal studies of iStent infinite and the PRESERFLO MicroShunt.

In addition, Glaukos expects top-line results by year-end from a Phase II study in demodex blepharitis. The company recently entered an exclusive licensing agreement with RevOpsis Therapeutics for RO-104, now designated GLK-901, a tri-specific biologic for retinal diseases, along with rights to the RevMod platform for additional multispecific biologics.

Chief Financial Officer Alex Thurman said Glaukos expects fourth-quarter operating expenses to increase 25% to 30%, while maintaining operating leverage. He said full-year 2026 operating expenses are expected to be about $630 million, representing growth of just over 30% from 2025.

About Glaukos (NYSE:GKOS)

Glaukos Corporation is an ophthalmic medical-technology company focused on developing and commercializing therapies for chronic eye diseases. The company's principal areas of focus include glaucoma, corneal disorders and retinal diseases, with an emphasis on treatments that may reduce reliance on conventional pharmaceuticals or more invasive surgical procedures.

Glaukos is best known for its micro-invasive glaucoma surgery (MIGS) products, including the iStent family of implantable devices used to help lower intraocular pressure in patients with glaucoma.

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