Financial Data and Key Metrics Changes - Glaukos Corporation reported record third quarter consolidated net sales of $133.5 million, up 38% on a reported basis or 37% on a constant currency basis compared to the same quarter last year [7] - The company raised its full year 2025 net sales guidance range to $490 to $495 million from a previous range of $480 to $486 million [7][24] Business Line Data and Key Metrics Changes - The U.S. glaucoma franchise achieved record third quarter net sales of $80.8 million, reflecting a strong year-over-year growth of 57%, driven by iDose TR, which generated approximately $40 million in sales [8] - The international glaucoma franchise delivered net sales of $29.4 million, representing a year-over-year growth of 20% on a reported basis and 17% on a constant currency basis [9] - The corneal health franchise reported net sales of $23.3 million, with Votrexa contributing $20.3 million, reflecting a year-over-year growth of 13% [10] Market Data and Key Metrics Changes - Surgeons showed high initial interest in iStent Infinite during its commercial launch activities in key European markets, indicating strong potential for growth in the international market [9] - The company continues to scale its international infrastructure to drive growth as a standard of care in various regions [9] Company Strategy and Development Direction - Glaukos aims to evolve into a diversified ophthalmic leader with transformational growth drivers across multiple geographies and disease states, focusing on glaucoma and rare diseases [11] - The FDA approval of Epioxa marks a significant milestone, introducing a new standard of care for keratoconus patients with a unique incision-free treatment [12][17] - The company plans to increase investments in patient awareness and access to address the challenges of underdiagnosis and under-treatment in keratoconus [17][18] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the potential of Epioxa to deliver exceptional value to patients and the healthcare system, emphasizing the importance of education and awareness in driving patient access [20][21] - The company anticipates Epioxa will be commercially available in the first quarter of 2026, with a focus on establishing a site of care network and addressing payer adoption challenges [22][24] Other Important Information - Glaukos has invested over $1 billion in R&D to develop a robust pipeline focused on chronic and rare ophthalmic diseases [19] - The company is constructing a new 200,000-square-foot research, development, and manufacturing facility in Huntsville, Alabama, to support long-term growth and innovation [19] Q&A Session Summary Question: Can you discuss the rationale behind the CAC meeting and potential outcomes? - Management highlighted the importance of educating MACs on the unmet need that iDose addresses and the robust FDA data supporting its utilization [30][31] Question: What is the confidence level regarding payer coverage for Epioxa? - Management indicated that education at the payer level is crucial, and they are optimistic about engaging in conversations to establish coverage [36] Question: Can you provide more granularity on the 2026 revenue guidance? - Management stated that the preliminary guidance reflects expectations for Epioxa's rollout and the transition from Votrexa, with more detailed insights to be provided in future calls [41][42] Question: How is iDose performing in terms of utilization? - Management reported strong sales growth for iDose, with contributions from various MAC regions and a growing trend in combination with cataract surgeries [45][46] Question: What are the expectations for patient access to Epioxa? - Management acknowledged that while there may be initial headwinds, they aim to significantly expand patient access over time through education and awareness initiatives [55]