GLAUKOS Corp — Call Transcript 2026

My name is Steve Lichtman. I'm the medical technology analyst here at William Blair, who covers our next presenter, Glaukos Corporation. Before we kick off the presentation, I am required to inform you that for a complete list of research disclosures or potential conflicts of interest, please visit our website at williamblair.com. With that, we're very happy to have with us today Alex Thurman, Senior VP and CFO, and Chris Lewis, VP and head of Investor Relations. After the presentation here, we'll have a breakout in the Richardson room. With that, I'm happy to turn the mic over to Alex. Thanks. Thank you, Steve, thank you, William Blair, for allowing us to be here today to talk to you all. Thank you all for coming, spending your lunch hour with us, so we can talk a little bit about Glaukos and let you know kind of what's going on. We'll start. I'm going to have Chris read this for us. Just kidding. Let's move on. We'll start out with kind of just a company overview. For those of you who don't know us, Glaukos has been around for about a little over 20 years. Our company mission we've got on the big box on the left there where it says, We'll go first. That really comes around because of the DNA of the company. The company was founded back, again 20 years ago, to try and solve a problem in the area of glaucoma. Back then, glaucoma was treated very simply by if you came in and you were a patient that showed signs of glaucoma, a doctor would prescribe you a set of drops. You would come back after three months, those drops wouldn't be working, you'd get another set of drops, a third set of drops, and finally a fourth set of drops until you just weren't able to manage your pressures on those drops. They would turn to a very invasive surgery where they, to say it in layman's term, would really put a hole in your eye to relieve the pressure of the fluid that was building up on the front of your eye. Our founders thought there had to be a better way to tackle this disease rather than this paradigm that was existing 20 years ago. They went first in that they designed the first ever stent that was designed to go into your eye and implanted in the back of the eye that would allow the drainage to happen naturally and to get away from these gruesome surgeries to the best that they could and start to manage that. That became the first thing that we innovated, as we say in there, innovation is at the core of everything we do. It solved a solution and a problem that helped patients and helped our customers, which were the physicians, to treat the disease more effectively. You see in the second bullet there, dropless therapies. I mentioned the fact that most of the paradigms back in those days were to prescribe more and more drops. It was interesting because you'd start on one drop and you'd come in and your pressures were not bad or were getting worse, and you'd do a second drop and a third drop. That was their very common procedure, and it wasn't until data got put together that showed, interestingly, patients weren't taking their drops. Why was that? It's so interesting that 90% of patients, data will show you, just didn't take their drops. It was because of all the side effects and the difficulty in administering drops, and we'll talk about that a little more. Only 50% of patients would refill their prescription, which is crazy. You've been diagnosed with a sight-threatening disease, and one in two would not even fill their second prescription. It was because of the difficulties with drops and the side effects. We've channeled the company to be around dropless therapies. How can we treat the disease without having to rely on drops? Last but not least, we've talked about being a proven new market pioneer, and that was really because before us, the stents and that business, there wasn't a MIGS category, a Micro-Invasive Glaucoma Surgery category. We built that market based off of the stents, and we've since progressed it to have more products, which we'll talk about over the course of the presentation. Just a little bit about us. On the left-hand side, you can see some of the stats. Last year, in 2025, we had a 30% top-line growth. In the first quarter, we were at 41% growth. Our 10-year CAGR is 20% growth. We're a high-growth company, always trying to release or innovate and produce more products that get that in the marketplace and continue to top-line grow. We have 12 commercially approved products out in the marketplace today. When we did our IPO just over 10 years ago, we only had one. We've obviously increased that. We have 13 disclosed pipeline products, up from four when we went public. Those pipeline products continue to drive the top-line growth that we experience as we continue to move those things through approvals. We are an R&D company. We pride ourselves in our pipeline and what we're doing and how we're advancing. You can see over the last six years, we've spent almost $1 billion, $800 million, in our R&D efforts as we've continued to develop and produce more products. On the right-hand side is we've developed the company into a platform type of a situation. We have five distinct platforms upon which we try to do a cascade of products over time to continue that high growth on the top line. We've already talked about our stents, and we've got now we're into our third generation of stents, which is called the iStent infinite. We'll talk a little more about that. iDose, which we'll talk about, is our first sustained pharmaceutical release. We have iLink, which most of you may know as our cross-linking or our keratoconus product, and we'll talk a little bit more about that. iLution, which is a novel drug delivery platform. We talked about the fact that we'd like to stay away from drops, our R&D guys were thinking, is there a way to deliver the pharmaceuticals in a drop through another mechanism? We thought there might be. We got involved in looking at a cream or we call it a lotion. Think of it that way, that you would just dab a little bit on your finger, put it on your eyelid, and does that effectively deliver the drugs to your eyes as opposed to using a drop. Then last and not least, we're dabbling and dipping our toes into the retina market. We've got a program underway in phase II around retina, but that's a large established market within ophthalmology, and we're excited about that. Today, we're sitting at a point, it's kind of an inflection point in the company's history where we have two revenue drivers, large revenue drivers in these two market areas, which we're calling interventional glaucoma and interventional keratoconus. We'll talk about each of those as we move through. The first one is just if we think about, and we've talked a little bit about this, the major problem in glaucoma care is this non-compliance with drops. You can see on the left there is the traditional paradigm that I kind of spoke to where you'd start with drops and then you'd add more drops. About a decade ago, the SLTs, which is a laser program, those became more in vogue, so to speak, and was used in this paradigm. Then you still had to go through if that didn't work, and we know from data that about 50% of those lasers fail after two years, about 75% after five years. You're facing these filtration surgeries where they put the hole in the eye and try to drain it that way. I've talked about those stats on the bottom already. We're driving the marketplace to what's on the right side, which is this new interventional glaucoma treatment paradigm, where it makes sense to now treat these patients interventionally with a procedure as opposed to just reflexively prescribing them a drop, which if used works. We know they just don't use them for all the side effects. You can see there the typical or what we drive towards is this laser treatment as the first-line therapy. Go ahead and do the laser. It's great. It's easy. It's in the office. It's very non-invasive for a patient. Easy to get them into what we're calling the interventional glaucoma funnel, have that conversation. Docs are very comfortable with that. The technology's been around for a long time. Ultimately, like I said, within five years, 75% of those procedures are going to fail, and that hole is going to disappear, and that pressure is going to start to build up again. Then we would propose that then they move to a procedural pharmaceutical, which is our iDose product, which we'll talk about, where you take the same active ingredient in those drops that slows down the production of the fluid within the front of the eye, implant that into their eye, and let that elute and deliver the drug to the eye instead of relying on the patient for their compliance. That, in our trials, as you'll see, has been very effective in maintaining pressures over a long period of time, as opposed to you having to take a drop every day. Once you're past that stage, you can add to that with different tools in the MIGS category. We have the stent still that we can complement that. Again, the procedural pharmaceutical is designed to stop the production of the fluid or slow that down. The MIGS or the stent part of the solution is to open up the drainage on the back part of that. You're on the outflow side, and you're being able to continually allow that fluid to flow and not get stuck in there and build up pressure on the front of the eye. You have some MIBS, which is micro-invasive bleb surgery, and then that final end of stage for your really tough eyes, the filtration surgery, sorry. We feel like we, in that paradigm, we're ideally situated to handle it. We've got these products, which I'll show you right here, that will handle those areas along that journey. It's interesting to note that a glaucoma patient, on average, will be in a practice with that disease for, on average, around 20 years of their life. They get diagnosed somewhere in their mid-60s to 70s. That takes them to the end of life because there is no cure for glaucoma. You've got to manage it as best you can and manage that pressure. On the bottom part of that little pathway area, you've got the stents. We've talked about the stents that will be allowed. We started out in this area of combo cataract. Now we've advanced into standalone with iStent infinite. It allows that drainage to happen through the back part of that front of the eye. On the top, you've got the iDose, which can be the workhorse in allowing that pharmaceutical to be administered in the eye 24/7, and that is along the whole journey of your disease. It's there, it just takes that compliance danger out of the hands of the patient, and we just put it right in the eye for them. With respect to iDose, it's designed to be long duration. You can see some of the interesting stats on here. One iDose in our pivotal trials was shown to last up to three years for 70% of the patients. You can imagine taking the drops out of the hands of a patient for up to three years, and that shows that they avoid taking drops 2,190 times. You can see that at the bottom. That is a great holiday for those patients. You talk to any of those patients, they love being off those drops. What are some of the side effects they have? A lot of times it gives them red eyes, so they look like they're hungover. A lot of times it gives them dry eyes, so it's itchy and they hate it. A lot of times it'll give them some fat atrophy in the bottom of their eyes, and so they look just kind of bloated in their eyes. It's not something they like. In fact, we've heard patients come in after having an iDose in three months, and the first thing they say is, Look, doc, look at my eyes. They're not red anymore. They're thrilled to have it. The product in the real world is working exceptionally well. It's gotten great clinical response from our customers on how it's working. You can see on the right-hand side that 81% of our patients in the clinical trials were free of the topical meds, and we already talked about this fact that 70% were well-controlled after three years. iDose is just the beginning. We talked about the fact that the company's designed on these five platforms, iDose being one of them. Today we have the iDose TR, which is the product that we were just talking about. Coming down that pipeline, we've got two other products that are in the near term. One is called iDose TREO on the left. TREO is T-R-E-O for in-office, and it's really just taking the same iDose canister that we have today and putting it into an injector system that's advanced and much smaller incision site so that the physicians can do it in the office in a much more confident manner. It is of note, I will say that our existing iDose product today can be used in the office. It does create a slightly larger incision. The iDose TREO is designed to make that smaller, make those surgeons more confident of doing it in the office. We ultimately would like to be site agnostic, meaning if surgeons want to go into a surgery center and an outpatient surgery center setting and do the iDose TR, they can certainly do that. If they'd rather do that in the office with an iDose TREO, we're happy to provide them that opportunity. We're going through the process of the clinical trial with that iDose TREO currently. We'll get the reimbursement codes set up to do that. They'll be free to operate and do those things in the office. The next one is the iDose TREX. We kind of lovingly call it TREX, although it's T-R-E-X for extended. From a geography standpoint or geometry standpoint, just by bowing out that canister, we're able to introduce about twice as much of the drug into the canister under the theory that it would last twice as long. We're going through the clinical trials on that, where we're hoping to see durations in, let's call it five to seven years, as opposed to three with the iDose TR. So far in the trials and the data that we've seen, it's having a great, robust IOP pressure-lowering effect on our patients. We get into the stents. I talked about iStent infinite. iStent infinite was the first product that we had that would allow us to go into standalone patients with glaucoma. Going back in the journey, if you recall, we started 20 years ago. We finally were able to get the first stent approved in 2012. The FDA was very hesitant to approve that stent on a standalone basis. They didn't like the idea of a surgeon going into an eye just to implant a stent. They approved it in combination with cataract surgery. For the first many, many years, all of our stents were only allowed to be implanted in combination with cataracts since the surgeon was already going to the eye to replace the cataract. In 2022, we were able to get finally everyone comfortable that these were safe and effective. We have iStent infinite, which is a three-stent solution that can go into the standalone patient or in combination with cataract, quite frankly, and be used as part of our MIGS offerings to our customers. Lots of data, lots of history there, very safe and effective on use with our patients. As you can see on that little picture, it is very small as well. We think it is the smallest medical device ever approved by the FDA, are these stents. Thinking about the market opportunity, and this goes to what I was just saying. When the company started and we were kind of constrained to the cataract combination market, you can see on the left-hand side, there's five million eyes that get cataract surgery, of which about 10%-15% have glaucoma alongside. We were playing in a market, let's call it of 500,000 eyes that could potentially get our stent products. On the right-hand side is the overall, let's call it glaucoma market of standalone eyes. You can see that the prevalence data would show you there's 22 million eyes out there that have glaucoma, of which only 13 million are diagnosed, of which 12 million are diagnosed and actively treated. Today, the vast majority are treated with drops, as we've talked about. It's a large opportunity for this glaucoma treatment and why we're so excited about the offerings that we have, both with the stents and with iDose, to tackle this problem and keep people from going blind over time, getting them away from drops and into this more interventional approach. The vision that our CEO has for the next 10 years with respect to interventional glaucoma and treating these patients, he likes to go back in time, he's been around for a long time, is to talk to the surgeons and get them to buy into this idea of treating patients interventionally. One of the things he thinks about is a lot of these customers, their bread and butter historically has been cataract surgery, and they do a lot of cataract surgery. 20 years ago, when they did a cataract surgery, their professional fee was $2,500. Today, though, as after chipping away of it over the last 20 years, they're only getting paid about $450. The professional fees are shrinking. As I mentioned, a glaucoma patient is in your practice or potentially in your practice for about 20 years, whereas a cataract patient is typically a one-and-done patient, right? If you can start to have them catch the vision that you're spending today all of your marketing dollars and all of your efforts to acquire a patient for a one-and-done procedure. Whereas if you just shift your paradigm thinking over and focus on glaucoma, of which there's a large market opportunity, and they're going to be in your practice for 20 years, and that'll give you multiple shots to help that patient with different technologies that we have, it can be a win-win for everybody. The second is around combination therapy. I mentioned that the iDose is treating the introduction of fluid in the eye. The stents are treating the outflow side of that fluid. If you can use them in combination one with another, it's a win-win and a better solution for patients because you're attacking it with two different mechanisms of action. We've got to get the data to support that, we're currently undergoing clinical trials to support that usage. We're hopeful and we're seeing doctors getting more excited about that combination therapy of using, for example, an iStent infinite and an iDose in the same eye in the same procedure. That's certainly, if I could, I'd have my mom do that as well. The next would be this in-office. More and more things around ophthalmology and other med tech are to the extent you can do it in the office. That's where we see things going over time. We mentioned the opportunity that we're pursuing to get the iDose into the office through the iDose TREO. It just seems like as professional fees and other fees, ASC fees get cut, there's more of a drive to get in the office. It's certainly a much easier conversation with a patient to get them to undergo an intervention in the office. As the steps along the journey, we think in-office will be more and more of a part of the treatment algorithm and the practice. The next would be for us to continue to drive this sustained-release drug delivery over the longer term, so they don't have to do it as often, right? We talked about TREX as that first opportunity, where if we can get it to be double the TR, where a patient only has to have that happen once every six or seven years, that's just better off and probably an easier conversation with them. PE groups also are becoming an increasingly more important part of this whole environment around ophthalmology in particular, wherein maybe you're seeing it in other practices where the PE groups are buying up small ophthalmology practices and combining them. At least one of the benefits of a PE, if you can say that, is they're very savvy when it comes to financials. They can understand the value associated with some of these patients that are going to be in a practice for 20 years, some of the revenue opportunities that come along with that, with multiple procedures over that journey. We do see and foresee that PE groups will become more and more an important part of this journey along the IG roadmap. Last but not least, we think that doctors will then pivot over time to become IG specialists, and that they'll advertise as being an IG specialist, and just because the market is being so large and so many patients are out there that they'll want to say to these patients, Hey, we're going to take you off drops. We're going to get you on this IG roadmap, and we're going to get you treated and monitor those pressures and become really good at doing that over time. This is our product roadmap. We've kind of talked about everything on this, except for one thing I'll just point out really quick. The fourth one down is PRESERFLO. That is our micro-invasive bleb surgery product that's in clinical trials now. We do have it approved outside the U.S., and we get great feedback from surgeons outside the U.S. in using this product. We're hoping it will get through the gauntlet here in the FDA, and we'll have that to be added to the arsenal of what our customers use in the future. Okay, the second area of driver for us from a revenue and a growth perspective in the company is interventional keratoconus. Now, for some of you've probably never heard of it. I'd never heard of it six years when we bought a company that was treating this. Let's talk about what it is. Keratoconus is a disease that affects the cornea and is typically found in younger patients where their corneal fibers are weak, and that causes a bulging out of the cornea that distorts the vision. Many times, they're kids, they're typically teenagers that start with this. Today, there's just not a lot of awareness about this disease, what it is. You can imagine if you're a mom or a dad and you have a child in high school or middle school who comes home and says, I can't see the board or, I can't see it anymore, the first thing they do is they run down to the optometrist and they stick their kid in front of the optometrist, and the optometrist takes a look and realizes, yeah, they will treat it, not knowing about keratoconus, they will treat it as a visual acuity problem. They'll put them in some glasses, they'll put them in some contact lenses. What happens is they'll come back in six months. The vision's deteriorated further. They're scratching their head, what's going on? They change the prescription. Just because there's a lack of awareness around keratoconus and what it is. As we see on here, one in five, we think one in five are not being diagnosed accurately with keratoconus. We say that the typical time when this happens is in teenage years. However, today, they're not getting treated until they're in their early 30s because people are just not aware, and they're trying to figure out what's going on. Why is the vision still distorting when I'm putting in contact lenses? What's happening here? I don't know how many years, I guess it was about 10 years ago, there was a company named Avedro that came out with a product that would stop or halt the progression of this keratoconus with a product called Photrexa. In 2019, Glaukos acquired this company, Avedro, and we started to work through this drug delivery. I guess there's a couple more stats on here. We talked about some of these already. You can imagine. Now, let me just talk a little bit about this product that they had called Photrexa. Photrexa worked. It stopped the progression of keratoconus. It's a drop that was put on the eye, shined with a light that activated a cross-linking effect that strengthened those corneal fibers and held them in place. All sounds great, except for one thing. In order to make it effective, the surgeon had to debride or scrape off the outer layer of the cornea, something that was painful, and the recovery time was long. When you're faced with losing your vision or having distorted vision, patients were willing to step up, but not in great numbers. You take that, along with the fact that it's a very unknown disease, and there just wasn't a lot of opportunity for us to continue to grow this market. We were treating about, well, let's call it 10,000 patients, about 18,000, 19,000 eyes a year over the six years that we had this product in our bag. Despite what we could do, that's the best that we could do. A lot of that was it was not seen as a rare disease. Despite it being just 10,000 patients, it wasn't seen initially as a rare disease, and it wasn't priced properly. There was a second generation that was coming around, and it was called Epioxa. This now has been approved. It got approved at the end of last year, and we just launched it in the first quarter. The great difference being that this one, you do not have to remove the outer layer of the epithelium or the cornea. This is a new topical drop that is put on the eye. You shine the light on it, you infuse some oxygen on it, and that does the same effect as Photrexa. It allows for a much better patient experience, obviously. Recovery time is much shorter. The whole treatment time is much shorter. It's a win-win all around for everybody. The nice or exciting thing about this is it allowed Glaukos to completely reset how we go to market with this disease, keratoconus. The reason I say that is we were offered the opportunity to introduce this as a rare disease drug, price it accordingly, and therefore allow us to have the capital to do the things we need to do to find the patients, to educate the patients, and get them treated so they can stop their disease at an earlier point in time. All of these things that are around this little lady right there are all the things that we're investing in with the new capital that we're going to realize on the higher price with Epioxa that allows us to attack this disease more fulsomely. I can see that the time is going fast, Steve says. Let's get skipping ahead. You can see the launch timelines. We're in the second quarter right now. We've done a great job in launching the product, creating a patient hub for our patients so that they're taken care of and through their journey, establishing a new site of care network, so we cover them geographically and make sure they have the opportunity to get treatment. We're going through the process now of payer coverage, going out to the insurance companies, replacing the existing Photrexa with the new Epioxa, et cetera, so that we can get patients treated. There's a third generation that comes behind that. I'll just quickly say the idea here very quickly is to take a topography of the eye, find out exactly where the corneal weaknesses are, and selectively target that so that they strengthen the target instead of just a random shotgun approach with Epioxa. It's going to be more targeted, more of a rifle approach to really get a very customized treatment for each patient with their keratoconus. I'm going to just skip that. We've talked about that. We'll talk quickly about iLution. This was this idea that can you put a pharmaceutical in a cream and put that on your eyelid? We're going after our lead candidate is around the Demodex blepharitis, which is the same market that many of you know with Tarsus, and you've seen the little commercials with the lovely mites crawling around on your eyelids. It's the same idea. Theirs is a drop, ours would be the cream. Can we put a cream on an eyelid or right on top of the critters and kill the critters and attack the disease? They've done a great job making awareness of that market, and we hope that our product can play in that space as well. Last but not least, we talked about retina. All I'll say here is that it's really early but very encouraging. The idea for us on this play around retina is can we design an implant that will last longer than the two to three months of therapy today? Our rabbit models you can see on the bottom, which are highly applicable to humans, but they can stay out three years. That might be too long for a commercial product. We're trying to dial that in. We've gone into a phase II trial with our retina in biodegradable implant, and we'll see what happens as we go through those clinical trials. Those are all the pipeline, all the products, everything that's going on in the company. You can see there's a lot happening with Glaukos we're very excited about. The last slide I'll show you really quick are some numbers. You can see the revenue on the top left, how it's a cascading, a nice linear growth there. Our current guidance is $620 million-$635 million for 2026, so that's the midpoint at $627.5 million. Great gross margins, guys. Margins in the mid 80%. With these pharmaceutical products, we expect accretion in the margins over the near and midterm. You can see we're diverse. We not just do glaucoma and cornea health. We also have an international practice that we haven't talked about. Last but not least is on the right-hand corner on the bottom, $281 million of cash in the bank with no debt. We continue to operate on a cash flow breakeven in the short term. Then soon, hopefully, as these products ramp up, these pharmaceutical products, we'll get to more of the cash flow generation, and we'll go from there. With that, I'm out of time. I'll turn it back over to Steve. Thank you so much. Yeah. Thanks, Alex. Thank you everyone for joining us. See you over at the Richardson Room for those that can be with us.

Speaker 2: My name is Steve Lichtman. I'm the medical technology analyst here at William Blair, who covers our next presenter, Glaukos Corporation. Before we kick off the presentation, I am required to inform you that for a complete list of research disclosures or potential conflicts of interest, please visit our website at williamblair.com. With that, we're very happy to have with us today Alex Thurman, Senior VP and CFO, and Chris Lewis, VP and head of Investor Relations. After the presentation here, we'll have a breakout in the Richardson room. With that, I'm happy to turn the mic over to Alex. Thanks. My name is Steve Lichtman. my name is steve lichtman I'm the medical technology analyst here at William Blair, who covers our next presenter, Glaukos Corporation. i'm the medical technology analyst here at william blair who covers our next presenter glaukos corporation Before we kick off the presentation, I am required to inform you that for a complete list of research disclosures or potential conflicts of interest, please visit our website at williamblair.com. before we kick off the presentation i am required to inform you that for a complete list of research disclosures or potential conflicts of interest please visit our website at williamblair.com With that, we're very happy to have with us today Alex Thurman, Senior VP and CFO, and Chris Lewis, VP and head of Investor Relations. with that we're very happy to have with us today alex thurman senior vp and cfo and chris lewis vp and head of investor relations After the presentation here, we'll have a breakout in the Richardson room. after the presentation here we'll have a breakout in the richardson room With that, I'm happy to turn the mic over to Alex. with that i'm happy to turn the mic over to alex Thanks. thanks

Speaker 1: Thank you, Steve, thank you, William Blair, for allowing us to be here today to talk to you all. Thank you all for coming, spending your lunch hour with us, so we can talk a little bit about Glaukos and let you know kind of what's going on. We'll start. I'm going to have Chris read this for us. Just kidding. Let's move on. We'll start out with kind of just a company overview. For those of you who don't know us, Glaukos has been around for about a little over 20 years. Our company mission we've got on the big box on the left there where it says, We'll go first. That really comes around because of the DNA of the company. The company was founded back, again 20 years ago, to try and solve a problem in the area of glaucoma. Thank you, Steve, thank you, William Blair, for allowing us to be here today to talk to you all. thank you steve thank you william blair for allowing us to be here today to talk to you all Thank you all for coming, spending your lunch hour with us, so we can talk a little bit about Glaukos and let you know kind of what's going on. thank you all for coming spending your lunch hour with us so we can talk a little bit about glaukos and let you know kind of what's going on We'll start. we'll start I'm going to have Chris read this for us. i'm going to have chris read this for us Just kidding. just kidding Let's move on. let's move on We'll start out with kind of just a company overview. we'll start out with kind of just a company overview For those of you who don't know us, Glaukos has been around for about a little over 20 years. for those of you who don't know us glaukos has been around for about a little over 20 years Our company mission we've got on the big box on the left there where it says, We'll go first. our company mission we've got on the big box on the left there where it says we'll go first That really comes around because of the DNA of the company. that really comes around because of the dna of the company The company was founded back, again 20 years ago, to try and solve a problem in the area of glaucoma. the company was founded back again 20 years ago to try and solve a problem in the area of glaucoma Back then, glaucoma was treated very simply by if you came in and you were a patient that showed signs of glaucoma, a doctor would prescribe you a set of drops. You would come back after three months, those drops wouldn't be working, you'd get another set of drops, a third set of drops, and finally a fourth set of drops until you just weren't able to manage your pressures on those drops. They would turn to a very invasive surgery where they, to say it in layman's term, would really put a hole in your eye to relieve the pressure of the fluid that was building up on the front of your eye. Our founders thought there had to be a better way to tackle this disease rather than this paradigm that was existing 20 years ago. Back then, glaucoma was treated very simply by if you came in and you were a patient that showed signs of glaucoma, a doctor would prescribe you a set of drops. back then glaucoma was treated very simply by if you came in and you were a patient that showed signs of glaucoma a doctor would prescribe you a set of drops You would come back after three months, those drops wouldn't be working, you'd get another set of drops, a third set of drops, and finally a fourth set of drops until you just weren't able to manage your pressures on those drops. you would come back after three months those drops wouldn't be working you'd get another set of drops a third set of drops and finally a fourth set of drops until you just weren't able to manage your pressures on those drops They would turn to a very invasive surgery where they, to say it in layman's term, would really put a hole in your eye to relieve the pressure of the fluid that was building up on the front of your eye. they would turn to a very invasive surgery where they to say it in layman's term would really put a hole in your eye to relieve the pressure of the fluid that was building up on the front of your eye Our founders thought there had to be a better way to tackle this disease rather than this paradigm that was existing 20 years ago. our founders thought there had to be a better way to tackle this disease rather than this paradigm that was existing 20 years ago They went first in that they designed the first ever stent that was designed to go into your eye and implanted in the back of the eye that would allow the drainage to happen naturally and to get away from these gruesome surgeries to the best that they could and start to manage that. That became the first thing that we innovated, as we say in there, innovation is at the core of everything we do. It solved a solution and a problem that helped patients and helped our customers, which were the physicians, to treat the disease more effectively. You see in the second bullet there, dropless therapies. I mentioned the fact that most of the paradigms back in those days were to prescribe more and more drops. They went first in that they designed the first ever stent that was designed to go into your eye and implanted in the back of the eye that would allow the drainage to happen naturally and to get away from these gruesome surgeries to the best that they could and start to manage that. they went first in that they designed the first ever stent that was designed to go into your eye and implanted in the back of the eye that would allow the drainage to happen naturally and to get away from these gruesome surgeries to the best that they could and start to manage that That became the first thing that we innovated, as we say in there, innovation is at the core of everything we do. that became the first thing that we innovated as we say in there innovation is at the core of everything we do It solved a solution and a problem that helped patients and helped our customers, which were the physicians, to treat the disease more effectively. it solved a solution and a problem that helped patients and helped our customers which were the physicians to treat the disease more effectively You see in the second bullet there, dropless therapies. you see in the second bullet there dropless therapies I mentioned the fact that most of the paradigms back in those days were to prescribe more and more drops. i mentioned the fact that most of the paradigms back in those days were to prescribe more and more drops It was interesting because you'd start on one drop and you'd come in and your pressures were not bad or were getting worse, and you'd do a second drop and a third drop. That was their very common procedure, and it wasn't until data got put together that showed, interestingly, patients weren't taking their drops. Why was that? It's so interesting that 90% of patients, data will show you, just didn't take their drops. It was because of all the side effects and the difficulty in administering drops, and we'll talk about that a little more. Only 50% of patients would refill their prescription, which is crazy. You've been diagnosed with a sight-threatening disease, and one in two would not even fill their second prescription. It was because of the difficulties with drops and the side effects. It was interesting because you'd start on one drop and you'd come in and your pressures were not bad or were getting worse, and you'd do a second drop and a third drop. it was interesting because you'd start on one drop and you'd come in and your pressures were not bad or were getting worse and you'd do a second drop and a third drop That was their very common procedure, and it wasn't until data got put together that showed, interestingly, patients weren't taking their drops. that was their very common procedure and it wasn't until data got put together that showed interestingly patients weren't taking their drops Why was that? why was that It's so interesting that 90% of patients, data will show you, just didn't take their drops. it's so interesting that 90% of patients data will show you just didn't take their drops It was because of all the side effects and the difficulty in administering drops, and we'll talk about that a little more. it was because of all the side effects and the difficulty in administering drops and we'll talk about that a little more Only 50% of patients would refill their prescription, which is crazy. only 50% of patients would refill their prescription which is crazy You've been diagnosed with a sight-threatening disease, and one in two would not even fill their second prescription. you've been diagnosed with a sight-threatening disease and one in two would not even fill their second prescription It was because of the difficulties with drops and the side effects. it was because of the difficulties with drops and the side effects We've channeled the company to be around dropless therapies. How can we treat the disease without having to rely on drops? Last but not least, we've talked about being a proven new market pioneer, and that was really because before us, the stents and that business, there wasn't a MIGS category, a Micro-Invasive Glaucoma Surgery category. We built that market based off of the stents, and we've since progressed it to have more products, which we'll talk about over the course of the presentation. Just a little bit about us. On the left-hand side, you can see some of the stats. Last year, in 2025, we had a 30% top-line growth. In the first quarter, we were at 41% growth. We've channeled the company to be around dropless therapies. we've channeled the company to be around dropless therapies How can we treat the disease without having to rely on drops? how can we treat the disease without having to rely on drops Last but not least, we've talked about being a proven new market pioneer, and that was really because before us, the stents and that business, there wasn't a MIGS category, a Micro-Invasive Glaucoma Surgery category. last but not least we've talked about being a proven new market pioneer and that was really because before us the stents and that business there wasn't a migs category a micro-invasive glaucoma surgery category We built that market based off of the stents, and we've since progressed it to have more products, which we'll talk about over the course of the presentation. we built that market based off of the stents and we've since progressed it to have more products which we'll talk about over the course of the presentation Just a little bit about us. just a little bit about us On the left-hand side, you can see some of the stats. on the left-hand side you can see some of the stats Last year, in 2025, we had a 30% top-line growth. last year in 2025 we had a 30% top-line growth In the first quarter, we were at 41% growth. in the first quarter we were at 41% growth Our 10-year CAGR is 20% growth. We're a high-growth company, always trying to release or innovate and produce more products that get that in the marketplace and continue to top-line grow. We have 12 commercially approved products out in the marketplace today. When we did our IPO just over 10 years ago, we only had one. We've obviously increased that. We have 13 disclosed pipeline products, up from four when we went public. Those pipeline products continue to drive the top-line growth that we experience as we continue to move those things through approvals. We are an R&D company. We pride ourselves in our pipeline and what we're doing and how we're advancing. You can see over the last six years, we've spent almost $1 billion, $800 million, in our R&D efforts as we've continued to develop and produce more products. Our 10-year CAGR is 20% growth. our 10-year cagr is 20% growth We're a high-growth company, always trying to release or innovate and produce more products that get that in the marketplace and continue to top-line grow. we're a high-growth company always trying to release or innovate and produce more products that get that in the marketplace and continue to top-line grow We have 12 commercially approved products out in the marketplace today. we have 12 commercially approved products out in the marketplace today When we did our IPO just over 10 years ago, we only had one. when we did our ipo just over 10 years ago we only had one We've obviously increased that. we've obviously increased that We have 13 disclosed pipeline products, up from four when we went public. we have 13 disclosed pipeline products up from four when we went public Those pipeline products continue to drive the top-line growth that we experience as we continue to move those things through approvals. those pipeline products continue to drive the top-line growth that we experience as we continue to move those things through approvals We are an R&D company. we are an r&d company We pride ourselves in our pipeline and what we're doing and how we're advancing. we pride ourselves in our pipeline and what we're doing and how we're advancing You can see over the last six years, we've spent almost $1 billion, $800 million, in our R&D efforts as we've continued to develop and produce more products. you can see over the last six years we've spent almost $1 billion $800 million in our r&d efforts as we've continued to develop and produce more products On the right-hand side is we've developed the company into a platform type of a situation. We have five distinct platforms upon which we try to do a cascade of products over time to continue that high growth on the top line. We've already talked about our stents, and we've got now we're into our third generation of stents, which is called the iStent infinite. We'll talk a little more about that. iDose, which we'll talk about, is our first sustained pharmaceutical release. We have iLink, which most of you may know as our cross-linking or our keratoconus product, and we'll talk a little bit more about that. iLution, which is a novel drug delivery platform. We talked about the fact that we'd like to stay away from drops, our R&D guys were thinking, is there a way to deliver the pharmaceuticals in a drop through another mechanism? On the right-hand side is we've developed the company into a platform type of a situation. on the right-hand side is we've developed the company into a platform type of a situation We have five distinct platforms upon which we try to do a cascade of products over time to continue that high growth on the top line. we have five distinct platforms upon which we try to do a cascade of products over time to continue that high growth on the top line We've already talked about our stents, and we've got now we're into our third generation of stents, which is called the iStent infinite. we've already talked about our stents and we've got now we're into our third generation of stents which is called the istent infinite We'll talk a little more about that. iDose, which we'll talk about, is our first sustained pharmaceutical release. we'll talk a little more about that idose which we'll talk about is our first sustained pharmaceutical release We have iLink, which most of you may know as our cross-linking or our keratoconus product, and we'll talk a little bit more about that. iLution, which is a novel drug delivery platform. we have ilink which most of you may know as our cross-linking or our keratoconus product and we'll talk a little bit more about that. ilution which is a novel drug delivery platform We talked about the fact that we'd like to stay away from drops, our R&D guys were thinking, is there a way to deliver the pharmaceuticals in a drop through another mechanism? we talked about the fact that we'd like to stay away from drops our r&d guys were thinking is there a way to deliver the pharmaceuticals in a drop through another mechanism We thought there might be. We got involved in looking at a cream or we call it a lotion. Think of it that way, that you would just dab a little bit on your finger, put it on your eyelid, and does that effectively deliver the drugs to your eyes as opposed to using a drop. Then last and not least, we're dabbling and dipping our toes into the retina market. We've got a program underway in phase II around retina, but that's a large established market within ophthalmology, and we're excited about that. Today, we're sitting at a point, it's kind of an inflection point in the company's history where we have two revenue drivers, large revenue drivers in these two market areas, which we're calling interventional glaucoma and interventional keratoconus. We'll talk about each of those as we move through. We thought there might be. we thought there might be We got involved in looking at a cream or we call it a lotion. we got involved in looking at a cream or we call it a lotion Think of it that way, that you would just dab a little bit on your finger, put it on your eyelid, and does that effectively deliver the drugs to your eyes as opposed to using a drop. think of it that way that you would just dab a little bit on your finger put it on your eyelid and does that effectively deliver the drugs to your eyes as opposed to using a drop Then last and not least, we're dabbling and dipping our toes into the retina market. then last and not least we're dabbling and dipping our toes into the retina market We've got a program underway in phase II around retina, but that's a large established market within ophthalmology, and we're excited about that. we've got a program underway in phase ii around retina but that's a large established market within ophthalmology and we're excited about that Today, we're sitting at a point, it's kind of an inflection point in the company's history where we have two revenue drivers, large revenue drivers in these two market areas, which we're calling interventional glaucoma and interventional keratoconus. today we're sitting at a point it's kind of an inflection point in the company's history where we have two revenue drivers large revenue drivers in these two market areas which we're calling interventional glaucoma and interventional keratoconus We'll talk about each of those as we move through. we'll talk about each of those as we move through The first one is just if we think about, and we've talked a little bit about this, the major problem in glaucoma care is this non-compliance with drops. You can see on the left there is the traditional paradigm that I kind of spoke to where you'd start with drops and then you'd add more drops. About a decade ago, the SLTs, which is a laser program, those became more in vogue, so to speak, and was used in this paradigm. Then you still had to go through if that didn't work, and we know from data that about 50% of those lasers fail after two years, about 75% after five years. You're facing these filtration surgeries where they put the hole in the eye and try to drain it that way. I've talked about those stats on the bottom already. The first one is just if we think about, and we've talked a little bit about this, the major problem in glaucoma care is this non-compliance with drops. the first one is just if we think about and we've talked a little bit about this the major problem in glaucoma care is this non-compliance with drops You can see on the left there is the traditional paradigm that I kind of spoke to where you'd start with drops and then you'd add more drops. you can see on the left there is the traditional paradigm that i kind of spoke to where you'd start with drops and then you'd add more drops About a decade ago, the SLTs, which is a laser program, those became more in vogue, so to speak, and was used in this paradigm. about a decade ago the slts which is a laser program those became more in vogue so to speak and was used in this paradigm Then you still had to go through if that didn't work, and we know from data that about 50% of those lasers fail after two years, about 75% after five years. then you still had to go through if that didn't work and we know from data that about 50% of those lasers fail after two years about 75% after five years You're facing these filtration surgeries where they put the hole in the eye and try to drain it that way. you're facing these filtration surgeries where they put the hole in the eye and try to drain it that way I've talked about those stats on the bottom already. i've talked about those stats on the bottom already We're driving the marketplace to what's on the right side, which is this new interventional glaucoma treatment paradigm, where it makes sense to now treat these patients interventionally with a procedure as opposed to just reflexively prescribing them a drop, which if used works. We know they just don't use them for all the side effects. You can see there the typical or what we drive towards is this laser treatment as the first-line therapy. Go ahead and do the laser. It's great. It's easy. It's in the office. It's very non-invasive for a patient. Easy to get them into what we're calling the interventional glaucoma funnel, have that conversation. Docs are very comfortable with that. The technology's been around for a long time. We're driving the marketplace to what's on the right side, which is this new interventional glaucoma treatment paradigm, where it makes sense to now treat these patients interventionally with a procedure as opposed to just reflexively prescribing them a drop, which if used works. we're driving the marketplace to what's on the right side which is this new interventional glaucoma treatment paradigm where it makes sense to now treat these patients interventionally with a procedure as opposed to just reflexively prescribing them a drop which if used works We know they just don't use them for all the side effects. we know they just don't use them for all the side effects You can see there the typical or what we drive towards is this laser treatment as the first-line therapy. you can see there the typical or what we drive towards is this laser treatment as the first-line therapy Go ahead and do the laser. go ahead and do the laser It's great. it's great It's easy. it's easy It's in the office. it's in the office It's very non-invasive for a patient. it's very non-invasive for a patient Easy to get them into what we're calling the interventional glaucoma funnel, have that conversation. easy to get them into what we're calling the interventional glaucoma funnel have that conversation Docs are very comfortable with that. docs are very comfortable with that The technology's been around for a long time. the technology's been around for a long time Ultimately, like I said, within five years, 75% of those procedures are going to fail, and that hole is going to disappear, and that pressure is going to start to build up again. Then we would propose that then they move to a procedural pharmaceutical, which is our iDose product, which we'll talk about, where you take the same active ingredient in those drops that slows down the production of the fluid within the front of the eye, implant that into their eye, and let that elute and deliver the drug to the eye instead of relying on the patient for their compliance. That, in our trials, as you'll see, has been very effective in maintaining pressures over a long period of time, as opposed to you having to take a drop every day. Ultimately, like I said, within five years, 75% of those procedures are going to fail, and that hole is going to disappear, and that pressure is going to start to build up again. ultimately like i said within five years 75% of those procedures are going to fail and that hole is going to disappear and that pressure is going to start to build up again Then we would propose that then they move to a procedural pharmaceutical, which is our iDose product, which we'll talk about, where you take the same active ingredient in those drops that slows down the production of the fluid within the front of the eye, implant that into their eye, and let that elute and deliver the drug to the eye instead of relying on the patient for their compliance. then we would propose that then they move to a procedural pharmaceutical which is our idose product which we'll talk about where you take the same active ingredient in those drops that slows down the production of the fluid within the front of the eye implant that into their eye and let that elute and deliver the drug to the eye instead of relying on the patient for their compliance That, in our trials, as you'll see, has been very effective in maintaining pressures over a long period of time, as opposed to you having to take a drop every day. that in our trials as you'll see has been very effective in maintaining pressures over a long period of time as opposed to you having to take a drop every day Once you're past that stage, you can add to that with different tools in the MIGS category. We have the stent still that we can complement that. Again, the procedural pharmaceutical is designed to stop the production of the fluid or slow that down. The MIGS or the stent part of the solution is to open up the drainage on the back part of that. You're on the outflow side, and you're being able to continually allow that fluid to flow and not get stuck in there and build up pressure on the front of the eye. You have some MIBS, which is micro-invasive bleb surgery, and then that final end of stage for your really tough eyes, the filtration surgery, sorry. We feel like we, in that paradigm, we're ideally situated to handle it. Once you're past that stage, you can add to that with different tools in the MIGS category. once you're past that stage you can add to that with different tools in the migs category We have the stent still that we can complement that. we have the stent still that we can complement that Again, the procedural pharmaceutical is designed to stop the production of the fluid or slow that down. again the procedural pharmaceutical is designed to stop the production of the fluid or slow that down The MIGS or the stent part of the solution is to open up the drainage on the back part of that. the migs or the stent part of the solution is to open up the drainage on the back part of that You're on the outflow side, and you're being able to continually allow that fluid to flow and not get stuck in there and build up pressure on the front of the eye. you're on the outflow side and you're being able to continually allow that fluid to flow and not get stuck in there and build up pressure on the front of the eye You have some MIBS, which is micro-invasive bleb surgery, and then that final end of stage for your really tough eyes, the filtration surgery, sorry. you have some mibs which is micro-invasive bleb surgery and then that final end of stage for your really tough eyes the filtration surgery sorry We feel like we, in that paradigm, we're ideally situated to handle it. we feel like we in that paradigm we're ideally situated to handle it We've got these products, which I'll show you right here, that will handle those areas along that journey. It's interesting to note that a glaucoma patient, on average, will be in a practice with that disease for, on average, around 20 years of their life. They get diagnosed somewhere in their mid-60s to 70s. That takes them to the end of life because there is no cure for glaucoma. You've got to manage it as best you can and manage that pressure. On the bottom part of that little pathway area, you've got the stents. We've talked about the stents that will be allowed. We started out in this area of combo cataract. Now we've advanced into standalone with iStent infinite. It allows that drainage to happen through the back part of that front of the eye. We've got these products, which I'll show you right here, that will handle those areas along that journey. we've got these products which i'll show you right here that will handle those areas along that journey It's interesting to note that a glaucoma patient, on average, will be in a practice with that disease for, on average, around 20 years of their life. it's interesting to note that a glaucoma patient on average will be in a practice with that disease for on average around 20 years of their life They get diagnosed somewhere in their mid-60s to 70s. they get diagnosed somewhere in their mid-60s to 70s That takes them to the end of life because there is no cure for glaucoma. that takes them to the end of life because there is no cure for glaucoma You've got to manage it as best you can and manage that pressure. you've got to manage it as best you can and manage that pressure On the bottom part of that little pathway area, you've got the stents. on the bottom part of that little pathway area you've got the stents We've talked about the stents that will be allowed. we've talked about the stents that will be allowed We started out in this area of combo cataract. we started out in this area of combo cataract Now we've advanced into standalone with iStent infinite. now we've advanced into standalone with istent infinite It allows that drainage to happen through the back part of that front of the eye. it allows that drainage to happen through the back part of that front of the eye On the top, you've got the iDose, which can be the workhorse in allowing that pharmaceutical to be administered in the eye 24/7, and that is along the whole journey of your disease. It's there, it just takes that compliance danger out of the hands of the patient, and we just put it right in the eye for them. With respect to iDose, it's designed to be long duration. You can see some of the interesting stats on here. One iDose in our pivotal trials was shown to last up to three years for 70% of the patients. You can imagine taking the drops out of the hands of a patient for up to three years, and that shows that they avoid taking drops 2,190 times. You can see that at the bottom. That is a great holiday for those patients. On the top, you've got the iDose, which can be the workhorse in allowing that pharmaceutical to be administered in the eye 24/7, and that is along the whole journey of your disease. on the top you've got the idose which can be the workhorse in allowing that pharmaceutical to be administered in the eye 24/7 and that is along the whole journey of your disease It's there, it just takes that compliance danger out of the hands of the patient, and we just put it right in the eye for them. it's there it just takes that compliance danger out of the hands of the patient and we just put it right in the eye for them With respect to iDose, it's designed to be long duration. with respect to idose it's designed to be long duration You can see some of the interesting stats on here. you can see some of the interesting stats on here One iDose in our pivotal trials was shown to last up to three years for 70% of the patients. one idose in our pivotal trials was shown to last up to three years for 70% of the patients You can imagine taking the drops out of the hands of a patient for up to three years, and that shows that they avoid taking drops 2,190 times. you can imagine taking the drops out of the hands of a patient for up to three years and that shows that they avoid taking drops 2,190 times You can see that at the bottom. you can see that at the bottom That is a great holiday for those patients. that is a great holiday for those patients You talk to any of those patients, they love being off those drops. What are some of the side effects they have? A lot of times it gives them red eyes, so they look like they're hungover. A lot of times it gives them dry eyes, so it's itchy and they hate it. A lot of times it'll give them some fat atrophy in the bottom of their eyes, and so they look just kind of bloated in their eyes. It's not something they like. In fact, we've heard patients come in after having an iDose in three months, and the first thing they say is, Look, doc, look at my eyes. They're not red anymore. They're thrilled to have it. The product in the real world is working exceptionally well. It's gotten great clinical response from our customers on how it's working. You talk to any of those patients, they love being off those drops. you talk to any of those patients they love being off those drops What are some of the side effects they have? what are some of the side effects they have A lot of times it gives them red eyes, so they look like they're hungover. a lot of times it gives them red eyes so they look like they're hungover A lot of times it gives them dry eyes, so it's itchy and they hate it. a lot of times it gives them dry eyes so it's itchy and they hate it A lot of times it'll give them some fat atrophy in the bottom of their eyes, and so they look just kind of bloated in their eyes. a lot of times it'll give them some fat atrophy in the bottom of their eyes and so they look just kind of bloated in their eyes It's not something they like. it's not something they like In fact, we've heard patients come in after having an iDose in three months, and the first thing they say is, Look, doc, look at my eyes. in fact we've heard patients come in after having an idose in three months and the first thing they say is look doc look at my eyes They're not red anymore. they're not red anymore They're thrilled to have it. they're thrilled to have it The product in the real world is working exceptionally well. the product in the real world is working exceptionally well It's gotten great clinical response from our customers on how it's working. it's gotten great clinical response from our customers on how it's working You can see on the right-hand side that 81% of our patients in the clinical trials were free of the topical meds, and we already talked about this fact that 70% were well-controlled after three years. iDose is just the beginning. We talked about the fact that the company's designed on these five platforms, iDose being one of them. Today we have the iDose TR, which is the product that we were just talking about. Coming down that pipeline, we've got two other products that are in the near term. One is called iDose TREO on the left. TREO is T-R-E-O for in-office, and it's really just taking the same iDose canister that we have today and putting it into an injector system that's advanced and much smaller incision site so that the physicians can do it in the office in a much more confident manner. You can see on the right-hand side that 81% of our patients in the clinical trials were free of the topical meds, and we already talked about this fact that 70% were well-controlled after three years. iDose is just the beginning. you can see on the right-hand side that 81% of our patients in the clinical trials were free of the topical meds and we already talked about this fact that 70% were well-controlled after three years idose is just the beginning We talked about the fact that the company's designed on these five platforms, iDose being one of them. we talked about the fact that the company's designed on these five platforms idose being one of them Today we have the iDose TR, which is the product that we were just talking about. today we have the idose tr which is the product that we were just talking about Coming down that pipeline, we've got two other products that are in the near term. coming down that pipeline we've got two other products that are in the near term One is called iDose TREO on the left. one is called idose treo on the left TREO is T-R- E-O for in-office, and it's really just taking the same iDose canister that we have today and putting it into an injector system that's advanced and much smaller incision site so that the physicians can do it in the office in a much more confident manner. treo is t-r- e-o for in-office and it's really just taking the same idose canister that we have today and putting it into an injector system that's advanced and much smaller incision site so that the physicians can do it in the office in a much more confident manner It is of note, I will say that our existing iDose product today can be used in the office. It does create a slightly larger incision. The iDose TREO is designed to make that smaller, make those surgeons more confident of doing it in the office. We ultimately would like to be site agnostic, meaning if surgeons want to go into a surgery center and an outpatient surgery center setting and do the iDose TR, they can certainly do that. If they'd rather do that in the office with an iDose TREO, we're happy to provide them that opportunity. We're going through the process of the clinical trial with that iDose TREO currently. We'll get the reimbursement codes set up to do that. They'll be free to operate and do those things in the office. The next one is the iDose TREX. It is of note, I will say that our existing iDose product today can be used in the office. it is of note i will say that our existing idose product today can be used in the office It does create a slightly larger incision. it does create a slightly larger incision The iDose TREO is designed to make that smaller, make those surgeons more confident of doing it in the office. the idose treo is designed to make that smaller make those surgeons more confident of doing it in the office We ultimately would like to be site agnostic, meaning if surgeons want to go into a surgery center and an outpatient surgery center setting and do the iDose TR, they can certainly do that. we ultimately would like to be site agnostic meaning if surgeons want to go into a surgery center and an outpatient surgery center setting and do the idose tr they can certainly do that If they'd rather do that in the office with an iDose TREO, we're happy to provide them that opportunity. if they'd rather do that in the office with an idose treo we're happy to provide them that opportunity We're going through the process of the clinical trial with that iDose TREO currently. we're going through the process of the clinical trial with that idose treo currently We'll get the reimbursement codes set up to do that. we'll get the reimbursement codes set up to do that They'll be free to operate and do those things in the office. they'll be free to operate and do those things in the office The next one is the iDose TREX. the next one is the idose trex We kind of lovingly call it TREX, although it's T-R-E-X for extended. From a geography standpoint or geometry standpoint, just by bowing out that canister, we're able to introduce about twice as much of the drug into the canister under the theory that it would last twice as long. We're going through the clinical trials on that, where we're hoping to see durations in, let's call it five to seven years, as opposed to three with the iDose TR. So far in the trials and the data that we've seen, it's having a great, robust IOP pressure-lowering effect on our patients. We get into the stents. I talked about iStent infinite. We kind of lovingly call it TREX, although it's T-R-E-X for extended. we kind of lovingly call it trex although it's t-r-e-x for extended From a geography standpoint or geometry standpoint, just by bowing out that canister, we're able to introduce about twice as much of the drug into the canister under the theory that it would last twice as long. from a geography standpoint or geometry standpoint just by bowing out that canister we're able to introduce about twice as much of the drug into the canister under the theory that it would last twice as long We're going through the clinical trials on that, where we're hoping to see durations in, let's call it five to seven years, as opposed to three with the iDose TR. we're going through the clinical trials on that where we're hoping to see durations in let's call it five to seven years as opposed to three with the idose tr So far in the trials and the data that we've seen, it's having a great, robust IOP pressure-lowering effect on our patients. so far in the trials and the data that we've seen it's having a great robust iop pressure-lowering effect on our patients We get into the stents. we get into the stents I talked about iStent infinite. i talked about istent infinite iStent infinite was the first product that we had that would allow us to go into standalone patients with glaucoma. Going back in the journey, if you recall, we started 20 years ago. We finally were able to get the first stent approved in 2012. The FDA was very hesitant to approve that stent on a standalone basis. They didn't like the idea of a surgeon going into an eye just to implant a stent. They approved it in combination with cataract surgery. For the first many, many years, all of our stents were only allowed to be implanted in combination with cataracts since the surgeon was already going to the eye to replace the cataract. In 2022, we were able to get finally everyone comfortable that these were safe and effective. iStent infinite was the first product that we had that would allow us to go into standalone patients with glaucoma. istent infinite was the first product that we had that would allow us to go into standalone patients with glaucoma Going back in the journey, if you recall, we started 20 years ago. going back in the journey if you recall we started 20 years ago We finally were able to get the first stent approved in 2012. we finally were able to get the first stent approved in 2012 The FDA was very hesitant to approve that stent on a standalone basis. the fda was very hesitant to approve that stent on a standalone basis They didn't like the idea of a surgeon going into an eye just to implant a stent. they didn't like the idea of a surgeon going into an eye just to implant a stent They approved it in combination with cataract surgery. they approved it in combination with cataract surgery For the first many, many years, all of our stents were only allowed to be implanted in combination with cataracts since the surgeon was already going to the eye to replace the cataract. for the first many many years all of our stents were only allowed to be implanted in combination with cataracts since the surgeon was already going to the eye to replace the cataract In 2022, we were able to get finally everyone comfortable that these were safe and effective. in 2022 we were able to get finally everyone comfortable that these were safe and effective We have iStent infinite, which is a three-stent solution that can go into the standalone patient or in combination with cataract, quite frankly, and be used as part of our MIGS offerings to our customers. Lots of data, lots of history there, very safe and effective on use with our patients. As you can see on that little picture, it is very small as well. We think it is the smallest medical device ever approved by the FDA, are these stents. Thinking about the market opportunity, and this goes to what I was just saying. When the company started and we were kind of constrained to the cataract combination market, you can see on the left-hand side, there's five million eyes that get cataract surgery, of which about 10%-15% have glaucoma alongside. We have iStent infinite, which is a three-stent solution that can go into the standalone patient or in combination with cataract, quite frankly, and be used as part of our MIGS offerings to our customers. we have istent infinite which is a three-stent solution that can go into the standalone patient or in combination with cataract quite frankly and be used as part of our migs offerings to our customers Lots of data, lots of history there, very safe and effective on use with our patients. lots of data lots of history there very safe and effective on use with our patients As you can see on that little picture, it is very small as well. as you can see on that little picture it is very small as well We think it is the smallest medical device ever approved by the FDA, are these stents. we think it is the smallest medical device ever approved by the fda are these stents Thinking about the market opportunity, and this goes to what I was just saying. thinking about the market opportunity and this goes to what i was just saying When the company started and we were kind of constrained to the cataract combination market, you can see on the left-hand side, there's five million eyes that get cataract surgery, of which about 10%-15% have glaucoma alongside. when the company started and we were kind of constrained to the cataract combination market you can see on the left-hand side there's five million eyes that get cataract surgery of which about 10%-15% have glaucoma alongside We were playing in a market, let's call it of 500,000 eyes that could potentially get our stent products. On the right-hand side is the overall, let's call it glaucoma market of standalone eyes. You can see that the prevalence data would show you there's 22 million eyes out there that have glaucoma, of which only 13 million are diagnosed, of which 12 million are diagnosed and actively treated. Today, the vast majority are treated with drops, as we've talked about. It's a large opportunity for this glaucoma treatment and why we're so excited about the offerings that we have, both with the stents and with iDose, to tackle this problem and keep people from going blind over time, getting them away from drops and into this more interventional approach. We were playing in a market, let's call it of 500,000 eyes that could potentially get our stent products. we were playing in a market let's call it of 500,000 eyes that could potentially get our stent products On the right-hand side is the overall, let's call it glaucoma market of standalone eyes. on the right-hand side is the overall let's call it glaucoma market of standalone eyes You can see that the prevalence data would show you there's 22 million eyes out there that have glaucoma, of which only 13 million are diagnosed, of which 12 million are diagnosed and actively treated. you can see that the prevalence data would show you there's 22 million eyes out there that have glaucoma of which only 13 million are diagnosed of which 12 million are diagnosed and actively treated Today, the vast majority are treated with drops, as we've talked about. today the vast majority are treated with drops as we've talked about It's a large opportunity for this glaucoma treatment and why we're so excited about the offerings that we have, both with the stents and with iDose, to tackle this problem and keep people from going blind over time, getting them away from drops and into this more interventional approach. it's a large opportunity for this glaucoma treatment and why we're so excited about the offerings that we have both with the stents and with idose to tackle this problem and keep people from going blind over time getting them away from drops and into this more interventional approach The vision that our CEO has for the next 10 years with respect to interventional glaucoma and treating these patients, he likes to go back in time, he's been around for a long time, is to talk to the surgeons and get them to buy into this idea of treating patients interventionally. One of the things he thinks about is a lot of these customers, their bread and butter historically has been cataract surgery, and they do a lot of cataract surgery. 20 years ago, when they did a cataract surgery, their professional fee was $2,500. Today, though, as after chipping away of it over the last 20 years, they're only getting paid about $450. The professional fees are shrinking. The vision that our CEO has for the next 10 years with respect to interventional glaucoma and treating these patients, he likes to go back in time, he's been around for a long time, is to talk to the surgeons and get them to buy into this idea of treating patients interventionally. the vision that our ceo has for the next 10 years with respect to interventional glaucoma and treating these patients he likes to go back in time he's been around for a long time is to talk to the surgeons and get them to buy into this idea of treating patients interventionally One of the things he thinks about is a lot of these customers, their bread and butter historically has been cataract surgery, and they do a lot of cataract surgery. 20 years ago, when they did a cataract surgery, their professional fee was $2,500. one of the things he thinks about is a lot of these customers their bread and butter historically has been cataract surgery and they do a lot of cataract surgery 20 years ago when they did a cataract surgery their professional fee was $2,500 Today, though, as after chipping away of it over the last 20 years, they're only getting paid about $450. today though as after chipping away of it over the last 20 years they're only getting paid about $450 The professional fees are shrinking. the professional fees are shrinking As I mentioned, a glaucoma patient is in your practice or potentially in your practice for about 20 years, whereas a cataract patient is typically a one-and-done patient, right? If you can start to have them catch the vision that you're spending today all of your marketing dollars and all of your efforts to acquire a patient for a one-and-done procedure. Whereas if you just shift your paradigm thinking over and focus on glaucoma, of which there's a large market opportunity, and they're going to be in your practice for 20 years, and that'll give you multiple shots to help that patient with different technologies that we have, it can be a win-win for everybody. The second is around combination therapy. I mentioned that the iDose is treating the introduction of fluid in the eye. The stents are treating the outflow side of that fluid. As I mentioned, a glaucoma patient is in your practice or potentially in your practice for about 20 years, whereas a cataract patient is typically a one-and-done patient, right? as i mentioned a glaucoma patient is in your practice or potentially in your practice for about 20 years whereas a cataract patient is typically a one-and-done patient right If you can start to have them catch the vision that you're spending today all of your marketing dollars and all of your efforts to acquire a patient for a one-and-done procedure. Whereas if you just shift your paradigm thinking over and focus on glaucoma, of which there's a large market opportunity, and they're going to be in your practice for 20 years, and that'll give you multiple shots to help that patient with different technologies that we have, it can be a win-win for everybody. if you can start to have them catch the vision that you're spending today all of your marketing dollars and all of your efforts to acquire a patient for a one-and-done procedure. whereas if you just shift your paradigm thinking over and focus on glaucoma of which there's a large market opportunity and they're going to be in your practice for 20 years and that'll give you multiple shots to help that patient with different technologies that we have it can be a win-win for everybody The second is around combination therapy. the second is around combination therapy I mentioned that the iDose is treating the introduction of fluid in the eye. i mentioned that the idose is treating the introduction of fluid in the eye The stents are treating the outflow side of that fluid. the stents are treating the outflow side of that fluid If you can use them in combination one with another, it's a win-win and a better solution for patients because you're attacking it with two different mechanisms of action. We've got to get the data to support that, we're currently undergoing clinical trials to support that usage. We're hopeful and we're seeing doctors getting more excited about that combination therapy of using, for example, an iStent infinite and an iDose in the same eye in the same procedure. That's certainly, if I could, I'd have my mom do that as well. The next would be this in-office. More and more things around ophthalmology and other med tech are to the extent you can do it in the office. That's where we see things going over time. We mentioned the opportunity that we're pursuing to get the iDose into the office through the iDose TREO. If you can use them in combination one with another, it's a win-win and a better solution for patients because you're attacking it with two different mechanisms of action. if you can use them in combination one with another it's a win-win and a better solution for patients because you're attacking it with two different mechanisms of action We've got to get the data to support that, we're currently undergoing clinical trials to support that usage. we've got to get the data to support that we're currently undergoing clinical trials to support that usage We're hopeful and we're seeing doctors getting more excited about that combination therapy of using, for example, an iStent infinite and an iDose in the same eye in the same procedure. we're hopeful and we're seeing doctors getting more excited about that combination therapy of using for example an istent infinite and an idose in the same eye in the same procedure That's certainly, if I could, I'd have my mom do that as well. that's certainly if i could i'd have my mom do that as well The next would be this in-office. the next would be this in-office More and more things around ophthalmology and other med tech are to the extent you can do it in the office. more and more things around ophthalmology and other med tech are to the extent you can do it in the office That's where we see things going over time. that's where we see things going over time We mentioned the opportunity that we're pursuing to get the iDose into the office through the iDose TREO. we mentioned the opportunity that we're pursuing to get the idose into the office through the idose treo It just seems like as professional fees and other fees, ASC fees get cut, there's more of a drive to get in the office. It's certainly a much easier conversation with a patient to get them to undergo an intervention in the office. As the steps along the journey, we think in-office will be more and more of a part of the treatment algorithm and the practice. The next would be for us to continue to drive this sustained-release drug delivery over the longer term, so they don't have to do it as often, right? We talked about TREX as that first opportunity, where if we can get it to be double the TR, where a patient only has to have that happen once every six or seven years, that's just better off and probably an easier conversation with them. It just seems like as professional fees and other fees, ASC fees get cut, there's more of a drive to get in the office. it just seems like as professional fees and other fees asc fees get cut there's more of a drive to get in the office It's certainly a much easier conversation with a patient to get them to undergo an intervention in the office. it's certainly a much easier conversation with a patient to get them to undergo an intervention in the office As the steps along the journey, we think in-office will be more and more of a part of the treatment algorithm and the practice. as the steps along the journey we think in-office will be more and more of a part of the treatment algorithm and the practice The next would be for us to continue to drive this sustained-release drug delivery over the longer term, so they don't have to do it as often, right? the next would be for us to continue to drive this sustained-release drug delivery over the longer term so they don't have to do it as often right We talked about TREX as that first opportunity, where if we can get it to be double the TR, where a patient only has to have that happen once every six or seven years, that's just better off and probably an easier conversation with them. we talked about trex as that first opportunity where if we can get it to be double the tr where a patient only has to have that happen once every six or seven years that's just better off and probably an easier conversation with them PE groups also are becoming an increasingly more important part of this whole environment around ophthalmology in particular, wherein maybe you're seeing it in other practices where the PE groups are buying up small ophthalmology practices and combining them. At least one of the benefits of a PE, if you can say that, is they're very savvy when it comes to financials. They can understand the value associated with some of these patients that are going to be in a practice for 20 years, some of the revenue opportunities that come along with that, with multiple procedures over that journey. We do see and foresee that PE groups will become more and more an important part of this journey along the IG roadmap. PE groups also are becoming an increasingly more important part of this whole environment around ophthalmology in particular, wherein maybe you're seeing it in other practices where the PE groups are buying up small ophthalmology practices and combining them. pe groups also are becoming an increasingly more important part of this whole environment around ophthalmology in particular wherein maybe you're seeing it in other practices where the pe groups are buying up small ophthalmology practices and combining them At least one of the benefits of a PE, if you can say that, is they're very savvy when it comes to financials. at least one of the benefits of a pe if you can say that is they're very savvy when it comes to financials They can understand the value associated with some of these patients that are going to be in a practice for 20 years, some of the revenue opportunities that come along with that, with multiple procedures over that journey. they can understand the value associated with some of these patients that are going to be in a practice for 20 years some of the revenue opportunities that come along with that with multiple procedures over that journey We do see and foresee that PE groups will become more and more an important part of this journey along the IG roadmap. we do see and foresee that pe groups will become more and more an important part of this journey along the ig roadmap Last but not least, we think that doctors will then pivot over time to become IG specialists, and that they'll advertise as being an IG specialist, and just because the market is being so large and so many patients are out there that they'll want to say to these patients, Hey, we're going to take you off drops. We're going to get you on this IG roadmap, and we're going to get you treated and monitor those pressures and become really good at doing that over time. This is our product roadmap. We've kind of talked about everything on this, except for one thing I'll just point out really quick. The fourth one down is PRESERFLO. That is our micro-invasive bleb surgery product that's in clinical trials now. Last but not least, we think that doctors will then pivot over time to become IG specialists, and that they'll advertise as being an IG specialist, and just because the market is being so large and so many patients are out there that they'll want to say to these patients, Hey, we're going to take you off drops. last but not least we think that doctors will then pivot over time to become ig specialists and that they'll advertise as being an ig specialist and just because the market is being so large and so many patients are out there that they'll want to say to these patients hey we're going to take you off drops We're going to get you on this IG roadmap, and we're going to get you treated and monitor those pressures and become really good at doing that over time. we're going to get you on this ig roadmap and we're going to get you treated and monitor those pressures and become really good at doing that over time This is our product roadmap. this is our product roadmap We've kind of talked about everything on this, except for one thing I'll just point out really quick. we've kind of talked about everything on this except for one thing i'll just point out really quick The fourth one down is PRESERFLO. the fourth one down is preserflo That is our micro-invasive bleb surgery product that's in clinical trials now. that is our micro-invasive bleb surgery product that's in clinical trials now We do have it approved outside the U.S., and we get great feedback from surgeons outside the U.S. in using this product. We're hoping it will get through the gauntlet here in the FDA, and we'll have that to be added to the arsenal of what our customers use in the future. Okay, the second area of driver for us from a revenue and a growth perspective in the company is interventional keratoconus. Now, for some of you've probably never heard of it. I'd never heard of it six years when we bought a company that was treating this. Let's talk about what it is. Keratoconus is a disease that affects the cornea and is typically found in younger patients where their corneal fibers are weak, and that causes a bulging out of the cornea that distorts the vision. We do have it approved outside the U.S., and we get great feedback from surgeons outside the U.S. in using this product. we do have it approved outside the u.s and we get great feedback from surgeons outside the u.s in using this product We're hoping it will get through the gauntlet here in the FDA, and we'll have that to be added to the arsenal of what our customers use in the future. we're hoping it will get through the gauntlet here in the fda and we'll have that to be added to the arsenal of what our customers use in the future Okay, the second area of driver for us from a revenue and a growth perspective in the company is interventional keratoconus. okay the second area of driver for us from a revenue and a growth perspective in the company is interventional keratoconus Now, for some of you've probably never heard of it. now for some of you've probably never heard of it I'd never heard of it six years when we bought a company that was treating this. i'd never heard of it six years when we bought a company that was treating this Let's talk about what it is. let's talk about what it is Keratoconus is a disease that affects the cornea and is typically found in younger patients where their corneal fibers are weak, and that causes a bulging out of the cornea that distorts the vision. keratoconus is a disease that affects the cornea and is typically found in younger patients where their corneal fibers are weak and that causes a bulging out of the cornea that distorts the vision Many times, they're kids, they're typically teenagers that start with this. Today, there's just not a lot of awareness about this disease, what it is. You can imagine if you're a mom or a dad and you have a child in high school or middle school who comes home and says, I can't see the board or, I can't see it anymore, the first thing they do is they run down to the optometrist and they stick their kid in front of the optometrist, and the optometrist takes a look and realizes, yeah, they will treat it, not knowing about keratoconus, they will treat it as a visual acuity problem. They'll put them in some glasses, they'll put them in some contact lenses. Many times, they're kids, they're typically teenagers that start with this. many times they're kids they're typically teenagers that start with this Today, there's just not a lot of awareness about this disease, what it is. today there's just not a lot of awareness about this disease what it is You can imagine if you're a mom or a dad and you have a child in high school or middle school who comes home and says, I can't see the board or, I can't see it anymore, the first thing they do is they run down to the optometrist and they stick their kid in front of the optometrist, and the optometrist takes a look and realizes, yeah, they will treat it, not knowing about keratoconus, they will treat it as a visual acuity problem. you can imagine if you're a mom or a dad and you have a child in high school or middle school who comes home and says i can't see the board or i can't see it anymore the first thing they do is they run down to the optometrist and they stick their kid in front of the optometrist and the optometrist takes a look and realizes yeah they will treat it not knowing about keratoconus they will treat it as a visual acuity problem They'll put them in some glasses, they'll put them in some contact lenses. they'll put them in some glasses they'll put them in some contact lenses What happens is they'll come back in six months. The vision's deteriorated further. They're scratching their head, what's going on? They change the prescription. Just because there's a lack of awareness around keratoconus and what it is. As we see on here, one in five, we think one in five are not being diagnosed accurately with keratoconus. We say that the typical time when this happens is in teenage years. However, today, they're not getting treated until they're in their early 30s because people are just not aware, and they're trying to figure out what's going on. Why is the vision still distorting when I'm putting in contact lenses? What's happening here? What happens is they'll come back in six months. what happens is they'll come back in six months The vision's deteriorated further. the vision's deteriorated further They're scratching their head, what's going on? they're scratching their head what's going on They change the prescription. they change the prescription Just because there's a lack of awareness around keratoconus and what it is. just because there's a lack of awareness around keratoconus and what it is As we see on here, one in five, we think one in five are not being diagnosed accurately with keratoconus. as we see on here one in five we think one in five are not being diagnosed accurately with keratoconus We say that the typical time when this happens is in teenage years. we say that the typical time when this happens is in teenage years However, today, they're not getting treated until they're in their early 30s because people are just not aware, and they're trying to figure out what's going on. however today they're not getting treated until they're in their early 30s because people are just not aware and they're trying to figure out what's going on Why is the vision still distorting when I'm putting in contact lenses? why is the vision still distorting when i'm putting in contact lenses What's happening here? what's happening here I don't know how many years, I guess it was about 10 years ago, there was a company named Avedro that came out with a product that would stop or halt the progression of this keratoconus with a product called Photrexa. In 2019, Glaukos acquired this company, Avedro, and we started to work through this drug delivery. I guess there's a couple more stats on here. We talked about some of these already. You can imagine. Now, let me just talk a little bit about this product that they had called Photrexa. Photrexa worked. It stopped the progression of keratoconus. It's a drop that was put on the eye, shined with a light that activated a cross-linking effect that strengthened those corneal fibers and held them in place. All sounds great, except for one thing. I don't know how many years, I guess it was about 10 years ago, there was a company named Avedro that came out with a product that would stop or halt the progression of this keratoconus with a product called Photrexa. i don't know how many years i guess it was about 10 years ago there was a company named avedro that came out with a product that would stop or halt the progression of this keratoconus with a product called photrexa In 2019, Glaukos acquired this company, Avedro, and we started to work through this drug delivery. in 2019 glaukos acquired this company avedro and we started to work through this drug delivery I guess there's a couple more stats on here. i guess there's a couple more stats on here We talked about some of these already. we talked about some of these already You can imagine. you can imagine Now, let me just talk a little bit about this product that they had called Photrexa. now let me just talk a little bit about this product that they had called photrexa Photrexa worked. photrexa worked It stopped the progression of keratoconus. it stopped the progression of keratoconus It's a drop that was put on the eye, shined with a light that activated a cross-linking effect that strengthened those corneal fibers and held them in place. it's a drop that was put on the eye shined with a light that activated a cross-linking effect that strengthened those corneal fibers and held them in place All sounds great, except for one thing. all sounds great except for one thing In order to make it effective, the surgeon had to debride or scrape off the outer layer of the cornea, something that was painful, and the recovery time was long. When you're faced with losing your vision or having distorted vision, patients were willing to step up, but not in great numbers. You take that, along with the fact that it's a very unknown disease, and there just wasn't a lot of opportunity for us to continue to grow this market. We were treating about, well, let's call it 10,000 patients, about 18,000, 19,000 eyes a year over the six years that we had this product in our bag. Despite what we could do, that's the best that we could do. A lot of that was it was not seen as a rare disease. In order to make it effective, the surgeon had to debride or scrape off the outer layer of the cornea, something that was painful, and the recovery time was long. in order to make it effective the surgeon had to debride or scrape off the outer layer of the cornea something that was painful and the recovery time was long When you're faced with losing your vision or having distorted vision, patients were willing to step up, but not in great numbers. when you're faced with losing your vision or having distorted vision patients were willing to step up but not in great numbers You take that, along with the fact that it's a very unknown disease, and there just wasn't a lot of opportunity for us to continue to grow this market. you take that along with the fact that it's a very unknown disease and there just wasn't a lot of opportunity for us to continue to grow this market We were treating about, well, let's call it 10,000 patients, about 18,000, 19,000 eyes a year over the six years that we had this product in our bag. we were treating about well let's call it 10,000 patients about 18,000 19,000 eyes a year over the six years that we had this product in our bag Despite what we could do, that's the best that we could do. despite what we could do that's the best that we could do A lot of that was it was not seen as a rare disease. a lot of that was it was not seen as a rare disease Despite it being just 10,000 patients, it wasn't seen initially as a rare disease, and it wasn't priced properly. There was a second generation that was coming around, and it was called Epioxa. This now has been approved. It got approved at the end of last year, and we just launched it in the first quarter. The great difference being that this one, you do not have to remove the outer layer of the epithelium or the cornea. This is a new topical drop that is put on the eye. You shine the light on it, you infuse some oxygen on it, and that does the same effect as Photrexa. It allows for a much better patient experience, obviously. Recovery time is much shorter. The whole treatment time is much shorter. It's a win-win all around for everybody. Despite it being just 10,000 patients, it wasn't seen initially as a rare disease, and it wasn't priced properly. despite it being just 10,000 patients it wasn't seen initially as a rare disease and it wasn't priced properly There was a second generation that was coming around, and it was called Epioxa. there was a second generation that was coming around and it was called epioxa This now has been approved. this now has been approved It got approved at the end of last year, and we just launched it in the first quarter. it got approved at the end of last year and we just launched it in the first quarter The great difference being that this one, you do not have to remove the outer layer of the epithelium or the cornea. the great difference being that this one you do not have to remove the outer layer of the epithelium or the cornea This is a new topical drop that is put on the eye. this is a new topical drop that is put on the eye You shine the light on it, you infuse some oxygen on it, and that does the same effect as Photrexa. you shine the light on it you infuse some oxygen on it and that does the same effect as photrexa It allows for a much better patient experience, obviously. it allows for a much better patient experience obviously Recovery time is much shorter. recovery time is much shorter The whole treatment time is much shorter. the whole treatment time is much shorter It's a win-win all around for everybody. it's a win-win all around for everybody The nice or exciting thing about this is it allowed Glaukos to completely reset how we go to market with this disease, keratoconus. The reason I say that is we were offered the opportunity to introduce this as a rare disease drug, price it accordingly, and therefore allow us to have the capital to do the things we need to do to find the patients, to educate the patients, and get them treated so they can stop their disease at an earlier point in time. All of these things that are around this little lady right there are all the things that we're investing in with the new capital that we're going to realize on the higher price with Epioxa that allows us to attack this disease more fulsomely. I can see that the time is going fast, Steve says. Let's get skipping ahead. The nice or exciting thing about this is it allowed Glaukos to completely reset how we go to market with this disease, keratoconus. the nice or exciting thing about this is it allowed glaukos to completely reset how we go to market with this disease keratoconus The reason I say that is we were offered the opportunity to introduce this as a rare disease drug, price it accordingly, and therefore allow us to have the capital to do the things we need to do to find the patients, to educate the patients, and get them treated so they can stop their disease at an earlier point in time. the reason i say that is we were offered the opportunity to introduce this as a rare disease drug price it accordingly and therefore allow us to have the capital to do the things we need to do to find the patients to educate the patients and get them treated so they can stop their disease at an earlier point in time All of these things that are around this little lady right there are all the things that we're investing in with the new capital that we're going to realize on the higher price with Epioxa that allows us to attack this disease more fulsomely. all of these things that are around this little lady right there are all the things that we're investing in with the new capital that we're going to realize on the higher price with epioxa that allows us to attack this disease more fulsomely I can see that the time is going fast, Steve says. i can see that the time is going fast steve says Let's get skipping ahead. let's get skipping ahead You can see the launch timelines. We're in the second quarter right now. We've done a great job in launching the product, creating a patient hub for our patients so that they're taken care of and through their journey, establishing a new site of care network, so we cover them geographically and make sure they have the opportunity to get treatment. We're going through the process now of payer coverage, going out to the insurance companies, replacing the existing Photrexa with the new Epioxa, et cetera, so that we can get patients treated. There's a third generation that comes behind that. I'll just quickly say the idea here very quickly is to take a topography of the eye, find out exactly where the corneal weaknesses are, and selectively target that so that they strengthen the target instead of just a random shotgun approach with Epioxa. You can see the launch timelines. you can see the launch timelines We're in the second quarter right now. we're in the second quarter right now We've done a great job in launching the product, creating a patient hub for our patients so that they're taken care of and through their journey, establishing a new site of care network, so we cover them geographically and make sure they have the opportunity to get treatment. we've done a great job in launching the product creating a patient hub for our patients so that they're taken care of and through their journey establishing a new site of care network so we cover them geographically and make sure they have the opportunity to get treatment We're going through the process now of payer coverage, going out to the insurance companies, replacing the existing Photrexa with the new Epioxa, et cetera, so that we can get patients treated. we're going through the process now of payer coverage going out to the insurance companies replacing the existing photrexa with the new epioxa et cetera so that we can get patients treated There's a third generation that comes behind that. there's a third generation that comes behind that I'll just quickly say the idea here very quickly is to take a topography of the eye, find out exactly where the corneal weaknesses are, and selectively target that so that they strengthen the target instead of just a random shotgun approach with Epioxa. i'll just quickly say the idea here very quickly is to take a topography of the eye find out exactly where the corneal weaknesses are and selectively target that so that they strengthen the target instead of just a random shotgun approach with epioxa It's going to be more targeted, more of a rifle approach to really get a very customized treatment for each patient with their keratoconus. I'm going to just skip that. We've talked about that. We'll talk quickly about iLution. This was this idea that can you put a pharmaceutical in a cream and put that on your eyelid? We're going after our lead candidate is around the Demodex blepharitis, which is the same market that many of you know with Tarsus, and you've seen the little commercials with the lovely mites crawling around on your eyelids. It's the same idea. Theirs is a drop, ours would be the cream. Can we put a cream on an eyelid or right on top of the critters and kill the critters and attack the disease? It's going to be more targeted, more of a rifle approach to really get a very customized treatment for each patient with their keratoconus. it's going to be more targeted more of a rifle approach to really get a very customized treatment for each patient with their keratoconus I'm going to just skip that. i'm going to just skip that We've talked about that. we've talked about that We'll talk quickly about iLution. we'll talk quickly about ilution This was this idea that can you put a pharmaceutical in a cream and put that on your eyelid? this was this idea that can you put a pharmaceutical in a cream and put that on your eyelid We're going after our lead candidate is around the Demodex blepharitis, which is the same market that many of you know with Tarsus, and you've seen the little commercials with the lovely mites crawling around on your eyelids. we're going after our lead candidate is around the demodex blepharitis which is the same market that many of you know with tarsus and you've seen the little commercials with the lovely mites crawling around on your eyelids It's the same idea. it's the same idea Theirs is a drop, ours would be the cream. theirs is a drop ours would be the cream Can we put a cream on an eyelid or right on top of the critters and kill the critters and attack the disease? can we put a cream on an eyelid or right on top of the critters and kill the critters and attack the disease They've done a great job making awareness of that market, and we hope that our product can play in that space as well. Last but not least, we talked about retina. All I'll say here is that it's really early but very encouraging. The idea for us on this play around retina is can we design an implant that will last longer than the two to three months of therapy today? Our rabbit models you can see on the bottom, which are highly applicable to humans, but they can stay out three years. That might be too long for a commercial product. We're trying to dial that in. We've gone into a phase II trial with our retina in biodegradable implant, and we'll see what happens as we go through those clinical trials. They've done a great job making awareness of that market, and we hope that our product can play in that space as well. they've done a great job making awareness of that market and we hope that our product can play in that space as well Last but not least, we talked about retina. last but not least we talked about retina All I'll say here is that it's really early but very encouraging. all i'll say here is that it's really early but very encouraging The idea for us on this play around retina is can we design an implant that will last longer than the two to three months of therapy today? the idea for us on this play around retina is can we design an implant that will last longer than the two to three months of therapy today Our rabbit models you can see on the bottom, which are highly applicable to humans, but they can stay out three years. our rabbit models you can see on the bottom which are highly applicable to humans but they can stay out three years That might be too long for a commercial product. that might be too long for a commercial product We're trying to dial that in. we're trying to dial that in We've gone into a phase II trial with our retina in biodegradable implant, and we'll see what happens as we go through those clinical trials. we've gone into a phase ii trial with our retina in biodegradable implant and we'll see what happens as we go through those clinical trials Those are all the pipeline, all the products, everything that's going on in the company. You can see there's a lot happening with Glaukos we're very excited about. The last slide I'll show you really quick are some numbers. You can see the revenue on the top left, how it's a cascading, a nice linear growth there. Our current guidance is $620 million-$635 million for 2026, so that's the midpoint at $627.5 million. Great gross margins, guys. Margins in the mid 80%. With these pharmaceutical products, we expect accretion in the margins over the near and midterm. You can see we're diverse. We not just do glaucoma and cornea health. We also have an international practice that we haven't talked about. Last but not least is on the right-hand corner on the bottom, $281 million of cash in the bank with no debt. Those are all the pipeline, all the products, everything that's going on in the company. those are all the pipeline all the products everything that's going on in the company You can see there's a lot happening with Glaukos we're very excited about. you can see there's a lot happening with glaukos we're very excited about The last slide I'll show you really quick are some numbers. the last slide i'll show you really quick are some numbers You can see the revenue on the top left, how it's a cascading, a nice linear growth there. you can see the revenue on the top left how it's a cascading a nice linear growth there Our current guidance is $620 million-$635 million for 2026, so that's the midpoint at $627.5 million. our current guidance is $620 million-$635 million for 2026 so that's the midpoint at $627.5 million Great gross margins, guys. great gross margins guys Margins in the mid 80%. margins in the mid 80% With these pharmaceutical products, we expect accretion in the margins over the near and midterm. with these pharmaceutical products we expect accretion in the margins over the near and midterm You can see we're diverse. you can see we're diverse We not just do glaucoma and cornea health. we not just do glaucoma and cornea health We also have an international practice that we haven't talked about. we also have an international practice that we haven't talked about Last but not least is on the right-hand corner on the bottom, $281 million of cash in the bank with no debt. last but not least is on the right-hand corner on the bottom $281 million of cash in the bank with no debt We continue to operate on a cash flow breakeven in the short term. Then soon, hopefully, as these products ramp up, these pharmaceutical products, we'll get to more of the cash flow generation, and we'll go from there. With that, I'm out of time. I'll turn it back over to Steve. Thank you so much. We continue to operate on a cash flow breakeven in the short term. we continue to operate on a cash flow breakeven in the short term Then soon, hopefully, as these products ramp up, these pharmaceutical products, we'll get to more of the cash flow generation, and we'll go from there. then soon hopefully as these products ramp up these pharmaceutical products we'll get to more of the cash flow generation and we'll go from there With that, I'm out of time. with that i'm out of time I'll turn it back over to Steve. i'll turn it back over to steve Thank you so much. thank you so much

Speaker 2: Yeah. Thanks, Alex. Thank you everyone for joining us. See you over at the Richardson Room for those that can be with us. Yeah. yeah Thanks, Alex. thanks alex Thank you everyone for joining us. thank you everyone for joining us See you over at the Richardson Room for those that can be with us. see you over at the richardson room for those that can be with us