Glaukos Builds Dual Growth Engines Amid Market Headwinds

Core Insights - Glaukos Corporation (GKOS) is experiencing significant growth, with first-half 2025 revenues reaching $230.8 million, a 27.3% year-over-year increase, primarily driven by the adoption of the iDose TR implant [1][8] - The company has raised its full-year revenue guidance to $480-$486 million, indicating strong commercial momentum [1][8] Near-Term Growth Drivers - The iDose TR launch is gaining traction, generating approximately $31 million in second-quarter sales, with over 80% of volume coming from regions with established reimbursement schedules [3][8] - International glaucoma revenues increased by 20% year-over-year to $31.3 million, supported by the EU MDR clearance for iStent Infinite, which enhances Glaukos' interventional glaucoma strategy [4][8] Long-Term Growth Catalysts - Glaukos is advancing a diversified pipeline across five therapeutic platforms, with pivotal trials for iStent Infinite and PRESERFLO MicroShunt underway, and Epioxa awaiting FDA approval by October 2025 [9][10] - The company is positioning itself in a new stand-alone interventional glaucoma market, with expectations of millions of procedures annually over the next decade [10][11] Challenges and Watchpoints - Reimbursement complexities, including MAC LCD restrictions, pose challenges, although iDose TR reimbursement is expanding [12][14] - Execution risk exists in scaling iDose TR, particularly in regions with slower adoption rates [13][14] - Corneal health sales showed only a 4% year-over-year increase, with anticipated revenue softness during the transition to Epioxa [15][16] Competitive Landscape - The iDose TR launch positions Glaukos favorably against competitors like Alcon, Johnson & Johnson, and Sight Sciences, although Glaukos shares have underperformed compared to these rivals [17][18][21]