A California eye-care company making tiny implants and dropless treatments for glaucoma and other eye conditions, its signature iStent is a micro-sized device placed in the eye to lower pressure. Founded in 1998, it pioneered micro-invasive glaucoma surgery with the first human implant of its stent in 2001. The name comes from ancient Greek "glaukos," meaning gleaming or blue-gray—the same root as the word "glaucoma."
Q2 2026 revenue rose 49.5% to $185.6M as iDose TR and Epioxa lifted gross margin to 81.7%.
Glaukos turned a quarterly operating cash outflow into positive cash generation for the first half of 2026. rose 49.5% to $185.6M and expanded to 81.7% as iDose TR volume and the Epioxa launch drove U.S. glaucoma sales up 64% and corneal health sales up 48%. The company is still unprofitable but the loss narrowed and cash flow improved.
Key takeaways
was $14.8M in Q2 2026, up 112.4% and a swing from the $12.5M outflow in Q1, leaving cash and short-term investments at $286.2M at quarter-end against over $80M planned for a Huntsville facility.
rose 49.5% to $185.6M, with U.S. glaucoma sales up 64% to $118.5M from higher iDose TR volume and pricing, and corneal health sales up 48% to $30.4M driven by the U.S. Epioxa launch transitioning from Photrexa.
expanded 3.8 points sequentially to 81.7%, benefiting from higher iDose TR and Epioxa sales, while operating expenses rose 41% to $168.9M on and growth.
Section summaries
Management's Discussion and Analysis
Q2 2026 net sales rose 50% to $185.6M, driven by iDose TR volume and Epioxa launch, while gross margin expanded to 82%.
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Total increased 50% to $185.6M, with U.S. glaucoma sales up 64% to $118.5M, primarily from higher iDose TR volume and pricing.
International glaucoma sales grew 17% to $36.6M on broad-based volume growth in France, UK, and Australia, partly offset by German reimbursement challenges.
Net loss was $18.4M versus $19.7M a year earlier, with of -$0.31 versus -$0.34, as expense growth partially offset the increase.
Glaukos is pursuing trade-secret claims against SpyGlass and a former employee who allegedly uploaded over 13,000 files; trial is set for January 26, 2027 with no financial exposure stated.
What changed
Q1 2026 flagged the Epioxa launch uptake and reimbursement as corneal health transitions from Photrexa: Q2 corneal health sales rose 48% to $30.4M on the U.S. Epioxa launch, settling the watch item with a positive start.
Q1 2026 flagged the January 2026 PDUFA decision on iDose TR re-administration: the filing does not report the outcome, leaving it unresolved against the $93.5M Q1 U.S. glaucoma base.
Q1 2026 flagged cash level after $80M+ Huntsville begins: cash and short-term investments were $286.2M at Q2 end with positive $2.3M for the half, before the facility spend ramps.
FY2025 fell to 56% on a $112.9M Photrexa ; Q2 2026 gross margin of 81.7% shows the underlying business without that non-cash charge, up from 77.9% in Q1 2026.
Proposed May 2026 MAC local coverage determinations on iDose TR use are a new risk factor this quarter, threatening future U.S. glaucoma sales beyond the restrictions already in place.
What to watch
May 2026 MAC local coverage determination outcome on iDose TR use and its effect on U.S. glaucoma sales
Q3 2026 iDose TR utilization and reimbursement against the $118.5M Q2 U.S. glaucoma base
Q3 2026 Epioxa launch uptake and reimbursement as corneal health transitions from Photrexa
Cash and short-term investments level after the over $80M Huntsville facility begins in 2026
Corneal health sales rose 48% to $30.4M, driven by the U.S. launch of Epioxa, which is transitioning from Photrexa, and increased iLink device placements.
improved to 82% from 78%, benefiting from higher iDose TR and Epioxa sales, while operating expenses rose 41% to $168.9M on SG&A and R&D growth.
SG&A increased 39% to $116.1M, including $9.4M in incremental from achieved performance equity awards and expanded commercial infrastructure.
Cash and short-term investments totaled $286.2M at quarter-end; turned positive at $2.3M for the first half, and the company plans over $80M in for a new Huntsville facility.
Quantitative and Qualitative Disclosures About Market Risk
There have been no material changes in our exposure to market risk since December 31, 2025. Refer to Item 7A “Quantitative and Qualitative Disclosures about Market Risk” in our Annual Report.
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There have been no material changes in our exposure to market risk since December 31, 2025.
Refer to Item 7A “Quantitative and Qualitative Disclosures about Market Risk” in our Annual Report.
Glaukos is pursuing trade-secret theft claims against SpyGlass and a former employee; SpyGlass and the employee have counterclaimed.
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Glaukos alleges former clinical leader Long Doan uploaded over 13,000 confidential files to a personal Google Drive and shared them with competitor SpyGlass.
The court entered an in December 2025 after finding Glaukos likely to succeed and at risk of irreparable harm.
Glaukos's amended complaint asserts federal trade-secret violations, breach of contract, fraud, and state computer-fraud claims.
SpyGlass counterclaims for intentional interference with contracts and prospective advantage, plus unfair competition.
Doan counterclaims for unfair competition, breach of contract, and breach of the .
Trial is scheduled for January 26, 2027; no financial exposure amount is stated.
Key risks center on commercial execution for iDose TR and Epioxa, macroeconomic and supply-chain disruptions, and evolving regulatory and reimbursement pressures.
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The commercial success of newly launched iDose TR and Epioxa therapies is uncertain and depends on physician adoption, consistent reimbursement, and manufacturing scale-up.
Unfavorable global conditions, including geopolitical conflicts, U.S. government shutdowns, and bank failures, could disrupt operations, increase costs, and limit access to cash.
A disruption at the sole manufacturing sites in San Clemente, CA or Burlington, MA, or from single-source suppliers, could materially impair production of the iStent family, iDose TR, and Epioxa.
Proposed Medicare Administrative Contractor (MAC) local coverage determinations in May 2026 could impose conditions on iDose TR use, threatening future U.S. Glaucoma sales.
The FDA's new Quality Management System Regulation (QMSR) became effective in February 2026, increasing compliance complexity and potential disclosure of trade secrets.
New state and federal AI regulations, including the EU AI Act effective August 2026, create compliance costs and legal risks for the company's internal use of artificial intelligence.