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    GKOS
    Earnings call· Mar 2026(Q1 FY26)

    GLAUKOS Q1 FY26 earnings call GKOS

    Apr 29, 2026 Source

    Executive summary

    Glaukos Corporation Q1 FY26 — Record Sales Driven by iDose TR and Epioxa Launch

    Glaukos delivered a strong first quarter, exceeding expectations across all franchises, primarily driven by the robust performance of iDose TR and the initial commercial availability of Epioxa. The company raised its full-year net sales guidance, reflecting confidence in its diversified ophthalmic leadership and transformational growth drivers. Management emphasized continued investment in its clinical pipeline and commercial infrastructure while maintaining discipline in capital allocation towards operating leverage and cash flow breakeven.

    Highlights

    5
    • Record consolidated net sales of $150.6 million, up 41% reported and 39% constant currency YoY.

    • U.S. Glaucoma franchise net sales grew 58% YoY to $93.5 million, driven by iDose TR.

    • iDose TR generated approximately $54 million in sales in Q1 FY26.

    • International Glaucoma franchise net sales grew 23% reported and 16% constant currency YoY to $35.8 million.

    • Full-year FY26 net sales guidance raised to $620 million-$635 million from $600 million-$620 million previously.

    Concerns

    4
    • International Glaucoma expects new competitive product trialing headwinds in some major markets through FY26.

    • Currency tailwinds are expected to abate for International Glaucoma going forward.

    • Corneal Health expects volatility due to Photrexa and Epioxa transition, and temporary J-code period in Q2 and Q3 FY26.

    • Q2 FY26 Corneal Health sales expected to see a dip YoY due to transition from Photrexa to Epioxa.

    Guidance & targets

    8
    CategoryTargetConfidence
    Full-year FY26 Net Sales
    $620M-$635M
    high materiality
    High
    International Glaucoma Growth
    high single-digit growth
    medium materiality
    Medium
    Corneal Health Growth
    high single-digit growth
    medium materiality
    Medium
    U.S. Glaucoma Growth
    low 30% type growth
    medium materiality
    Medium
    iDose TRIO Filing
    by the end of this year
    medium materiality
    High
    iDose TRIO Approval
    targeted approval in the fourth quarter of 2027
    medium materiality
    High
    Gross Margin
    84%-86%
    medium materiality
    High
    Operating Expenses Growth
    high teens
    medium materiality
    Medium

    Segment performance

    3
    SegmentRevenueYoYQoQMargin
    U.S. Glaucoma
    Strong growth driven by increasing contributions from iDose TR, expanding trained surgeons, utilization, and market access.
    iDose TR sales: ~$54M
    $93.5M58%
    International Glaucoma
    Broad-based growth as international infrastructure scales. Expects competitive product trialing headwinds and abating currency tailwinds.
    $35.8M23% reported, 16% constant currency
    Corneal Health
    Includes sales from Photrexa and initial contributions from Epioxa. Expects volatility due to product transition and J-code period.
    Photrexa and early Epioxa net sales: $17.7M
    $21.3M15%

    Operational metrics

    10
    Gross Margin
    84%up 120 bps YoY
    Q1 FY26

    Reported for the first quarter.

    Consolidated Net Sales Growth
    41%YoY
    Q1 FY26

    Record first quarter consolidated net sales.

    iDose TR Sales
    $54M
    Q1 FY26

    Strong contribution to U.S. Glaucoma franchise.

    iDose TR Peer-Reviewed Publications
    22
    as of Q1 FY26

    Robust and growing body of clinical evidence.

    Epioxa Site of Care Network Reach
    65%
    Q1 FY26

    Active deployment of O2N systems across locations. Pipeline progressing to expand reach to 95%.

    Epioxa Covered Commercial Lives
    100M+
    Q1 FY26

    Access pathways established or in progress with several plans updating policies.

    Epioxa J-Code Effective Date
    July 1, 2026
    Future

    CMS assigned product-specific J-code, expected to streamline reporting and reimbursement.

    iDose Commercial/Medicare Advantage Access
    99%
    Q1 FY26

    Percentage of patients with an access pathway. Remainder covered by 'silence' with successful pull-through.

    iDose Prior Authorization Success Rate
    very, very high
    Q1 FY26

    Success rate for prior authorizations submitted across the landscape.

    Keratoconus Addressable Patient Eyes
    50,000-100,000
    Annual

    Estimated number of keratoconus eyes that should be diagnosed and treated annually.

    Product announcements

    3
    ProductTypeDetails
    Epioxalaunch
    iStent infinitelaunch
    KC screening devicelaunch

    Risks & headwinds

    6
    International competitive product trialing headwindsFY26

    expected through 2026

    Mitigation: Offset by growing contributions from iStent infinite following EU MDR certification and European launch.

    Currency tailwinds abatinggoing forward

    based on current rate environment

    Epioxa payer adoption headwindsearly stages of launch

    initial patient access will be gated

    Mitigation: Considerable progress with payers, several plans updating policies, 100M+ covered commercial lives, co-pay assistance program, specialty pharmacy partner network.

    Epioxa temporary J-code perioduntil July 1, 2026

    measured adoption over this initial period

    Mitigation: CMS assigned product-specific J-code (J2789) effective July 1, 2026, to streamline reporting and reimbursement.

    Corneal Health volatilityQ2 and Q3 FY26

    fair number of moving parts

    Mitigation: Anticipates exiting Q4 FY26 with strong performance curve as Epioxa pulls through.

    Competitor supply chain disruptionsQ1 FY26

    benefited a little bit

    Mitigation: Expected to subside, leading to conservative outlook for non-iDose U.S. Glaucoma sales.

    What to watch in Q2 FY26

    5

    Epioxa J-code impact on adoption

    Q3 FY26
    CurrentCommercially available under new technology miscellaneous J-code, anticipating measured adoption.
    TargetStreamlined reporting and reimbursement, increased adoption.

    Why it matters

    The new J-code is crucial for accelerating Epioxa's commercial ramp and broader market access, impacting revenue growth.

    The new code J2789 is scheduled to take effect on July 1, 2026, and we believe it will help streamline the reporting and reimbursement process for Epioxa among U.S. payers over time.

    Q&A highlights

    8

    How are initial experiences with Epioxa's claims and prior authorization processes going, and what does early demand look like based on the patient portal?

    The claims process is slower due to the miscellaneous J-code, but the company is encouraged by patient flow into the portal and positive claims adjudication. The site of care network and payer pathways are foundational, and the funnel of clinical demand is developing positively.

    But I will say that we've been very encouraged by those sites of care who come online, as Tom referenced. And the patient flow that's coming from that and into our portal in the hub, as you say, as a leading indicator of what it can mean for the clinical demand associated with an Epi-On therapy like Epioxa.

    asked by Thomas Stephan · answered by Joseph Gilliam

    2 min read5 chapters

    Detailed Narrative

    01

    iDose TR Performance and Market Evolution

    iDose TR delivered strong first-quarter net sales of approximately $54 million, driving a 58% year-over-year growth in the U.S. Glaucoma franchise. The product continues to show strong clinical outcomes, physician interest, and adoption, supported by 22 peer-reviewed publications and active Phase IV studies. Glaukos is focused on expanding its trained surgeon base, increasing utilization, broadening market access, and scaling commercial investments, contributing to a broader shift towards earlier intervention in glaucoma care.

    02

    Epioxa Launch and Market Access Progress

    Glaukos announced the commercial availability of Epioxa, a novel incision-free treatment for keratoconus. The company has established a broad site-of-care network covering approximately 65% of the U.S. population, with plans to expand to 95%. Significant progress has been made with payers, securing access pathways for over 100 million covered commercial lives, including 4 of the 5 largest payers. A product-specific J-code (J2789) is scheduled to take effect on July 1, 2026, which is expected to streamline reimbursement.

    03

    International Glaucoma and Corneal Health Dynamics

    The International Glaucoma franchise achieved record net sales of $35.8 million, growing 23% reported and 16% constant currency year-over-year, driven by broad-based strength. The company anticipates competitive product trialing headwinds in some major international markets and expects currency tailwinds to abate. Corneal Health, including Photrexa and early Epioxa sales, delivered $21.3 million in net sales, growing 15% year-over-year. The transition from Photrexa to Epioxa is expected to cause some volatility in Q2 and Q3 FY26, with Photrexa anticipated to fully sunset by the end of Q3 FY26.

    04

    Clinical Pipeline Advancements

    Glaukos continues to advance a broad clinical pipeline across five therapeutic platforms, encompassing 13 publicly disclosed programs. Key ongoing pivotal trials include iDose TREX, iStent infinite for mild-to-moderate patients, and PRESERFLO MicroShunt. An active Phase II trial is underway for iLution demodex blepharitis, and the iLink platform is progressing with a planned market introduction of a KC screening device later this year. The iDose TRIO clinical study has been completed, with a filing planned by year-end FY26 and targeted approval in Q4 FY27.

    05

    Strategic Investments and Profitability Outlook

    The company is making significant investments in patient awareness, education, and access for Epioxa, including targeted marketing and DTC initiatives. For iDose, investments are focused on increasing awareness and education, particularly for commercial and Medicare Advantage patients. While operating expenses are expected to grow in the high teens for FY26, management remains focused on achieving cash flow breakeven and driving operating leverage, with a clear line of sight towards profitability in the coming years, balancing growth investments with financial discipline.

    AI-generated summary of the company’s earnings call. Not investment advice.