Glaukos Corporation

Glaukos reported second-quarter 2026 consolidated net sales of $185.6 million, up 50% on a reported basis and 49% on a constant-currency basis versus the year-ago quarter. U.S. glaucoma revenue was $118.5 million, up 64%; international glaucoma revenue was $36.6 million, up 17% reported and 16% constant currency; and Corneal Health revenue was $30.4 million, up 48%, including about $11 million from Epioxa. Gross margin was approximately 85%, up about 90 basis points from last quarter, and management reiterated full-year gross margin guidance of 84% to 86%. The company raised full-year 2026 net sales guidance to $680 million-$700 million, and said operating expenses for the year should land around $600 million. Management also said full-year U.S. glaucoma growth should be around 50% plus or minus, international glaucoma low- to mid-teens growth, Corneal Health around 20% plus or minus, and iDose revenue around $275 million-$280 million for 2026.

Tom Burns said the quarter validated Glaukos' strategy of building new markets in ophthalmology and highlighted two main growth engines: iDose TR in interventional glaucoma and Epioxa in corneal health. He sounded optimistic about long-term growth and margin expansion, saying the company is positioning for a best-in-class growth and margin profile into the next decade while continuing to invest in pipeline and commercial infrastructure. He also emphasized that Glaukos intends to protect and expand the Epioxa market with future pipeline products and a strong commercial organization.

Alex Thurman said the quarter showed strong performance across the P&L, including margin improvement, operating expense leverage, and cash generation. He noted gross margin reached about 85%, with continued modest accretion expected as iDose and Epioxa become a larger share of revenue, while keeping the full-year gross margin target at 84%-86%. He also said operating expenses should be around $600 million for the year, while the company remains focused on prudently investing back into commercial and R&D programs to support growth and move toward cash flow breakeven over time.

Analysts focused on the durability and cadence of the iDose and Epioxa launches, including whether iDose benefited from any pull-forward ahead of the LCD process and how the proposed LCD could affect adoption. Management said it did not see LCD-related pull-forward, described the quarter as broad-based across Medicare, commercial, and Medicare Advantage, and said it expects the final LCD outcome to be more favorable than the draft. On Epioxa, questions centered on the J-code transition, prior auth timing, gross-to-net/340B dynamics, and site-of-care deployment; management said Q3 may be volatile as the launch moves from miscellaneous coding to the permanent J-code, but access pathways now cover more than 125 million commercial lives and the site-of-care network already reaches roughly 85% of the U.S. population, with expansion to about 95% in progress.