Glaukos (NYSE:GKOS) reported record second-quarter 2026 consolidated net sales of $185.6 million, up 50% from the prior-year period on a reported basis and 49% on a constant-currency basis, as growth in its U.S. glaucoma, international glaucoma and corneal health businesses exceeded management’s expectations.
Chairman and CEO Tom Burns said the company raised its full-year net sales guidance to $680 million to $700 million, up from its prior range of $620 million to $635 million. The company cited continued adoption of iDose TR, the launch of Epioxa, and broad-based international growth as drivers of the stronger outlook.
iDose TR Drives U.S. Glaucoma Growth
Burns said physician interest and adoption of iDose TR continued to grow, supported by its clinical outcomes and what the company views as a shift toward earlier interventional glaucoma care. Glaukos is focused on adding trained surgeons and active accounts, increasing utilization, expanding market access, and growing clinical evidence for the treatment.
President and COO Joe Gilliam said Glaukos now expects U.S. glaucoma revenue to grow about 50%, plus or minus, for the full year. The company expects its broader U.S. glaucoma portfolio to post at least low-single-digit growth, while iDose TR revenue is expected to land in a range of roughly $275 million to $280 million in 2026.
Gilliam said the second-quarter iDose performance reflected acceleration across Medicare Administrative Contractor regions as well as increased activity among commercial and Medicare Advantage patients. He said the company did not identify material demand pull-forward related to proposed Medicare local coverage determinations, or LCDs.
Five of seven Medicare Administrative Contractors issued proposed LCDs for iDose TR during the quarter. Gilliam said Glaukos was encouraged by support from physicians, medical societies and patients during public meetings and comment periods. He said the company believes the evidence supporting iDose TR should lead to a more favorable final policy if LCDs are finalized.
Earlier in July, CMS issued proposed 2027 rules that, as drafted, largely maintain 2026 ambulatory payment classifications, facility payments and relative physician fee rates for Glaukos procedures in hospital outpatient and ambulatory surgical center settings, Burns said.
International and Corneal Health Performance
International glaucoma revenue was $36.6 million, up 17% reported and 16% on a constant-currency basis. Gilliam said Glaukos now expects low- to mid-teens international glaucoma growth for the full year.
Management expects foreign-exchange tailwinds to diminish in the second half. The company also cited competitive product trialing and reimbursement headwinds in Germany and Switzerland, though it expects those factors to be partly offset by growth from PRESERFLO and iStent infinite.
Corneal health revenue rose 48% to $30.4 million, including about $11 million in Epioxa sales. Epioxa is the company’s FDA-approved epithelium-on corneal cross-linking therapy for keratoconus.
Gilliam said Glaukos now expects the overall corneal health franchise to grow approximately 20%, plus or minus, in 2026. He cautioned that third-quarter performance could be volatile as the company transitions from Photrexa and a miscellaneous billing code to Epioxa’s permanent product-specific J-code, which became effective July 1.
“There will be some volatility” during the transition, Gilliam said, though he expects the related issues to begin moving behind the company in the fourth quarter.
- O2n systems are deployed at locations serving roughly 85% of the U.S. population, with a pipeline that Glaukos expects could extend reach to approximately 95%.
- Access pathways for Epioxa have been established for more than 125 million covered commercial lives, including arrangements involving the five largest U.S. payers.
- Glaukos launched a co-pay assistance program for eligible patients and is investing in awareness, referral networks, earlier diagnosis and patient-support programs.
Gilliam said the company has been encouraged by the number of patients being submitted for Epioxa approval, though providers and payers are adjusting to the new permanent J-code. He said some institutions and larger groups are more comfortable using a buy-and-bill model, while many community practices are initially relying more heavily on specialty pharmacy distribution.
Pipeline and Profitability Focus
Glaukos said it continues to advance programs across five therapeutic platforms. Its pipeline includes iDose TREX, which is in a Phase II-B/III program; iDose Trio, with a Phase III-B study targeting FDA approval by the end of 2027; and a planned commercial introduction later this year of a keratoconus screening device.
The company also said it is preparing a Phase III program for a third-generation customized topographically guided iLink therapy in 2027. In other programs, Glaukos completed enrollment in a 510(k) pivotal study for PRESERFLO MicroShunt and in a Phase II study for demodex blepharitis, with top-line results from the latter expected by year-end. The company is also advancing a first-in-human study of GLK-401 for wet age-related macular degeneration.
Chief Financial Officer Alex Thurman said the company was pleased with second-quarter progress across gross margin, operating expenses, the bottom line and cash generation. Gross margin was approximately 85% in the quarter, up about 90 basis points sequentially, driven by a greater revenue contribution from iDose TR and Epioxa.
Glaukos maintained its full-year gross-margin target of 84% to 86% and expects modest additional accretion through the remainder of 2026, particularly in the fourth quarter. Thurman said operating expenses are now expected to total around $600 million for the year.
While management sees a clearer path toward profitability as revenue grows, Thurman said Glaukos intends to continue investing in commercialization and clinical development to support its product launches and pipeline, while managing the business toward cash-flow breakeven.
About Glaukos (NYSE:GKOS)
Glaukos Corporation is a medical technology company specializing in the development, manufacturing and commercialization of innovative therapies for patients with glaucoma and other chronic eye diseases. The company’s core offerings focus on micro-invasive glaucoma surgery (MIGS), designed to reduce intraocular pressure and manage glaucoma more safely and effectively than traditional surgical approaches. Glaukos’s flagship products include the iStent, iStent inject and iStent infinite trabecular micro-bypass stents, which are implanted during cataract surgery to improve aqueous outflow and help control eye pressure.
Beyond its MIGS portfolio, Glaukos has expanded into sustained drug-delivery solutions.
