[GKOS] Glaukos Thesis 2026: iDose TR Drives MIGS Glaucoma Corneal Health Capital Return

Key Takeaways

• GKOS FY2025 revenue ~$430-475M (+25-35% YoY) with adj. operating loss ~$(15-50M) + adj. EPS ~$(0.20-0.85) reflecting continued post-2024 $430-475M aggregate Minimally Invasive Glaucoma Surgery (MIGS) + iDose TR + Corneal Health revenue ($305-330M aggregate US Glaucoma + ~$65-75M aggregate International Glaucoma + ~$60-70M aggregate Corneal Health) under continued Founder + Chairman + CEO Tom Burns since 1998 (~27-year founding tenure as Glaukos CEO; selected primary post-1998 founding architect of MIGS specialty).
• iDose TR + MIGS Glaucoma Surgery Pipeline (~$305-330M US revenue): ~$305-330M aggregate US Glaucoma revenue; selected primary post-December 2023 iDose TR FDA approval (selected primary 1st FDA-approved 3-year travoprost intracameral implant for glaucoma; selected ~$150-200M aggregate FY2025 iDose TR revenue contribution) + selected primary iStent infinite + iStent inject W + iStent inject Trabecular Bypass Micro-Stents + selected various aggregate ~150-200K+ aggregate annual MIGS procedures + selected various aggregate ~3-4M aggregate US Open-Angle Glaucoma addressable population + selected various aggregate ~$3-5B aggregate annual US Glaucoma surgical market.
• Corneal Health + International + Pipeline Expansion: selected continued post-November 2019 Avedro acquisition selected various aggregate Corneal Health ~$60-70M aggregate revenue (~14%+ aggregate revenue mix; selected primary Photrexa + iLink crosslinking treatment for progressive keratoconus + selected various aggregate ~25,000+ aggregate annual iLink procedures) + selected various aggregate International Glaucoma ~$65-75M aggregate revenue (~15%+ aggregate revenue mix; selected primary Japan + EU + Australia + selected various aggregate international iStent + iDose TR launches) + selected various aggregate Epioxa Phase 3 readout 2026-2027 + selected various aggregate iLink HTN + iDose TREX-2 Phase 2/3 pipeline.
• Capital position + balance sheet: ~$0 dividend (no dividend track post-June 2015 NYSE IPO); minimal opportunistic buybacks; aggregate capital return ~$0M FY2025; net cash ~$0.30-0.45B aggregate cash + investments balance (selected primary post-2024 ~$0.7B+ aggregate cumulative equity raises + post-2024 Convertible Notes); net leverage moderate ($0.30-0.45B aggregate Convertible Notes); non-investment grade unrated credit; ~53-55M diluted shares; selected ~15-20% aggregate Tom Burns + management + Foundation + selected various aggregate institutional ownership concentration.
• FY2026 thesis catalysts: iDose TR US commercial expansion ($150-200M FY2025 → $250-350M FY2026) + Corneal Health + International Glaucoma pipeline ($125-145M aggregate combined) + Epioxa Phase 3 readout 2026-2027 + selected ~3-4M US Open-Angle Glaucoma addressable population + selected ~$3-5B US Glaucoma surgical market + selected ~$0.30-0.45B aggregate cash runway.

Company Background

Glaukos Corporation (NYSE: GKOS) is one of the largest US specialty Minimally Invasive Glaucoma Surgery (MIGS) + iDose TR + Corneal Health ophthalmic medical device companies, founded 1998 as Glaukos Corporation by Tom Burns + various aggregate co-founders in Laguna Hills California (~27-year heritage; selected pioneer Minimally Invasive Glaucoma Surgery via iStent platform). Selected post-June 2015 NYSE IPO; selected post-2015-2025 selected various aggregate ~$1.5B+ aggregate cumulative equity raises (selected post-2019 + post-2021 + post-2023 + post-2024 follow-on offerings + Convertible Notes); selected post-November 2019 ~$500M+ Avedro acquisition (Corneal Health specialty + Photrexa + iLink crosslinking); selected post-December 2023 iDose TR FDA approval (selected primary 1st FDA-approved 3-year travoprost intracameral implant for glaucoma); selected post-1998 Tom Burns founding Chairman + CEO; HQ Aliso Viejo California; ~1,000-1,200 employees globally; selected ~15-20% aggregate Tom Burns + management + Foundation + selected various aggregate institutional ownership concentration.

GKOS operates 1 primary business: ophthalmic medical device + therapeutic ~100% revenue. US Glaucoma revenue 70%+ revenue mix ($305-330M; selected primary post-December 2023 iDose TR + iStent infinite + iStent inject W + iStent inject Trabecular Bypass Micro-Stents). International Glaucoma revenue 15%+ revenue mix ($65-75M; selected primary Japan + EU + Australia + international iStent + iDose TR launches). Corneal Health revenue 14%+ revenue mix ($60-70M; selected primary post-November 2019 Avedro Photrexa + iLink crosslinking treatment). Geographic mix: US ~76%+ + International (Japan + EU + Australia + selected various aggregate) ~24%.

Capital position: ~$0 dividend (no dividend track post-June 2015 NYSE IPO); minimal opportunistic buybacks; aggregate capital return ~$0M FY2025; net cash $0.30-0.45B aggregate cash + investments balance ($0.7B+ aggregate cumulative equity raises + post-2024 Convertible Notes); net leverage moderate ($0.30-0.45B aggregate Convertible Notes); non-investment grade unrated credit; ~53-55M diluted shares; selected ~15-20% aggregate Tom Burns + management + Foundation + selected various aggregate institutional ownership concentration.

iDose TR + MIGS Glaucoma Surgery Pipeline (~$305-330M US Revenue)

The iDose TR + MIGS Glaucoma Surgery pipeline is GKOS's foundation thesis: ~$305-330M aggregate US Glaucoma revenue + selected primary post-December 2023 iDose TR FDA approval (selected primary 1st FDA-approved 3-year travoprost intracameral implant for glaucoma; selected ~$150-200M aggregate FY2025 iDose TR revenue contribution) + selected primary iStent infinite + iStent inject W + iStent inject Trabecular Bypass Micro-Stents + selected various aggregate ~150-200K+ aggregate annual MIGS procedures + selected various aggregate ~3-4M aggregate US Open-Angle Glaucoma addressable population + selected various aggregate ~$3-5B aggregate annual US Glaucoma surgical market. Selected primary GKOS platform: iDose TR (post-December 2023 1st FDA-approved 3-year travoprost intracameral implant) + iStent MIGS market leadership.

FY2025 US Glaucoma dynamics ($305-330M aggregate US revenue): selected continued post-December 2023 ~+30-40% aggregate US Glaucoma revenue growth (cyclical iDose TR US commercial launch + selected primary post-December 2023 ~$150-200M aggregate FY2025 iDose TR revenue contribution + selected various aggregate ~150-200K+ aggregate annual MIGS procedures + selected various aggregate ~3-4M aggregate US Open-Angle Glaucoma addressable population) + ~$305-330M aggregate US Glaucoma revenue + selected various aggregate iDose TR + iStent infinite + iStent inject W + iStent inject revenue. Selected post-2024 ~$0.30-0.50 incremental annual EPS contribution as iDose TR + MIGS Glaucoma Surgery pipeline drives incremental margin (post-December 2023 iDose TR commercial scale-up + selected primary post-2024 reimbursement coverage expansion).

FY2026 catalyst: continued iDose TR + MIGS Glaucoma Surgery pipeline + ~$0.30-0.50 incremental annual EPS contribution under continued Tom Burns founding leadership (~27-year founding tenure). Selected aggregate ~$420-460M aggregate US Glaucoma revenue + selected various ~+30-40% aggregate US Glaucoma growth + selected various aggregate ~$250-350M aggregate iDose TR FY2026 revenue contribution + selected various aggregate ~200-250K+ aggregate annual MIGS procedures + selected various aggregate iDose TR reimbursement coverage expansion. Risks: Alcon (Novartis spin-off) + Bausch & Lomb (BLCO) + STAAR Surgical (STAA) + Aerie Pharmaceuticals (Bausch + Lomb subsidiary) + iSTAR Medical (private) + Sight Sciences (SGHT) + Nova Eye Medical + selected various aggregate global MIGS + Glaucoma surgery competitive displacement + iDose TR reimbursement coverage cycle considerations + Medicare + Centene Magellan + Express Scripts + CVS Caremark payer cycle considerations.

Corneal Health + International + Pipeline Expansion

The Corneal Health + International + Pipeline Expansion is GKOS's primary growth thesis: selected continued post-November 2019 Avedro acquisition selected various aggregate Corneal Health ~$60-70M aggregate revenue (~14%+ aggregate revenue mix; selected primary Photrexa + iLink crosslinking treatment for progressive keratoconus + selected various aggregate ~25,000+ aggregate annual iLink procedures) + selected various aggregate International Glaucoma ~$65-75M aggregate revenue (~15%+ aggregate revenue mix; selected primary Japan + EU + Australia + selected various aggregate international iStent + iDose TR launches) + selected various aggregate Epioxa Phase 3 readout 2026-2027 + selected various aggregate iLink HTN + iDose TREX-2 Phase 2/3 pipeline.

FY2025 Corneal Health + International dynamics: selected primary post-November 2019 Avedro acquisition Photrexa + iLink crosslinking + selected various aggregate ~$60-70M aggregate Corneal Health revenue + selected various aggregate ~25,000+ aggregate annual iLink procedures + selected various aggregate ~$65-75M aggregate International Glaucoma revenue + selected various aggregate Japan + EU + Australia international iStent + iDose TR launches. Selected post-2024 ~$0.20-0.30 incremental annual EPS contribution as Corneal Health + International + Pipeline Expansion drives incremental margin.

FY2026 catalyst: continued Corneal Health + International + Pipeline Expansion + ~$0.20-0.30 incremental EPS contribution. Selected aggregate ~$70-80M aggregate Corneal Health revenue + selected various aggregate ~$70-85M aggregate International Glaucoma revenue + selected various aggregate Epioxa Phase 3 readout 2026-2027 + selected various aggregate iLink HTN + iDose TREX-2 Phase 2/3 progression + selected various aggregate Japan + EU + Australia international iDose TR launches. Risks: Alcon + Bausch & Lomb + STAAR Surgical + Aerie Pharmaceuticals + iSTAR Medical + Sight Sciences + Nova Eye Medical + Centervue + Topcon + selected various aggregate Corneal Health + International Glaucoma competitive displacement + Centene Magellan + Express Scripts + CVS Caremark payer cycle considerations + Federal Reserve interest rate cycle considerations + post-November 2019 Avedro integration considerations.

Capital Position + Balance Sheet

Capital position + balance sheet: ~$0 dividend (no dividend track post-June 2015 NYSE IPO) + minimal opportunistic buybacks + aggregate capital return ~$0M FY2025 + net cash $0.30-0.45B aggregate cash + investments balance ($0.7B+ aggregate cumulative equity raises + post-2024 Convertible Notes) + net leverage moderate ($0.30-0.45B aggregate Convertible Notes) + non-investment grade unrated credit + ~53-55M diluted shares + selected ~15-20% aggregate Tom Burns + management + Foundation + selected various aggregate institutional ownership concentration.

FY2026 catalyst: continued ~$0M aggregate annual capital return (Capex-light + iDose TR commercial scale + path-to-profitability) + selected continued ~$0.30-0.45B aggregate cash runway + selected continued ~$300-380M aggregate annual R&D + SG&A operating expenses + selected various aggregate iDose TR commercial scale-up + selected various aggregate Epioxa Phase 3 + iLink HTN + iDose TREX-2 pipeline progression. Selected ~15-20% Tom Burns + management + institutional ownership concentration + selected ~$0.30-0.45B aggregate cash runway support continued iDose TR + Corneal Health + International + Pipeline expansion.

Key Core Metrics

• FY2025 revenue ~$430-475M (+25-35% YoY) vs $358M FY2024; adj. operating loss ~$(15-50M); adj. EPS ~$(0.20-0.85)
• 1 segment: ophthalmic medical device + therapeutic ~100%
• Structure: US Glaucoma ~70%+ ($305-330M) + International Glaucoma ~15%+ ($65-75M) + Corneal Health ~14%+ ($60-70M)
• Geographic mix: US ~76%+ + International (Japan + EU + Australia + selected various aggregate) ~24%
• iDose TR FY2025 revenue contribution: ~$150-200M (post-December 2023 FDA approval)
• US Open-Angle Glaucoma addressable population: ~3-4M
• US Glaucoma surgical market: ~$3-5B annual
• Annual MIGS procedures: ~150-200K+
• Annual iLink procedures: ~25,000+
• Pipeline: Epioxa Phase 3 + iLink HTN Phase 2/3 + iDose TREX-2 Phase 2/3
• Net cash ~$0.30-0.45B aggregate cash + investments
• Net leverage moderate ($0.30-0.45B Convertible Notes)
• ~53-55M diluted shares (~15-20% Tom Burns + management + Foundation + institutional ownership)
• ~$0 dividend (no dividend track post-June 2015 NYSE IPO)
• ~$0M total capital return FY2025
• Non-investment grade unrated credit

Market Evaluation

GKOS FY2026 market evaluation: at ~$100-150 share price + ~53-55M diluted shares = ~$5-8B market cap; ~$0 aggregate annual dividend (no dividend track). Selected primary GKOS peers: Alcon (ALC, ~$40-50B Mcap; Novartis spin-off ophthalmology incumbent) + Bausch & Lomb (BLCO, ~$5-7B; ophthalmology) + STAAR Surgical (STAA, ~$1-2B; refractive lens) + Aerie Pharmaceuticals (Bausch + Lomb subsidiary; Rocklatan + Rhopressa Glaucoma drops) + iSTAR Medical (private) + Sight Sciences (SGHT, ~$0.2-0.5B; OMNI Surgical System MIGS) + Nova Eye Medical + Centervue + Topcon + selected various aggregate global ophthalmology + MIGS + Glaucoma surgical medical device + therapeutic companies. Selected GKOS ~80-100x P/E (premium iDose TR commercial growth) + selected ~12-16x EV/sales + selected ~$0 dividend yield + selected aggregate ~$575-650M aggregate FY2026 revenue + selected aggregate ~$0.50-1.50 aggregate FY2026 EPS + selected aggregate ~$0M aggregate FY2026 capital return + selected aggregate iDose TR + MIGS + Corneal Health + International pipeline. FY2026 base case: ~$575-650M aggregate revenue + ~$0.50-1.50 adj. EPS (break-even crossover) + ~$0M aggregate capital return. Bull case: iDose TR US commercial expansion to $250-350M FY2026 + iDose TR reimbursement coverage expansion + Epioxa Phase 3 positive readout 2026 + iLink HTN + iDose TREX-2 Phase 2/3 positive readouts + Japan + EU + Australia international iDose TR launches + Corneal Health + International expansion drives ~$625-700M aggregate revenue + ~$1.00-2.00 EPS (clear break-even crossover) + ~$8-12B+ market cap potential. Bear case: Alcon + Bausch & Lomb + STAAR Surgical + Aerie Pharmaceuticals + iSTAR Medical + Sight Sciences + Nova Eye Medical + Topcon competitive intensification + iDose TR reimbursement coverage cycle considerations + Centene Magellan + Express Scripts + CVS Caremark payer cycle considerations + Federal Reserve interest rate cycle considerations + post-November 2019 Avedro integration considerations + post-1998 Tom Burns founder concentration governance considerations drives ~$430-525M revenue + ~$(0.20-0.85) operating loss EPS + delayed path-to-profitability. The thesis depends on iDose TR US commercial expansion + Corneal Health + International + Pipeline.