Glaukos at ASCRS 2026: Epioxa commercial launch and the growing case for interventional eye care

Glaukos Corporation arrived at the 2026 American Society of Cataract and Refractive Surgery Annual Meeting in Washington DC this week as one of the event’s most commercially active exhibitors, and with good reason. The Aliso Viejo, California-based ophthalmic pharmaceutical and medical technology company is simultaneously managing two product launches that are reshaping its revenue mix: the recently commercially launched Epioxa, the first FDA-approved epithelium-on corneal crosslinking treatment for keratoconus, and iDose TR, its long-duration travoprost intracameral implant for glaucoma, which posted 53 percent year-over-year revenue growth in the fourth quarter of 2025. The ASCRS platform, where Glaukos is exhibiting at booth 407 and sponsoring a dedicated Epioxa symposium, is serving double duty as both a clinical education forum and a commercial awareness exercise for a company that is entering 2026 with full-year revenue guidance of US$600 million to US$620 million.

What is Epioxa and why does its commercial launch matter for keratoconus treatment?

Keratoconus is a progressive corneal disorder in which the normally dome-shaped cornea gradually thins and bulges outward into a cone-like shape, distorting vision and causing light sensitivity, double vision, and halos around lights. The condition affects an estimated 50 to 200 people per 100,000 in the general population and is most aggressive in individuals under 30 years old. In advanced cases it can lead to severe vision loss requiring corneal transplantation. The treatment landscape for keratoconus has long been dominated by a single non-surgical intervention: corneal collagen crosslinking, a procedure that uses riboflavin drops and ultraviolet light to stiffen corneal collagen fibres and halt the progression of the disease. Glaukos itself has marketed Photrexa, the only previously FDA-approved crosslinking therapy in the United States, which received orphan drug approval in 2016. However, the conventional crosslinking procedure requires the surgical removal of the corneal epithelium, the outermost layer of the eye, before riboflavin can be applied. That step causes pain and extends recovery time, two barriers that have historically limited adoption in a condition that is already widely underdiagnosed and undertreated.

Epioxa changes that equation. The FDA approved Glaukos’s new drug application for Epioxa HD and Epioxa in October 2025, making it the first and only FDA-approved topical drug therapy for keratoconus that does not require removal of the corneal epithelium. Instead, the therapy uses an oxygen-enriched riboflavin formulation applied directly to the intact epithelial surface and activated by ultraviolet light in an oxygen-enhanced environment. The procedure is conducted using Glaukos’s O2n System and Boost Goggles. Glaukos announced the commercial availability of Epioxa in the United States in March 2026, following the FDA approval. To support access, the company launched EpioxaCareConnect, a patient-support portal designed to assist with prior authorisation, appeals, and financial assistance, reflecting a commercial strategy that addresses the reimbursement complexity that affects most newly launched ophthalmic pharmaceutical products.

What clinical data is Glaukos presenting on Epioxa at ASCRS 2026?

The Glaukos symposium on Epioxa took place on Friday, April 10, from noon to 1pm at the Walter E. Washington Convention Center, co-hosted with ASCRS and EyeWorld and moderated by Brandon D. Ayres, MD. The faculty included Kenneth A. Beckman, MD, Maanasa Indaram, MD, and Matt Jensen, MBA. Beckman is also the presenter of a dedicated abstract at the meeting examining the persistence of the epithelium-on crosslinking treatment effect in patients with keratoconus, which provides data on how the clinical benefit of Epioxa holds up over time after the initial procedure. The FDA approval of Epioxa was supported by two prospective, randomised, multicentre, double-masked Phase 3 pivotal trials enrolling a total of more than 400 patients, both of which met their pre-specified primary efficacy endpoints with a favourable tolerability and safety profile. The most common reported adverse reaction was conjunctival hyperaemia at 31 percent of patients, with other reactions including corneal opacity or haze, photophobia, and punctate keratitis occurring in 5 to 25 percent of eyes. Glaukos also has a separate abstract in the corneal track from Michael B. Raizman, MD, presenting a design review and clinical plan for a novel keratoconus screening device, extending the company’s reach from treatment into the diagnosis gap that has been identified as a structural market constraint.

How is Glaukos’s glaucoma portfolio performing and what is at ASCRS 2026 from the MIGS and iDose side?

The glaucoma business remains Glaukos’s primary revenue driver and the company is presenting a substantial body of data at ASCRS 2026 on its trabecular micro-bypass stent platform and its travoprost intracameral implant programmes. John P. Berdahl, MD, presents safety and efficacy data for the travoprost intracameral implant 75 mcg in combination with the trabecular micro-bypass system at three months. Christine N. Funke, MD, presents one-month outcomes for third-generation trabecular micro-bypass stents plus a travoprost intracameral implant with or without cataract surgery. Steven R. Sarkisian Jr., MD, presents three-month initial cohort data for the second-generation travoprost intracameral implant. Zachary D. Vest, MD, presents two-year outcomes for third-generation trabecular micro-bypass performed with phacoemulsification in patients with open-angle glaucoma. Arkadiy Yadgarov, MD, presents 12-month outcomes for standalone third-generation trabecular micro-bypass stents in open-angle glaucoma.

The commercial backdrop for this data slate is significant. Glaukos reported fourth-quarter 2025 US glaucoma net sales of US$86.4 million, up 53 percent year-over-year, driven almost entirely by iDose TR adoption. Full-year 2025 consolidated net sales reached a record US$507.4 million, up 32 percent versus 2024, and the company has guided for US$600 million to US$620 million in 2026. US glaucoma growth for 2026 is guided at approximately 30 percent year-over-year, again driven by iDose TR. In January 2026, Glaukos also received FDA approval of an NDA supplement allowing for re-administration of iDose TR, removing a previous clinical constraint that had limited the device’s long-term utility for patients who needed a repeat implant after the first device exhausted its drug supply. Management has indicated that re-administration will become a more meaningful revenue contributor from 2027 onwards.

What is the broader significance of Glaukos’s ASCRS 2026 presence for the interventional ophthalmology market?

The simultaneous commercial launches of Epioxa for keratoconus and iDose TR for glaucoma position Glaukos as the most commercially active interventional ophthalmology company at the 2026 ASCRS meeting. The company’s strategy, which it describes as building a portfolio of dropless or drug-sparing platform technologies, is premised on the clinical and commercial argument that sustained, device-delivered or procedural drug therapy produces better patient adherence and outcomes than daily topical eye drops, which have historically suffered from poor long-term compliance rates across both glaucoma and corneal disease. The ASCRS Business of Interventional Glaucoma programme on April 9, running the day before the main meeting and drawing what observers described as a packed room, reflects growing practice-level interest in building and monetising interventional glaucoma services, an area where Glaukos’s stent and implant platforms are directly relevant.

The keratoconus launch adds a second growth vector that operates in a different patient demographic and commercial pathway from glaucoma. Keratoconus patients are typically younger, often in their 20s and 30s, and the diagnosis and treatment gap is significant: Glaukos President and COO Joseph Gilliam has acknowledged publicly that a large proportion of eligible patients are never identified, a problem the company is trying to address through its patient awareness campaign and its investment in keratoconus screening technology development. The corneal health revenue line, transitioning from Photrexa to Epioxa, carries more timing volatility than the glaucoma segment in 2026 guidance due to reimbursement dynamics during the product transition, but Glaukos has signalled it expects the corneal business to grow modestly year-over-year as Epioxa gains traction in US practices across the remainder of the year.