Executive Summary

Record Q3 revenue and raised outlook: Net sales $133.5M (+38% y/y, +7.6% q/q), with non-GAAP gross margin ~84%; FY25 revenue guidance raised to $490–$495M and preliminary FY26 guide introduced at $600–$620M .
iDose TR momentum: U.S. Glaucoma revenue hit a record $80.8M (+57% y/y) with iDose TR contributing ~$40M; management framed iDose as creating a new category and highlighted expanding MAC coverage and pending CAC discussions .
Epioxa approved and priced: FDA approved Epioxa (epi-on cross-linking) with wholesale acquisition cost of $78,500; commercial launch targeted for Q1’26 with staged transition away from Photrexa; management emphasized access programs and payer education .
Beat vs S&P Global consensus: Revenue $133.5M vs $122.5M consensus; non-GAAP EPS ($0.16) vs ($0.26) consensus; strong top-line beat driven by iDose TR adoption and broader IG initiatives; see Estimates Context section (S&P Global) .
Key stock catalysts: iDose TR reimbursement trajectory (CAC/LCD outcomes), early Epioxa launch execution and payer coverage, FY26 growth path across glaucoma and corneal franchises, and iDose TR re-administration PDUFA (Jan 28, 2026) .

What Went Well and What Went Wrong

What Went Well
- Strong growth and guidance raise: Q3 net sales +38% y/y to $133.5M; FY25 revenue guide raised to $490–$495M; preliminary FY26 $600–$620M introduced .
- iDose TR traction: U.S. Glaucoma $80.8M (+57% y/y) supported by ~$40M iDose TR sales; “we are pioneering a brand new therapeutic category that has the potential to reshape glaucoma management” (Tom Burns) .
- Epioxa FDA approval: First incision-free topical therapy for keratoconus; launch planned Q1’26 with robust access and awareness investments; management calls it a “reset moment” for keratoconus care .
What Went Wrong
- Corneal Health near-term headwinds: Q4 guide commentary implies a “fairly material” y/y decline as business transitions from Photrexa to Epioxa; early signs of patients deferring Photrexa post-approval .
- International glaucoma and U.S. stent dynamics: International facing competitive trialing in key markets; U.S. stent business stabilizing but expected low single-digit decline in Q4 on tougher comps and LCD impacts .
- Non-GAAP add-backs notable: Non-GAAP margin relies on recurring amortization (Avedro/Mobius) and a non-recurring inventory write-down ($1.3M) in Q3; investors should account for differential vs GAAP .

Financial Results

Metric	Q3 2024	Q2 2025	Q3 2025
Revenue ($M)	$96.7	$124.1	$133.5
Gross Margin (GAAP)	76.6%	78.3%	78.4%
Gross Margin (Non-GAAP)	82.4%	83.0%	83.9%
Diluted EPS (GAAP)	($0.39)	($0.34)	($0.28)
Diluted EPS (Non-GAAP)	($0.28)	($0.24)	($0.16)

Notes on adjustments: Non-GAAP gross margin excludes amortization of developed technology (Avedro) ~$5.5M, Mobius IP amortization, and a non-recurring inventory write-down of ~$1.3M in Q3 2025 .

Segment breakdown (sales, $M)

Segment	Q1 2025	Q2 2025	Q3 2025
U.S. Glaucoma	$59.1	$72.3	$80.8
International Glaucoma	$29.009	$31.251	$29.443
Corneal Health	—	—	$23.3
Glaucoma Total	$88.1	$103.5	$110.2

KPIs and other metrics

KPI	Q3 2025
iDose TR Sales (approx.)	~$40.0M
Cash, ST investments & restricted cash	~$277.5M; no debt
Capital Expenditures	~$1.6M
Non-GAAP Operating Loss	($9.3)M

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Net Sales (Revenue)	FY 2025	$480–$486M (as of Q2’25)	$490–$495M	Raised
Net Sales (Revenue)	FY 2026	—	$600–$620M (preliminary)	Introduced

Management also flagged Q4 dynamics: mid-40% y/y growth for U.S. glaucoma; low double-digit growth for International; “fairly material” y/y decline for Corneal Health during the Photrexa→Epioxa transition; iDose TR growth continues but tempered sequentially given surgeon schedules and timing of NGS professional-fee tailwind .

Earnings Call Themes & Trends

Topic	Previous Mentions (Q-2 and Q-1)	Current Period (Q3 2025)	Trend
iDose TR adoption & reimbursement	Scaling adoption with FY25 guide increases; strong U.S. glaucoma growth in Q1/Q2 press releases	~$40M iDose TR sales; 70% of Medicare lives with professional fees incl. NGS; CAC/LCD education underway	Accelerating adoption; reimbursement advancing; policy overhang in focus
Epioxa (epi-on CXL)	Not approved yet in Q1/Q2	FDA approval; WAC $78,500; Q1’26 launch; access/awareness build; staged Photrexa discontinuation	Major new growth vector; near-term corneal headwind as transition begins
Regulatory & policy	FY25 guide framework included LCD/MAC considerations (implied); MIGS LCDs impacted U.S. stents earlier in year	CAC on iDose TR; LCD coverage vs payment nuance; re-administration PDUFA 1/28/26; EU MDR iStent infinite launch in EU	Policy path clearer but still key variable
International glaucoma	Growth with competitive dynamics emerging	+20% y/y in Q3; notes of competitive trialing headwinds in 2025	Solid but moderating vs competitive backdrop
Tariffs & supply chain	Not highlighted	Minimal direct tariff exposure given U.S. manufacturing/sourcing	Low direct risk currently
R&D execution	Pipeline advancing across glaucoma/corneal/retina	Broad pipeline updates; iDose TREX ph2b/3, iStent infinite trials, Retina XR FIH; Huntsville facility groundbreaking	Sustained investment and milestones ahead

Management Commentary

“Record third quarter consolidated net sales of $133.5 million… We are raising our full year 2025 net sales guidance… Our results… driven by growing iDose TR adoption and utilization, along with broader IG initiatives globally.” – Tom Burns .
“We have established a wholesale acquisition cost for Epioxa of $78,500… unique as a single administration therapy… we anticipate Epioxa will be commercially available in the first quarter of 2026 under a miscellaneous J code…” – Management .
“PDUFA date… January 28, 2026… we are hopeful, but we’re not counting on the FDA giving us the nod to move forward with re-administration.” – Management on iDose TR re-administration .
“We commenced commercial launch activities for iStent infinite in our key European markets at the ESCRS… interest levels… very high.” – Management .
“We expect minimal direct exposure to the most recently implemented tariff-related policies… we manufacture and source primarily within the U.S.” – Company quarterly summary .

Note: The transcript references “Votrexa,” which corresponds to Photrexa in the press materials .

Q&A Highlights

iDose TR reimbursement/CAC: Management views the CAC process as education to support appropriate coverage; highlighted robust clinical evidence and growing MAC coverage; LCDs affect coverage while separate work continues on payment levels .
Epioxa pricing and access: WAC $78,500; management expects a phased access ramp in 2026 (miscellaneous code 1H26, J-code by July 2026), with significant investments in payer education, patient support, and site-of-care buildout .
iDose TR ramp shape: Early-phase trajectory described as “pretty solid linear”; potential for broader utilization as reimbursement stabilizes; NGS effect to show later .
2026 guide composition: Company deferred franchise splits to Q4 call but indicated multiple paths across U.S./International Glaucoma and corneal health to achieve $600–$620M .
Clinical timelines: Level 1 studies (iDose + cataract vs cataract alone; iDose + iStent infinite vs infinite alone) enrolling; potential readouts late 2026 to 2027 .

Estimates Context

Results vs S&P Global Wall Street consensus (Q3 2025):

Metric	Actual	Consensus	Surprise
Revenue ($M)	$133.537	$122.548*	+$10.989M
Adj. EPS (Non-GAAP)	($0.16)	($0.259)*	+$0.10

Values marked with * are retrieved from S&P Global.
S&P Global consensus inputs: 15 estimates for revenue and EPS; GetEstimates shows consensus means and actuals aligned to reported quarter.

Implications: Significant top-line beat driven by iDose TR adoption and broader IG execution; non-GAAP EPS beat benefited from scale, gross margin accretion and controlled opex while still investing in commercial and R&D .

Key Takeaways for Investors

Glaucoma engine accelerating: iDose TR delivered ~$40M in Q3 with expanding MAC coverage; U.S. Glaucoma up 57% y/y; continued momentum into 2026 underpins raised FY25 and new FY26 guides .
Epioxa transforms corneal franchise: FDA approval with premium WAC and Q1’26 launch should reset growth trajectory, but near-term (Q4) corneal headwinds as patients/providers await Epioxa; watch payer coverage cadence and J-code timing .
Policy/reimbursement is the swing factor: CAC/LCD outcomes and professional fee progression can drive utilization mix and uptake for iDose TR; management expects more stability over time .
Non-GAAP vs GAAP quality: Non-GAAP margins exclude sizable amortization and a one-time inventory write-down; track GAAP-to-Non-GAAP reconciliation as scale improves .
2026 road map credible but execution-heavy: Multiple levers (iDose TR, EU iStent infinite, Epioxa) support $600–$620M target; execution on site-of-care buildout, payer education, and regulatory milestones is critical .
Watch clinical catalysts: iDose TR re-administration PDUFA (Jan 28, 2026) and Level 1 combo studies (late 2026–2027) could expand labels/usage and support longer-term penetration .
International competitiveness: Good base but monitor competitive trialing impacts in key markets; balanced expectations set by management .

Appendix: Additional Data and Disclosures

Balance sheet strength: ~$277.5M in cash/ST investments/restricted cash; no debt at quarter end .
Sequential trends: Total net sales +16.4% q/q in Q2 and +7.6% q/q in Q3; international glaucoma declined q/q in Q3 due to mix/competitive dynamics .
Non-GAAP reconciliation references: Detailed add-backs include Avedro/Mobius intangible amortization and one-time inventory write-down; see press release and 8-K exhibits .

References

Q3 2025 8-K and exhibits (press release and quarterly summary): .
Q3 2025 press release (Business Wire): .
Q3 2025 earnings call transcript: .
Epioxa FDA approval press release: .
Prior quarters press releases for trend analysis: Q2 2025 ; Q1 2025 .

S&P Global Consensus Disclaimer

Asterisked values in Estimates Context are retrieved from S&P Global via GetEstimates.

GLAUKOS Corp (GKOS)·Q3 2025 Earnings Summary