Glaukos (GKOS) 10-Q 6 May 21 2021 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2021	May 03, 2021
Document and Entity Information
Entity Registrant Name	GLAUKOS Corp
Entity Central Index Key	0001192448
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2021
Document Transition Report	false
Entity File Number	001-37463
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	33-0945406
Entity Address, Address Line One	229 Avenida Fabricante
Entity Address, City or Town	San Clemente
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92672
City Area Code	949
Local Phone Number	367-9600
Title of 12(b) Security	Common Stock
Trading Symbol	GKOS
Security Exchange Name	NYSE
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q1
Entity Common Stock, Shares Outstanding		46,281,586

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 96,625	$ 96,596
Short-term investments	310,755	307,772
Accounts receivable, net	36,694	36,059
Inventory, net	15,271	15,809
Prepaid expenses and other current assets	14,954	13,206
Total current assets	474,299	469,442
Restricted cash	9,416	9,566
Property and equipment, net	43,314	24,008
Operating lease right-of-use asset	19,720	20,009
Finance lease right-of-use asset	50,838	51,443
Intangible assets, net	351,465	357,693
Goodwill	66,134	66,134
Deposits and other assets	7,591	7,207
Total assets	1,022,777	1,005,502
Current liabilities:
Accounts payable	8,624	4,371
Accrued liabilities	47,944	45,331
Convertible senior notes	278,996
Total current liabilities	335,564	49,702
Convertible senior notes		189,416
Operating lease liability	20,450	20,704
Finance lease liability	61,068	60,690
Deferred tax liability, net	8,323	10,512
Other liabilities	7,598	7,029
Total liabilities	433,003	338,053
Commitments and contingencies (Note 12)
Stockholders' equity:
Preferred stock, $0.001 par value; 5,000 shares authorized; no shares issued and outstanding
Common stock, $0.001 par value; 150,000 shares authorized; 46,016 and 45,275 shares issued and 45,988 and 43,247 shares outstanding at March 31, 2021 and December 31, 2020, respectively	46	45
Additional paid-in capital	920,819	976,590
Accumulated other comprehensive income	1,128	1,004
Accumulated deficit	(332,087)	(310,058)
Less treasury stock (28 shares as of March 31, 2021 and December 31, 2020)	(132)	(132)
Total stockholders' equity	589,774	667,449
Total liabilities and stockholders' equity	$ 1,022,777	$ 1,005,502

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (PARENTHETICAL) - $ / shares	Mar. 31, 2021	Dec. 31, 2020
CONDENSED CONSOLIDATED BALANCE SHEETS
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized	150,000,000	150,000,000
Common stock, shares issued	46,016,000	45,275,000
Common stock, shares outstanding	45,988,000	45,247,000
Treasury stock, shares	28,000	28,000

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
Net sales	$ 67,968	$ 55,336
Cost of sales	16,633	32,529
Gross profit	51,335	22,807
Operating expenses:
Selling, general and administrative	41,921	50,546
Research and development	21,219	24,873
Total operating expenses	63,140	75,419
Loss from operations	(11,805)	(52,612)
Non-operating (expense) income:
Interest income	383	696
Interest expense	(3,229)	(881)
Other expense, net	(1,539)	(1,711)
Total non-operating expense	(4,385)	(1,896)
Loss before taxes	(16,190)	(54,508)
Income tax provision (benefit)	279	(450)
Net loss	$ (16,469)	$ (54,058)
Basic and diluted net loss per share (in dollar per share)	$ (0.36)	$ (1.24)
Weighted average shares used to compute basic and diluted net loss per share (in shares)	45,709	43,766

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS
Net loss	$ (16,469)	$ (54,058)
Other comprehensive income:
Foreign currency translation gain	541	1,169
Unrealized loss on short-term investments	(417)	(480)
Other comprehensive income	124	689
Total comprehensive loss	$ (16,345)	$ (53,369)

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands	AdjustmentAdditional Paid-in-Capital	AdjustmentAccumulated Deficit	Adjustment	Common Stock	Additional Paid-in-Capital	Accumulated Other Comprehensive Income (loss)	Accumulated Deficit	Treasury Stock	Total
Balance at Dec. 31, 2019				$ 44	$ 861,740	$ 1,330	$ (189,710)	$ (132)	$ 673,272
Balance (in shares) at Dec. 31, 2019				43,530				(28)
Stockholders' Deficit
Common stock issued under stock plans					4,220				4,220
Common stock issued under stock plans (in shares)				589
Stock-based compensation					17,176				17,176
Other comprehensive income						689			689
Net loss							(54,058)		(54,058)
Balance at Mar. 31, 2020				$ 44	883,136	2,019	(243,768)	$ (132)	641,299
Balance (in shares) at Mar. 31, 2020				44,119				(28)
Balance (Accounting Standards Update 2020-06) at Dec. 31, 2020	$ (81,553)	$ (5,560)	$ (87,113)
Balance at Dec. 31, 2020				$ 45	976,590	1,004	(310,058)	$ (132)	$ 667,449
Balance (in shares) at Dec. 31, 2020				45,275				(28)	45,247
Stockholders' Deficit
Common stock issued under stock plans				$ 1	17,034				$ 17,035
Common stock issued under stock plans (in shares)				741
Stock-based compensation					8,748				8,748
Other comprehensive income						124			124
Net loss							(16,469)		(16,469)
Balance at Mar. 31, 2021				$ 46	$ 920,819	$ 1,128	$ (332,087)	$ (132)	$ 589,774
Balance (in shares) at Mar. 31, 2021				46,016				(28)	45,988

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Operating Activities
Net loss	$ (16,469)	$ (54,058)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Depreciation	1,150	1,082
Amortization of intangible assets	6,228	6,228
Amortization of lease right-of-use lease assets	1,170	1,311
Amortization of debt issuance costs	343
Deferred income tax benefit	(24)	(709)
Stock-based compensation	8,748	17,176
Change in fair value of cash settled stock options		(3,171)
Unrealized foreign currency losses	1,101	2,024
Amortization of premium (discount) on short-term investments	256	(19)
Other liabilities	570	207
Changes in operating assets and liabilities:
Accounts receivable, net	(547)	9,246
Inventory, net	403	14,568
Prepaid expenses and other current assets	(1,803)	(2,235)
Accounts payable and accrued liabilities	3,023	(4,750)
Other assets	29	1
Net cash provided by (used in) operating activities	4,178	(13,099)
Investing activities
Purchases of short-term investments	(54,007)	(18,680)
Proceeds from sales and maturities of short-term investments	50,349	19,676
Purchases of property and equipment	(17,182)	(782)
Investment in company-owned life insurance	(423)	414
Net cash (used in) provided by investing activities	(21,263)	628
Financing activities
Proceeds from exercise of stock options	16,552	4,454
Proceeds from share purchases under Employee Stock Purchase Plan	1,549	1,278
Payment of employee taxes related to vested restricted stock units	(1,065)	(1,512)
Principal paid on finance lease	(251)
Proceeds from tenant improvement allowance	629
Net cash provided by financing activities	17,414	4,220
Effect of exchange rate changes on cash and cash equivalents	(450)	(565)
Net decrease in cash, cash equivalents and restricted cash	(121)	(8,816)
Cash, cash equivalents and restricted cash at beginning of period	106,162	71,756
Cash, cash equivalents and restricted cash at end of period	106,041	62,940
Supplemental disclosures of cash flow information
Taxes (refunded) paid	$ (35)	$ 250

Organization and Basis of Prese

Organization and Basis of Presentation	3 Months Ended
	Mar. 31, 2021
Organization and Basis of Presentation
Organization and Basis of Presentation	Note 1. Organization and Basis of Presentation Organization and business Glaukos Corporation (Glaukos or the Company), incorporated in Delaware on July 14, 1998, is an ophthalmic medical technology and pharmaceutical company focused on developing novel therapies for the treatment of glaucoma, corneal disorders, and retinal disease. The Company developed Micro-Invasive Glaucoma Surgery (MIGS) to serve as an alternative to the traditional glaucoma treatment paradigm and launched its first MIGS device commercially in 2012. The Company also offers commercially a proprietary bio-activated pharmaceutical therapy for the treatment of a corneal disorder, keratoconus, that was approved by the U.S. Food and Drug Administration in 2016 and is developing a pipeline of surgical devices, sustained pharmaceutical therapies, and implantable biosensors intended to treat glaucoma progression, corneal disorders such as keratoconus, dry eye and refractive vision correction, and retinal diseases such as neovascular age-related macular degeneration, diabetic macular edema and retinal vein occlusion. The accompanying condensed consolidated financial statements include the accounts of Glaukos and its wholly-owned subsidiaries. All significant intercompany balances and transactions among the consolidated entities have been eliminated in consolidation. Basis of presentation The accompanying condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (GAAP) for interim financial information and pursuant to the instructions to Form 10-Q and Article 10 of Regulation S-X. The unaudited interim financial statements have been prepared on a basis consistent with the audited financial statements. As permitted under those rules, certain footnotes and other financial information that are normally required by GAAP have been condensed or omitted. In the opinion of management, the unaudited interim financial statements reflect all adjustments necessary for the fair presentation of the Company’s financial information contained herein. All such adjustments are of a normal and recurring nature. The condensed consolidated balance sheet as of December 31, 2020 has been derived from audited financial statements at that date, but excludes disclosures required by GAAP for complete financial statements. These interim financial statements do not include all disclosures required by GAAP and should be read in conjunction with the Company’s financial statements and accompanying notes for the fiscal year ended December 31, 2020, which are contained in the Company’s Annual Report on Form 10-K filed with the United States (U.S.) Securities and Exchange Commission (SEC) on March 1, 2021. The results for the three months ended March 31, 2021 are not necessarily indicative of the results to be expected for the year ending December 31, 2021 or for any other interim period. Recent Developments Acquisition of Avedro, Inc. On November 21, 2019, the Company acquired Avedro, Inc. (Avedro), a hybrid ophthalmic pharmaceutical and medical technology company focused on developing therapies designed to treat corneal diseases and disorders and correct refractive conditions, in a stock-for-stock transaction (Avedro Merger). Avedro developed novel bio-activated drug formulations used in combination with proprietary systems for the treatment of progressive keratoconus and corneal ectasia following refractive surgery. The therapy is the first and only minimally invasive anterior segment product offering approved by the FDA shown to halt the progression of keratoconus. ​

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2021
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies	Note 2. Summary of Significant Accounting Policies There have been no significant changes in the Company’s significant accounting policies during the three months ended March 31, 2021, as compared with those disclosed in its Annual Report on Form 10-K for the year ended December 31, 2020 filed with the SEC on March 1, 2021, including in connection with the Company’s adoption of the accounting pronouncements noted below in the sub-heading “ Recently Adopted Accounting Pronouncements exception of the adoption of Accounting Standards Update (ASU) No. 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity Recently Adopted Accounting Pronouncements Note 9. Convertible Senior Notes Use of Estimates The preparation of the condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts in the condensed consolidated financial statements and accompanying notes. Actual results could differ materially from those estimates and assumptions. Management considers many factors in selecting appropriate financial accounting policies and controls and in developing the estimates and assumptions that are used in the preparation of these condensed consolidated financial statements. Management must apply significant judgment in this process. In addition, other factors may affect estimates, including expected business and operational changes, sensitivity and volatility associated with the assumptions used in developing estimates, and whether historical trends are expected to be representative of future trends. The estimation process often may yield a range of reasonable estimates of the ultimate future outcomes, and management must select an amount that falls within that range of reasonable estimates. The most significant estimates in the accompanying condensed consolidated financial statements relate to revenue recognition, the fair value of the liability component of the Convertible Notes, the incremental borrowing rate related to the Company’s leased assets, stock-based compensation expense and the valuation of certain intangible assets related to the Company’s acquisition of Avedro. Although these estimates are based on the Company’s knowledge of current events and actions it may undertake in the future, this process may result in actual results differing materially from those estimated amounts used in the preparation of the condensed consolidated financial statements. ​ The Company’s condensed consolidated financial statements as of and for the three months ended March 31, 2021 reflect the Company’s estimates of the impact of the ongoing COVID-19 pandemic. The full extent to which the COVID-19 pandemic will directly or indirectly impact the Company’s business, results of operations and financial condition, including sales, expenses, reserves and allowances, manufacturing, clinical trials, research and development costs and employee-related amounts, will depend on future developments that are uncertain, including the duration and severity of the COVID-19 outbreak, the severity and transmission rates of new variants of COVID-19, and the actions taken to contain it or treat COVID-19, including the availability, distribution, rate of public acceptance and efficacy of vaccines for COVID-19 , ​ Cash, Cash Equivalents and Restricted Cash The following table provides a reconciliation of cash and cash equivalents and restricted cash reported within the condensed consolidated balance sheets that equate to the amount reported in the condensed consolidated statement of cash flows as of the beginning and end of the three months ended March 31, 2021 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ ​ ​ 2021 ​ 2020 ​ Cash and cash equivalents ​ $ 96,625 ​ $ 96,596 ​ Restricted cash ​ ​ 9,416 ​ ​ 9,566 ​ Cash, cash equivalents and restricted cash in the condensed consolidated statements of cash flows ​ $ 106,041 ​ $ 106,162 ​ ​ Recently Adopted Accounting Pronouncements In August 2020, the Financial Accounting Standards Board (FASB )issued ASU 2020-06, which simplifies accounting for convertible instruments . 2020-06 using the modified retrospective adoption approach. The cumulative effect of the change was recognized as an adjustment to the opening balance of retained earnings at the date of adoption. The comparative information has not been restated and continues to be presented according to accounting standards in effect for those periods. ​ The adoption of ASU 2020-06 resulted in an increase to accumulated deficit of $5.5 million, a decrease to additional paid-in capital of $81.6 million, a decrease in the deferred tax liability of $2.2 million and an increase to convertible notes, net of $89.2 million. Interest expense recognized in future periods will be reduced as a result of accounting for the convertible debt instrument as a single liability measured at its amortized cost. ​ Recently Issued Accounting Pronouncements Not Yet Adopted We reviewed recently issued accounting pronouncements and concluded that they were either not applicable or not expected to have a significant impact to the condensed consolidated financial statements.

Balance Sheet Details

Balance Sheet Details	3 Months Ended
	Mar. 31, 2021
Balance Sheet Details
Balance Sheet Details	Note 3. Balance Sheet Details Short-term Investments Short-term investments consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At March 31, 2021 ​ ​ Maturity ​ Amortized cost ​ Unrealized ​ Unrealized ​ Estimated ​ (in years) or cost gains losses fair value U.S. government agency bonds ​ less than 3 ​ ​ 198,062 ​ ​ 121 ​ ​ (32) ​ ​ 198,151 ​ Bank certificates of deposit ​ less than 2 ​ ​ 20,799 ​ ​ 5 ​ ​ (6) ​ ​ 20,798 ​ Corporate notes ​ less than 3 ​ 61,391 ​ 198 ​ (74) ​ 61,515 ​ Asset-backed securities ​ less than 2 ​ 12,945 ​ 150 ​ (1) ​ 13,094 ​ Municipal bonds ​ less than 3 ​ ​ 17,218 ​ ​ 8 ​ ​ (29) ​ ​ 17,197 ​ Total ​ ​ ​ $ 310,415 ​ $ 482 ​ $ (142) ​ $ 310,755 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At December 31, 2020 ​ ​ Maturity ​ Amortized cost ​ Unrealized ​ Unrealized ​ Estimated ​ (in years) or cost gains losses fair value U.S. government agency bonds ​ less than 3 ​ ​ 206,704 ​ ​ 223 ​ ​ (3) ​ ​ 206,924 ​ Bank certificates of deposit ​ less than 1 ​ ​ 20,700 ​ ​ 8 ​ ​ — ​ ​ 20,708 ​ Commercial paper ​ less than 1 ​ 1,500 ​ — ​ — ​ 1,500 ​ Corporate notes ​ less than 3 ​ 54,866 ​ 308 ​ (1) ​ 55,173 ​ Asset-backed securities ​ less than 2 ​ 13,290 ​ 205 ​ — ​ 13,495 ​ Municipal bonds ​ less than 3 ​ ​ 9,954 ​ ​ 21 ​ ​ (3) ​ ​ 9,972 ​ Total ​ ​ ​ $ 307,014 ​ $ 765 ​ $ (7) ​ $ 307,772 ​ ​ Accounts Receivable, Net Accounts receivable consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ ​ 2021 2020 Accounts receivable ​ $ 38,161 ​ $ 37,729 ​ Allowance for credit losses ​ ​ (1,467) ​ ​ (1,670) ​ ​ ​ $ 36,694 ​ $ 36,059 ​ ​ The Company’s allowance for credit losses represents management’s estimate of current expected credit losses and there were immaterial bad-debt write offs charged during the three months ended March 31, 2021. ​ As of March 31, 2021, the Company evaluated the current and expected future economic and market conditions surrounding the COVID-19 pandemic as it relates to collectability of its accounts receivable and determined the estimate of expected credit losses was not materially impacted. The Company will continue to re-evaluate the estimate of credit losses related to COVID-19 in conjunction with its assessment of expected credit losses in subsequent quarters. ​ Additionally, no customers accounted for more than 10% of net accounts receivable as of any such date. Inventory, Net Inventory, net consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ ​ 2021 2020 Finished goods ​ $ 6,662 ​ $ 5,346 ​ Work in process ​ ​ 3,761 ​ ​ 3,584 ​ Raw material ​ ​ 4,848 ​ ​ 6,879 ​ ​ ​ $ 15,271 ​ $ 15,809 ​ ​ Accrued Liabilities Accrued liabilities consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ 2021 2020 Accrued bonuses ​ $ 4,669 ​ $ 10,815 Accrued vacation benefits ​ ​ 4,175 ​ ​ 3,728 Accrued payroll taxes ​ ​ 7,568 ​ ​ 3,198 Other accrued liabilities ​ ​ 31,532 ​ ​ 27,590 ​ ​ $ 47,944 ​ $ 45,331 ​

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2021
Fair Value Measurements
Fair Value Measurements	Note 4. Fair Value Measurements Fair value is an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. The carrying amounts of cash equivalents, accounts receivable, accounts payable, and accrued liabilities are considered to be representative of their respective fair values because of the short-term nature of those instruments. The valuation of assets and liabilities is subject to fair value measurements using a three-tiered approach and fair value measurements are classified and disclosed by the Company in one of the following three categories: Level 1: Unadjusted quoted prices in active markets that are accessible at the measurement date for identical, unrestricted assets or liabilities; Level 2: Quoted prices for similar assets and liabilities in active markets, quoted prices in markets that are not active, or inputs which are observable, either directly or indirectly, for substantially the full term of the asset or liability; and Level 3: Prices or valuation techniques that require inputs that are both significant to the fair value measurement and unobservable (i.e., supported by little or no market activity). The following tables present information about the Company’s financial assets and liabilities measured at fair value on a recurring basis as of March 31, 2021 and December 31, 2020 and indicate the fair value hierarchy of the valuation techniques utilized by the Company to determine such fair value (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At March 31, 2021 ​ ​ ​ ​ ​ Quoted prices ​ Significant ​ ​ ​ ​ ​ ​ ​ in active ​ other ​ Significant ​ ​ ​ ​ ​ markets for ​ observable ​ unobservable ​ ​ March 31, ​ identical assets ​ inputs ​ inputs ​ 2021 (Level 1) (Level 2) (Level 3) Assets ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash equivalents: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Money market funds (i) ​ $ 3,089 ​ $ 3,089 ​ $ - ​ $ - Available for sale securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ U.S. government agency bonds (ii) ​ ​ 198,150 ​ ​ - ​ ​ 198,150 ​ ​ - Bank certificates of deposit (ii)(iii) ​ ​ 24,799 ​ ​ - ​ ​ 24,799 ​ ​ - Corporate notes (ii) ​ ​ 61,515 ​ ​ - ​ ​ 61,515 ​ ​ - Asset-backed securities (ii) ​ ​ 13,094 ​ ​ - ​ ​ 13,094 ​ ​ - Municipal bonds (ii) ​ ​ 17,197 ​ ​ - ​ ​ 17,197 ​ ​ - Investments held for deferred compensation plans ​ ​ 5,754 ​ ​ ​ ​ ​ 5,754 ​ ​ ​ Total Assets ​ $ 323,598 ​ $ 3,089 ​ $ 320,509 ​ $ - Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Deferred compensation plans ​ $ 5,689 ​ $ - ​ $ 5,689 ​ $ - Total Liabilities ​ $ 5,689 ​ ​ - ​ $ 5,689 ​ $ - ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At December 31, 2020 ​ ​ ​ ​ ​ Quoted prices ​ Significant ​ ​ ​ ​ ​ ​ ​ in active ​ other ​ Significant ​ ​ ​ ​ ​ markets for ​ observable ​ unobservable ​ ​ December 31, ​ identical assets ​ inputs ​ inputs ​ 2020 (Level 1) (Level 2) (Level 3) Assets ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash equivalents: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Money market funds (i) ​ $ 5,169 ​ $ 5,169 ​ $ - ​ $ - Available for sale securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ U.S. government agency bonds (ii) ​ ​ 206,924 ​ ​ - ​ ​ 206,924 ​ ​ - Bank certificates of deposit (ii) (iii) ​ ​ 25,708 ​ ​ - ​ ​ 25,708 ​ ​ - Commercial paper (ii) ​ ​ 1,500 ​ ​ - ​ ​ 1,500 ​ ​ - Corporate notes (ii) ​ ​ 55,173 ​ ​ - ​ ​ 55,173 ​ ​ - Asset-backed securities (ii) ​ ​ 13,495 ​ ​ - ​ ​ 13,495 ​ ​ - Municipal bonds (ii) ​ ​ 9,972 ​ ​ - ​ ​ 9,972 ​ ​ - Investments held for deferred compensation plans ​ ​ 5,331 ​ ​ ​ ​ ​ 5,331 ​ ​ - Total Assets ​ $ 323,273 ​ $ 5,169 ​ $ 318,104 ​ $ - Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Deferred compensation plans ​ $ 5,232 ​ ​ - ​ $ 5,232 ​ ​ - Total Liabilities ​ $ 5,232 ​ $ - ​ $ 5,232 ​ $ - (i) Included in cash and cash equivalents with a maturity of three months or less from date of purchase on the condensed consolidated balance sheets. (ii) Included in short-term investments on the condensed consolidated balance sheets. (iii) As of March 31, 2021 and December 31, 2020, a bank certificate of deposit totaling $4,000 and $5,000 (in thousands), respectively, is included in cash and cash equivalents on the condensed consolidated balance sheets, as the investment has a maturity of three months or less from the date of purchase on the condensed consolidated balance sheets. Money market funds and currency are highly liquid investments and are actively traded. The pricing information on these investment instruments is readily available and can be independently validated as of the measurement date. This approach results in the classification of these securities as Level 1 of the fair value hierarchy. U.S. government agency bonds, U.S. government bonds, bank certificates of deposit, commercial paper, municipal bonds, corporate notes and asset-backed securities are measured at fair value using Level 2 inputs. The Company reviews trading activity and pricing for these investments as of each measurement date. Pursuant to the Company’s deferred compensation plan (the Deferred Compensation Plan), the Company has also established a rabbi trust that serves as an investment to shadow the Deferred Compensation Plan liability. The investments of the rabbi trust and Deferred Compensation Plan liability consist of company-owned life insurance policies (COLIs) and the pricing on these investments can be independently evaluated. When sufficient quoted pricing for identical securities is not available, the Company uses market pricing and other observable market inputs for similar securities obtained from third party data providers. These inputs represent quoted prices for similar assets in active markets or these inputs have been derived from observable market data. This approach results in the classification of these securities as Level 2 of the fair value hierarchy. There were no transfers between levels within the fair value hierarchy during the periods presented. The Company did not have any assets or liabilities measured at fair value on a recurring basis within Level 3 fair value measurements as of March 31, 2021 and December 31, 2020. Convertible Senior Notes As of March 31, 2021, the fair value of the Convertible Notes was $488.4 million. The fair value was determined on the basis of the market prices observable for similar instruments and is considered Level 2 in the fair value hierarchy. See Note 9, Convertible Senior Notes

Leases

Leases	3 Months Ended
	Mar. 31, 2021
Leases
Leases	Note 5. Leases The Company has operating and finance leases for facilities and certain equipment. Leases with an initial term of 12 months or less are not recorded on the condensed consolidated balance sheet. Lease expense for operating leases is recognized on a straight-line basis over the lease term. For lease agreements entered into or reassessed after the adoption of ASC 842, the Company combines lease and non-lease components. The Company’s leases have remaining non-cancelable lease terms of approximately one year to thirteen years, some of which include options to extend terminate On November 14, 2018, the Company entered into an office building lease pursuant to which the Company will lease one property containing three existing office buildings, comprising approximately 160,000 rentable square feet of space, located in Aliso Viejo, California (Aliso Facility) which was accounted for as a finance lease. The term of the Aliso Facility commenced on April 1, 2019 and continues for thirteen years . The agreement contains an option to extend the lease for two additional five year periods at market rates. The Company intends to relocate its corporate administrative headquarters, along with certain laboratory, research and development and warehouse space, to the Aliso Facility. The lease landlord agreed to provide the Company with a tenant improvement allowance in the amount of the cost of any leasehold improvements, not to exceed approximately $12.7 million, upon the Company providing the necessary documentation evidencing the costs of the allowable leasehold improvements. Nearly all of the aforementioned tenant improvement allowances were utilized by the end of the quarter ended March 31, 2021 and the Company expects to receive reimbursement during the quarter ending June 30, 2021. The Company leases two adjacent facilities located in San Clemente, California. The total leased square footage of these facilities equals approximately 98,000. On July 2, 2020, the Company extended the term of these facilities by five years , both of which now expire on May 31, 2030. Each agreement contains an option to extend the lease for one additional five year period at market rates. In conjunction with these extensions, the lease landlords agreed to provide the Company with tenant improvement allowances in the amount of the cost of any leasehold improvements, not to exceed approximately $0.5 million, upon the Company providing the necessary documentation evidencing the costs of the allowable leasehold improvements. The Company currently intends to maintain its manufacturing facilities at its San Clemente location for the foreseeable future. The Company leases approximately 27,000 square feet of office and laboratory space in Waltham, Massachusetts, pursuant to a lease agreement that expires in 2023. The Company also currently occupies approximately 19,000 square feet of leased manufacturing space in Burlington, Massachusetts pursuant to a lease agreement that expires in 2031. ​ The Company’s remaining U.S.-based and foreign subsidiaries’ leased office space totals less than 14,000 square feet. The following table presents the maturity of the Company’s operating and finance lease liabilities as of March 31, 2021: ​ ​ ​ ​ ​ ​ ​ ​ ​ Maturity of Lease Liabilities ​ Operating ​ Finance (in thousands) Leases (a) ​ Leases (b) Remainder of 2021 ​ $ 2,001 ​ $ — 2022 ​ ​ 2,953 ​ ​ — 2023 ​ ​ 2,555 ​ ​ 1,465 2024 ​ ​ 2,408 ​ ​ 5,184 2025 ​ ​ 2,444 ​ ​ 5,340 2026 ​ ​ 2,498 ​ ​ 5,500 Thereafter ​ ​ 20,790 ​ ​ 107,522 Total lease payments ​ $ 35,649 ​ $ 125,011 Less: imputed interest ​ ​ 13,926 ​ ​ 63,943 Total lease liabilities ​ $ 21,723 ​ $ 61,068 (a) Operating lease payments include $12.2 million related to options to extend lease terms that are reasonably certain of being exercised. (b) Finance lease payments include $75.8 million related to options to extend lease terms that are reasonably certain of being exercised.

Intangible Assets and Goodwill

Intangible Assets and Goodwill	3 Months Ended
	Mar. 31, 2021
Intangible Assets and Goodwill
Intangible Assets and Goodwill	Note 6. Intangible Assets and Goodwill Avedro intangible assets As part of the Avedro Merger on November 21, 2019, the Company acquired identifiable intangible assets for (1) developed technology related to Photrexa ​ The fair value of developed technology and IPR&D assets were determined using an excess earnings methodology. Significant assumptions used in the valuation include: (i) the period in which material net cash inflows are expected to commence, which was estimated to be 2021 for developed technology and 2023 for IPR&D assets, and (ii) the risk-adjusted discount rate of 11.5% for developed technology and 13% for IPR&D assets. ​ For the three months ended March 31, 2021 and March 31, 2020, amortization expense related to the above finite-lived intangible assets was approximately $5.5 million and $0.7 million, recorded in cost of sales and selling, general and administrative expenses, respectively, in the condensed consolidated statement of operations. The Company evaluated its indefinite-lived intangible assets for impairment, including any considerations specific to the COVID-19 pandemic utilizing the methodology pursuant to the adoption of ASU 2017-04, Intangibles – Goodwill and Other (Topic 350) Goodwill The assessment of goodwill by reporting unit is performed annually, in the fourth quarter, or more frequently if events or circumstances indicate the carrying value may no longer be recoverable and that an impairment loss may have occurred. The Company considered the current and expected future economic and market conditions surrounding the COVID-19 pandemic and its impact on the Company’s reporting unit. Based on interim assessments, the Company did not identify any “triggering” events, as described in ASC 350-20, which would indicate an impairment of goodwill is more likely than not as of March 31, 2021. ​ The following table presents the composition of our intangible assets and goodwill (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Estimated ​ As of March 31, 2021 ​ As of December 31, 2020 ​ ​ Useful ​ Gross ​ ​ ​ ​ ​ Gross ​ ​ ​ ​ ​ ​ Life ​ Carrying ​ Accumulated ​ Net ​ Carrying ​ Accumulated ​ Net ​ (in years) Amount Amortization Amount Amount Amortization Amount Developed technology ​ 11.4 ​ $ 252,200 ​ (29,916) ​ 222,284 ​ 252,200 ​ (24,393) ​ 227,807 Customer relationships ​ 5.0 ​ ​ 14,100 ​ ​ (3,819) ​ ​ 10,281 ​ ​ 14,100 ​ ​ (3,114) ​ ​ 10,986 Intangible assets subject to amortization ​ ​ ​ ​ 266,300 ​ ​ (33,735) ​ ​ 232,565 ​ ​ 266,300 ​ ​ (27,507) ​ ​ 238,793 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ In-process research and development ​ Indefinite ​ $ 118,900 ​ ​ — ​ ​ 118,900 ​ ​ 118,900 ​ ​ — ​ ​ 118,900 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Goodwill ​ Indefinite ​ $ 66,134 ​ ​ — ​ ​ 66,134 ​ ​ 66,134 ​ ​ — ​ ​ 66,134 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ ​ ​ $ 451,334 ​ $ (33,735) ​ $ 417,599 ​ $ 451,334 ​ $ (27,507) ​ $ 423,827 ​ As of March 31, 2021, expected amortization expense for unamortized finite-lived intangible assets for the next five years and thereafter is as follows (in thousands): ​ ​ ​ ​ ​ ​ Amortization Expense Remainder of 2021 ​ $ 18,684 2022 ​ ​ 24,912 2023 ​ ​ 24,912 2024 ​ ​ 24,618 2025 ​ ​ 22,092 Thereafter ​ ​ 117,347 Total amortization ​ $ 232,565 ​ Actual amortization expense to be reported in future periods could differ from these estimates as a result of asset impairments, acquisitions, or other facts and circumstances.

Revenue from Contracts with Cus

Revenue from Contracts with Customers	3 Months Ended
	Mar. 31, 2021
Revenue from Contracts with Customers
Revenue from Contracts with Customers	Note 7. Revenue from Contracts with Customers The Company’s net sales are generated primarily from sales of iStent Photrexa Revenue is recognized in an amount that reflects the consideration the Company expects to be entitled to in exchange for goods or services, and all of the Company’s net sales are considered revenue from contracts with customers. Disaggregation of Revenue ​ The Company’s revenues disaggregated by product category and geography, for the three months ended March 31, 2021 and March 31, 2020 was as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ International ​ Total ​ ​ 2021 ​ 2020 ​ 2021 ​ 2020 ​ 2021 ​ 2020 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Glaucoma $ 39,889 ​ $ 32,577 ​ $ 13,810 ​ $ 11,556 $ 53,699 ​ $ 44,133 Corneal Health ​ 12,055 ​ 8,807 ​ ​ 2,214 ​ 2,396 ​ ​ 14,269 ​ 11,203 ​ Total $ 51,944 ​ $ 41,384 ​ $ 16,024 ​ $ 13,952 $ 67,968 ​ $ 55,336 ​ ​ Contract Balances ​ Contract Assets ​ Amounts are recorded as accounts receivable when the Company’s right to consideration becomes unconditional. Payment terms on invoiced amounts are typically 30 days for glaucoma and corneal health products, though extended payment terms on corneal health products may be offered. However, the Company does not consider any significant financing components in customer contracts given the expected time between transfer of the promised products and the payment of the associated consideration is less than one year. As of March 31, 2021 and December 31, 2020, all amounts included in accounts receivable, net on the condensed consolidated balance sheets are related to contracts with customers. ​ Sales commissions earned on U.S. sales of KXL systems are capitalized as the commissions represent costs to obtain a contract and the amortization period is deemed greater than one year. These costs are deferred in other assets on the Company’s condensed consolidated balance sheet, net of the short term portion included in prepaid assets and other current assets, and are amortized as a sales and marketing expense on a straight-line basis over the expected period of benefit. Capitalized sales commissions and the related amortization expense included in the condensed consolidated financial statements were immaterial as of March 31, 2021 and December 31, 2020. ​ Aside from the aforementioned contract assets, the Company does not have any contract assets given that the Company does not have any unbilled receivables and sales commissions on other products are expensed within selling, general and administrative expenses within the condensed consolidated statement of operations when incurred as any incremental cost of obtaining contracts with customers would have an amortization period of less than one year. ​ Contract Liabilities ​ Contract liabilities reflect consideration received from customers’ purchases allocated to the Company’s future performance obligations. ​ The Company has a performance obligation to issue a rebate to customers who may be eligible for a rebate at the conclusion of their contract term. This performance obligation is transferred over time and the Company’s method of measuring progress is the output method, whereby the progress is measured by the estimated rebate earned to date over the total rebate estimated to be earned over the contract period. The Company’s rebate allowance is included in accrued liabilities in the condensed consolidated balance sheets and estimated rebates accrued were not material during the periods presented. ​ Additionally, in the U.S. the Company has a performance obligation related to its customers’ right to a future discount on single dose pharmaceutical purchases, and, to a lesser extent, extended warranty service contracts. The amount allocated to the customers’ right to a future discount is expected to be recognized when the customer elects to utilize the discount, which is generally within one year. As of March 31, 2021 and December 31, 2020, this amount was immaterial as was the amount allocated to extended warranty service contracts. ​ During the three months ended March 31, 2021 and March 31, 2020, the Company did not recognize any revenue related to material changes in transaction prices regarding its contracts with customers and did not recognize any material changes in revenue related to amounts included in contract liabilities at the beginning of the period. ​ The Company’s net sales within a fiscal year may be impacted seasonally, as

Net Loss per Share

Net Loss per Share	3 Months Ended
	Mar. 31, 2021
Net Loss per Share
Net Loss per Share	Note 8. Net Loss per Share Basic net loss per share is calculated by dividing the net loss by the weighted average number of common shares that were outstanding for the period, without consideration for common stock equivalents. For periods when the Company realizes a net loss, no common stock equivalents are included in the calculation of weighted average number of dilutive common stock equivalents as the effect of applying the treasury stock method is considered anti-dilutive. For periods when the Company realizes net income, diluted net income per share is calculated by dividing the net income by the weighted average number of common shares plus the sum of the weighted average number of dilutive common stock equivalents outstanding for the period determined using the treasury stock method. Common stock equivalents are comprised of stock options outstanding and unvested restricted stock units (RSUs) under the Company’s incentive compensation plans, and shares issuable under the Company’s Employee Stock Purchase Plan (ESPP). Potentially dilutive securities not included in the calculation of diluted net loss per share because to do so would be anti-dilutive were as follows (in common stock equivalent shares, in thousands): ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ ​ ​ March 31, ​ ​ 2021 2020 Convertible senior notes ​ 5,125 ​ - ​ Stock options outstanding ​ 3,640 ​ 4,328 ​ Unvested restricted stock units ​ 654 ​ 470 ​ Employee stock purchase plan ​ 17 ​ 6 ​ ​ ​ 9,436 ​ 4,804 ​ ​ ​ ​ ​ The Convertible Notes would have had an impact on the Company’s diluted share count as of March 31, 2021 pursuant to the Company’s adoption of ASU 2020-06. See “ Recently Adopted Accounting Pronouncements ” and Note 9. Convertible Senior Notes for additional detail.

Convertible Senior Notes

Convertible Senior Notes	3 Months Ended
	Mar. 31, 2021
Convertible Senior Notes
Convertible Senior Notes	Note 9. Convertible Senior Notes In June 2020, the Company issued $287.5 million in aggregate principal amount of Convertible Notes pursuant to an indenture dated June 11, 2020, between the Company and Wells Fargo Bank, National Association, as trustee (the Indenture), in a private offering to qualified institutional buyers in accordance with Rule 144A under the Securities Act of 1933, as amended. The Convertible Notes are senior unsecured obligations of the Company and bear interest at a rate of 2.75% per year, payable semi-annually in arrears on June 15 and December 15 of each year, beginning on December 15, 2020. The Convertible Notes will mature on June 15, 2027, unless earlier converted, redeemed or repurchased in accordance with their terms. In connection with issuing the Convertible Notes, the Company received $242.2 million in proceeds, after deducting fees and offering expenses and paying the cost of the capped call transactions described below. ​ The Convertible Notes may be converted at the option of the holders at any time prior to the close of business on the business day immediately preceding March 15, 2027, only under the following circumstances: (1) during any calendar quarter commencing after the calendar quarter ended on September 30, 2020 (and only during such calendar quarter), if the last reported sale price of the Company’s common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day; (2) during the five business day period immediately after any ten consecutive trading day period (the Measurement Period) in which the trading price (as defined in the Indenture) per $1,000 principal amount of the Convertible Notes for each trading day of the Measurement Period was less than 98% of the product of (i) the last reported sale price of the Company’s common stock and (ii) the conversion rate in effect on each such trading day; (3) with respect to any Convertible Notes the Company calls for redemption, at any time prior to the close of business on the business day immediately preceding the redemption date, even if the Convertible Notes are not otherwise convertible at such time; or (4) upon the occurrence of specified corporate events. On or after March 15, 2027 until the close of business on the second scheduled trading day immediately preceding the maturity date, holders may convert all or any portion of their Convertible Notes, in multiples of $1,000 principal amount, at the option of the holder regardless of the foregoing circumstances. Upon conversion, the Company will pay or deliver, as the case may be, cash, shares of the Company’s common stock or a combination of cash and shares of the Company’s common stock, at the Company’s election, in the manner and subject to the terms and conditions provided in the Indenture. The Company’s current intent is to settle the principal amount of the Convertible Notes in cash upon conversion, with any remaining conversion value being delivered in shares of our common stock. ​ During the quarter ended March 31, 2021, the last reported sale price of the Company’s common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter was greater than or equal to 130% of the conversion price on each applicable trading day, and therefore the Convertible Notes may be converted at the option of the holders during the quarter ending June 30, 2021. Consequently, the Convertible Notes were classified within current liabilities on the condensed consolidated balance sheet as of March 31, 2021. If the foregoing conditions are met during the quarter ending June 30, 2021 or any subsequent calendar quarter prior to March 15, 2027, holders of the Convertible Notes will continue to have the right to convert the Convertible Notes for the next succeeding applicable calendar quarter. ​ The conversion rate for the Convertible Notes is initially 17.8269 shares of the Company’s common stock per $1,000 principal amount of the Convertible Notes (equivalent to an initial conversion price of approximately $56.10 per share of the Company’s common stock). The conversion rate is subject to adjustment in some events in accordance with the terms of the Indenture but will not be adjusted for any accrued and unpaid interest. In addition, following certain corporate events that occur prior to the maturity date or if the Company delivers a notice of redemption, the Company will, in certain circumstances, increase the conversion rate for a holder who elects to convert its Convertible Notes in connection with such a corporate event or notice of redemption, as the case may be. ​ The Company may not redeem the Convertible Notes prior to June 20, 2024. The Company may redeem for cash all or any portion of the Convertible Notes, at its option, on or after June 20, 2024 but before the 45th scheduled trading day immediately preceding the maturity date, if the last reported sale price of the Company’s common stock has been at least 130% of the conversion price then in effect on (i) each of at least 20 trading days (whether or not consecutive) during the 30 consecutive trading day period ending on, and including, the trading day immediately preceding the date on which the Company provides notice of redemption and (ii) the trading day immediately preceding the date the Company sends such notice, at a redemption price equal to 100% of the principal amount of the Convertible Notes to be redeemed, plus accrued and unpaid interest to, but excluding, the redemption date. No sinking fund is provided for the Convertible Notes. ​ If the Company undergoes a fundamental change (as defined in the Indenture), holders may require the Company to repurchase for cash all or any portion of their Convertible Notes at a fundamental change repurchase price equal to 100% of the principal amount of the Convertible Notes to be repurchased, plus accrued and unpaid interest to, but excluding, the fundamental change repurchase date. ​ Prior to the adoption of ASU 2020-06, the Company allocated the gross proceeds of the Convertible Notes between the liability and equity components of the Convertible Notes. The initial carrying amount of the liability component was $189.8 million, which was calculated by using a discount rate of 9.5%, which was estimated to be the Company’s borrowing rate on the issuance date for a similar debt instrument without the conversion feature. The carrying amount of the equity component was $97.7 million, which represents the conversion option, and was determined by deducting the fair value of the liability component from the par value of the Convertible Notes. ​ After the adoption of ASU 2020-06, the Convertible Notes are no longer bifurcated into separate liability and equity components in the Company’s March 31, 2021 condensed consolidated balance sheet. Rather, the $287.5 million principal amount of the Convertible Notes, less $8.5 million in unamortized debt issuance costs, was classified as a current liability in the condensed consolidated balance sheet as of March 31, 2021. ​ Total transaction costs for the issuance of the Convertible Notes were $9.6 million, consisting of the initial purchasers’ discount, commissions, and other issuance costs. Prior to the adoption of ASU 2020-06, the Company allocated the total transaction costs proportionally to the liability and equity components. The transaction costs attributed to the liability component were $6.3 million, which were recorded as debt issuance costs (presented as contra debt in the Company’s condensed consolidated balance sheets) and are amortized to interest expense in the condensed consolidated statements of operations over the term of the Convertible Notes. The transaction costs attributed to the equity component were $3.3 million, which were included in additional paid-in capital. ​ After the adoption of ASU 2020-06, the Company recorded an adjustment to the liability and equity components under the same premise (i.e., as if debt issuance costs had always been treated as a contra-liability only). As of March 31, 2021, the unamortized debt issuance costs on the Convertible Notes was $8.5 million and is amortized using the effective interest rate method over the term of the Convertible Notes, for the next 6.3 years. ​ Interest expense relating to the Convertible Notes in the condensed consolidated statements of operations for the three months ended March 31, 2021 are summarized as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ ​ ​ March 31, ​ ​ 2021 Contractual interest expense ​ $ 1,977 ​ Amortization of debt issuance costs ​ ​ 343 ​ Total interest expense ​ $ 2,320 ​ ​ The effective interest rate for the three months ended March 31, 2021 was 3.23% . ​ As of March 31, 2021, the Convertible senior notes on the condensed consolidated balance sheets represented the carrying amount of the Convertible Notes, net of unamortized debt issuance costs, which are summarized as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ As of ​ ​ March 31, ​ 2021 Convertible Notes ​ $ 287,500 Less: Unamortized debt issuance costs ​ ​ (8,504) Carrying amount of Convertible Notes ​ $ 278,996 ​ Capped Call Transactions ​ In connection with the offering of the Convertible Notes, in June 2020 the Company entered into privately negotiated capped call transactions with certain financial institutions (the Option Counterparties) and used an aggregate $35.7 million of the net proceeds from the Convertible Notes to pay the cost of the capped call transactions. The capped call transactions are expected generally to reduce potential dilution to the Company’s common stock upon any conversion of the Convertible Notes or at the Company’s election (subject to certain conditions) offset any cash payments the Company is required to make in excess of the aggregate principal amount of converted Convertible Notes, as the case may be, with such reduction or offset subject to a cap based on the cap price. The cap price of the capped call transactions is initially $86.30 per share, which represents a premium of 100% over the last reported sale price of the Company’s common stock on June 8, 2020, and is subject to certain adjustments under the terms of the capped call transactions. The capped calls have an initial strike price of approximately $56.10 per share, subject to certain adjustments, which corresponds to the conversion option strike price in the Convertible Notes. The capped call transactions cover, subject to customary adjustments, the number of shares of common stock initially underlying the Convertible Notes (or approximately 5.1 million shares of the Company’s common stock). ​ The capped call transactions are separate transactions that the Company entered into with the Option Counterparties, are not part of the terms of the Convertible Notes and will not change the holders’ rights under the Convertible Notes. As the capped call transactions meet certain accounting criteria, the cost of the capped call transactions of $35.7 million was recorded as a reduction in additional paid-in capital in the condensed consolidated balance sheets and will not be remeasured to fair value as long as the accounting criteria continue to be met. As of March 31, 2021, the Company had not purchased any shares under the capped call transactions.

Stock-Based Compensation

Stock-Based Compensation	3 Months Ended
	Mar. 31, 2021
Stock-Based Compensation.
Stock-Based Compensation	Note 10. Stock-Based Compensation The Company has 5,000,000 of authorized preferred stock issuable, and there is no preferred stock outstanding as of March 31, 2021 and December 31, 2020. Each share of common stock is entitled to one vote. ​ The Company has four stock-based compensation plans (collectively, the Stock Plans)—the 2001 Stock Option Plan (the 2001 Stock Plan), the 2011 Stock Plan (the 2011 Stock Plan), the 2015 Omnibus Incentive Compensation Plan (the 2015 Stock Plan) and the ESPP. The 2015 Stock Plan permits grants of RSU awards. The purpose of these Stock Plans is to provide incentives to employees, directors and nonemployee consultants. The Company no longer grants any awards under the 2001 Stock Plan and the 2011 Stock Plan. The maximum term of any stock options granted under the Stock Plans is 10 years. For employees and nonemployees, stock options generally vest 25% on the first anniversary of the original vesting date, with the balance vesting monthly or annually over the remaining three years. Stock options are granted at exercise prices at least equal to the fair value of the underlying stock at the date of the grant. For employees and nonemployees, generally, RSU awards vest 25% on each of the first, second third fourth The Compensation Committee has approved the grant of performance-based equity awards (PBEAs) to the Company’s named executive officers and certain other employees pursuant to the 2015 Stock Plan. These PBEAs will only vest upon the Compensation Committee’s determination that pre-defined Company operational goals were satisfied. The ESPP permits eligible employees to purchase shares of the Company’s common stock, using contributions via payroll deductions of up to 15% of their earnings, at a price per share equal to 85% of the lower of the stock’s fair market value on the offering date or purchase date. The ESPP is intended to qualify as an “employee stock purchase plan” under Section 423 of the Internal Revenue Code. On November 21, 2019, in connection with the Avedro Merger, the Company granted the following Replacement Awards to employees of Avedro: (i) approximately 0.2 million cash-settled stock options to certain executives, which became fully vested on December 31, 2019, (ii) approximately 0.1 million stock options and approximately 5,500 RSUs to members of Avedro’s board of directors, which were granted with no post-combination vesting requirements, and (iii) approximately 0.7 million stock options and approximately 0.1 million RSUs, which are subject to time-based vesting requirements. Approximately $30.8 million of the fair value of the Replacement Awards was attributable to pre-combination service and was included in the purchase price of Avedro. The remaining value of the Replacement Awards of $26.0 million will be recognized as post-combination expense over the remaining requisite service period for the time-vesting awards. For the three months ended March 31, 2021 and March 31, 2020, $0.5 million and $9.3 million was expensed related to the Replacement Awards, respectively. All share-based compensation arrangements The following table summarizes the allocation of stock-based compensation related to stock options and RSUs and includes Replacement Awards, as well as cash-settled stock options in the accompanying condensed consolidated statements of operations (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ ​ March 31, ​ 2021 2020 Cost of sales ​ $ 420 ​ $ 461 Selling, general and administrative ​ ​ 6,494 ​ ​ 10,257 Research and development ​ ​ 1,834 ​ ​ 3,287 Total ​ $ 8,748 ​ $ 14,005 ​ ​ (i) Of the total stock-based compensation of $14.0 million for the three months ended March 31, 2020, a $(3.2) million fair value adjustment was recorded during the three months ended March 31, 2020 related to cash-settled options. At March 31, 2021, the total unamortized stock-based compensation expense was approximately $50.9 million of which $13.6 million was attributable to stock options and is to be recognized over the stock options’ remaining vesting terms of approximately 4.0 years (2.1 years on a weighted average basis). The remaining $37.3 million was attributable to RSUs and is to be recognized over the RSUs’ vesting terms of approximately 4.0 years (2.9 years on a weighted-average basis). The total stock-based compensation cost capitalized in inventory was not material for the three month periods ended March 31, 2021 and March 31, 2020.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2021
Income Taxes
Income Taxes	Note 11. Income Taxes The provision for income taxes is determined using an effective tax rate. For the three months ended March 31, 2021, the Company’s estimated annual effective tax rate of (0.88)%, was lower than the U.S. federal statutory rate primarily due to the generation of U.S. NOL carryforwards, which are partially offset by a valuation allowance, as well as state and foreign income taxes. The effective tax rate may be subject to fluctuations during the year as new information is obtained which may affect the assumptions used to estimate the effective tax rate, including factors such as expected utilization of NOL carryforwards, changes in or the interpretation of tax laws in jurisdictions where the Company conducts business, the Company’s expansion into new states or foreign countries, and the amount of valuation allowances against deferred tax assets. For the three months ended March 31, 2021, the Company recorded a provision for income taxes of $0.3 million, which was primarily comprised of state and foreign income taxes. For the three months ended March 31, 2020, the Company recorded a benefit for income taxes of ($0.5) million, which was primarily comprised of U.S. federal, state, and foreign income taxes. ​ The Company recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities, along with NOL and tax credit carryforwards. The Company records a valuation allowance against its deferred tax assets to reduce the net carrying value to an amount it believes is more likely than not to be realized. When the Company establishes or reduces the valuation allowance against its deferred tax assets, the provision for income taxes will increase or decrease, respectively, in the period such determination is made. For the three months ended March 31, 2021, the Company has recorded a valuation allowance against the portion of its deferred tax asset which are not more likely than not to be realized. ​ Additionally, the Company follows an accounting standard addressing the accounting for uncertainty in income taxes that prescribes rules for recognition, measurement and classification in the financial statements of tax positions taken or expected to be taken in a tax return. As of March 31, 2021 and March 31, 2020, the Company had gross unrecognized tax benefits of $23.5 million and $17.8 million, respectively. ​ On March 11, 2021, the United States enacted the American Rescue Plan Act of 2021 which provided funding for COVID-19 related relief and recovery. The Company is evaluating the impact of the American Rescue Plan Act of 2021 on its condensed consolidated financial statements and related disclosures. ​

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2021
Commitments and Contingencies
Commitments and Contingencies	Note 12. Commitments and Contingencies Patent Litigation On April 14, 2018, the Company filed a patent infringement lawsuit against Ivantis, Inc. (Ivantis) in the U.S. District Court for the Central District of California, Southern Division (the Court), alleging that Ivantis’ Hydrus © Microstent device infringes the Company’s U.S. Patent Nos. 6,626,858 and 9,827,143. ​ Secured Letters of Credit The Company had a bank issue a letter of credit in the amount of $8.8 million that is related to its Aliso Facility. The letter of credit is secured with an amount of cash held in a restricted account of approximately $8.8 million as of March 31, 2021 and December 31, 2020. Beginning as of the first day of the thirty-seventh month of the lease term, and on each twelve month anniversary thereafter, the letter of credit will be reduced by 20% until the letter of credit amount has been reduced to $2.0 million. The Company has one other irrevocable standby letters of credit secured with approximately $0.6 million of cash in a restricted account related to its office lease agreements. ​ Regents of the University of California On December 30, 2014, the Company executed an agreement (the UC Agreement) with the Regents of the University of California (the University) to correct inventorship in connection with a group of the Company’s U.S. patents (the Patent Rights) and to obtain from the University a covenant that it did not and would not claim any right or title to the Patent Rights and will not challenge or assist any others in challenging the Patent Rights. In connection with the UC Agreement, Glaukos agreed to pay to the University a low single-digit percentage of worldwide net sales of certain current and future products, including the Company’s iStent GMP Visions Solutions, Inc. ​ In November 2013, the Company entered into an amended agreement (the Buyout Agreement) with GMP Vision Solutions, Inc. (GMP) pursuant to which the Company agreed to buyout any remaining royalty obligations related to the transfer and assignment of certain intellectual property from GMP to the Company. Pursuant to the Buyout Agreement, in the event of a Company sale as defined therein, the Company would be required to pay GMP a percentage of the sale consideration above a certain threshold, with such payment not to exceed $2.0 million. ​ Executive Deferred Compensation Plan Pursuant to the Company’s Deferred Compensation Plan, eligible senior level employees are permitted to make elective deferrals of compensation to which he or she will become entitled in the future. The Company has also established a rabbi trust that serves as an investment to shadow the Deferred Compensation Plan liability. The investments of the rabbi trust consist of COLIs. The fair value of the Deferred Compensation Plan liability, included in other liabilities on the condensed consolidated balance sheets, was approximately $5.7 million and $5.2 million as of March 31, 2021 and December 31, 2020, respectively, and the cash surrender value of the COLIs, included in deposits and other assets on the condensed consolidated balance sheets, which reflects the underlying assets at fair value, was approximately $5.8 million and $5.3 million as of March 31, 2021 and December 31, 2020, respectively. Global Enterprise Systems Implementation In the first quarter of 2019, the Company began implementing new enterprise systems and other technology optimizations and facilities infrastructure globally. The first phase of the Company’s new enterprise system went live in May 2020; therefore, software services along with any associated implementation costs for this first phase incurred after May 1, 2020 are being capitalized in accordance with the Company’s policy. As of March 31, 2021, the Company has firm purchase commitments related to software costs and systems implementations for future phases of approximately $1.3 million, which the Company expects to primarily incur during the remainder of 2021.

Business Segment Information

Business Segment Information	3 Months Ended
	Mar. 31, 2021
Business Segment Information
Business Segment Information	Note 13. Business Segment Information The Company has one business activity: the development and commercialization of therapies designed to treat glaucoma, corneal disorders and retinal diseases, and operates as one operating segment. The Company determined its operating segment on the same basis that it uses to evaluate its performance internally. The Company’s revenues disaggregated by revenue and product category are included in Note 7, Revenue from Contracts with Customers ​

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2021
Subsequent Events
Subsequent Events	Note 14. Subsequent Events On April 22, 2021, the Company announced that it had entered into an amendment of its exclusive licensing agreement with Intratus, Inc. The amendment expanded the existing agreement, a global licensing arrangement to research, develop, manufacture and commercialize Intratus’ patented, non-invasive drug delivery platform for use in the treatment of dry eye disease, glaucoma and other corneal disorders, to also include the treatment of presbyopia. An upfront payment of $5.0 million was made in connection with the execution of the amendment. the quarter ending June 30, 2021. ​

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2021
Summary of Significant Accounting Policies
Basis of presentation	Basis of presentation The accompanying condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (GAAP) for interim financial information and pursuant to the instructions to Form 10-Q and Article 10 of Regulation S-X. The unaudited interim financial statements have been prepared on a basis consistent with the audited financial statements. As permitted under those rules, certain footnotes and other financial information that are normally required by GAAP have been condensed or omitted. In the opinion of management, the unaudited interim financial statements reflect all adjustments necessary for the fair presentation of the Company’s financial information contained herein. All such adjustments are of a normal and recurring nature. The condensed consolidated balance sheet as of December 31, 2020 has been derived from audited financial statements at that date, but excludes disclosures required by GAAP for complete financial statements. These interim financial statements do not include all disclosures required by GAAP and should be read in conjunction with the Company’s financial statements and accompanying notes for the fiscal year ended December 31, 2020, which are contained in the Company’s Annual Report on Form 10-K filed with the United States (U.S.) Securities and Exchange Commission (SEC) on March 1, 2021. The results for the three months ended March 31, 2021 are not necessarily indicative of the results to be expected for the year ending December 31, 2021 or for any other interim period.
Use of Estimates	Use of Estimates The preparation of the condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts in the condensed consolidated financial statements and accompanying notes. Actual results could differ materially from those estimates and assumptions. Management considers many factors in selecting appropriate financial accounting policies and controls and in developing the estimates and assumptions that are used in the preparation of these condensed consolidated financial statements. Management must apply significant judgment in this process. In addition, other factors may affect estimates, including expected business and operational changes, sensitivity and volatility associated with the assumptions used in developing estimates, and whether historical trends are expected to be representative of future trends. The estimation process often may yield a range of reasonable estimates of the ultimate future outcomes, and management must select an amount that falls within that range of reasonable estimates. The most significant estimates in the accompanying condensed consolidated financial statements relate to revenue recognition, the fair value of the liability component of the Convertible Notes, the incremental borrowing rate related to the Company’s leased assets, stock-based compensation expense and the valuation of certain intangible assets related to the Company’s acquisition of Avedro. Although these estimates are based on the Company’s knowledge of current events and actions it may undertake in the future, this process may result in actual results differing materially from those estimated amounts used in the preparation of the condensed consolidated financial statements. ​ The Company’s condensed consolidated financial statements as of and for the three months ended March 31, 2021 reflect the Company’s estimates of the impact of the ongoing COVID-19 pandemic. The full extent to which the COVID-19 pandemic will directly or indirectly impact the Company’s business, results of operations and financial condition, including sales, expenses, reserves and allowances, manufacturing, clinical trials, research and development costs and employee-related amounts, will depend on future developments that are uncertain, including the duration and severity of the COVID-19 outbreak, the severity and transmission rates of new variants of COVID-19, and the actions taken to contain it or treat COVID-19, including the availability, distribution, rate of public acceptance and efficacy of vaccines for COVID-19 ,
Cash, Cash Equivalents and Restricted Cash	Cash, Cash Equivalents and Restricted Cash The following table provides a reconciliation of cash and cash equivalents and restricted cash reported within the condensed consolidated balance sheets that equate to the amount reported in the condensed consolidated statement of cash flows as of the beginning and end of the three months ended March 31, 2021 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ ​ ​ 2021 ​ 2020 ​ Cash and cash equivalents ​ $ 96,625 ​ $ 96,596 ​ Restricted cash ​ ​ 9,416 ​ ​ 9,566 ​ Cash, cash equivalents and restricted cash in the condensed consolidated statements of cash flows ​ $ 106,041 ​ $ 106,162 ​
Recently Adopted and Issued Accounting Pronouncements	Recently Adopted Accounting Pronouncements In August 2020, the Financial Accounting Standards Board (FASB )issued ASU 2020-06, which simplifies accounting for convertible instruments . 2020-06 using the modified retrospective adoption approach. The cumulative effect of the change was recognized as an adjustment to the opening balance of retained earnings at the date of adoption. The comparative information has not been restated and continues to be presented according to accounting standards in effect for those periods. ​ The adoption of ASU 2020-06 resulted in an increase to accumulated deficit of $5.5 million, a decrease to additional paid-in capital of $81.6 million, a decrease in the deferred tax liability of $2.2 million and an increase to convertible notes, net of $89.2 million. Interest expense recognized in future periods will be reduced as a result of accounting for the convertible debt instrument as a single liability measured at its amortized cost. ​ Recently Issued Accounting Pronouncements Not Yet Adopted We reviewed recently issued accounting pronouncements and concluded that they were either not applicable or not expected to have a significant impact to the condensed consolidated financial statements.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2021
Summary of Significant Accounting Policies
Schedule of cash and cash equivalents and restricted cash	The following table provides a reconciliation of cash and cash equivalents and restricted cash reported within the condensed consolidated balance sheets that equate to the amount reported in the condensed consolidated statement of cash flows as of the beginning and end of the three months ended March 31, 2021 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ ​ ​ 2021 ​ 2020 ​ Cash and cash equivalents ​ $ 96,625 ​ $ 96,596 ​ Restricted cash ​ ​ 9,416 ​ ​ 9,566 ​ Cash, cash equivalents and restricted cash in the condensed consolidated statements of cash flows ​ $ 106,041 ​ $ 106,162 ​

Balance Sheet Details (Tables)

Balance Sheet Details (Tables)	3 Months Ended
	Mar. 31, 2021
Balance Sheet Details
Schedule of short-term investments	Short-term investments consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At March 31, 2021 ​ ​ Maturity ​ Amortized cost ​ Unrealized ​ Unrealized ​ Estimated ​ (in years) or cost gains losses fair value U.S. government agency bonds ​ less than 3 ​ ​ 198,062 ​ ​ 121 ​ ​ (32) ​ ​ 198,151 ​ Bank certificates of deposit ​ less than 2 ​ ​ 20,799 ​ ​ 5 ​ ​ (6) ​ ​ 20,798 ​ Corporate notes ​ less than 3 ​ 61,391 ​ 198 ​ (74) ​ 61,515 ​ Asset-backed securities ​ less than 2 ​ 12,945 ​ 150 ​ (1) ​ 13,094 ​ Municipal bonds ​ less than 3 ​ ​ 17,218 ​ ​ 8 ​ ​ (29) ​ ​ 17,197 ​ Total ​ ​ ​ $ 310,415 ​ $ 482 ​ $ (142) ​ $ 310,755 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At December 31, 2020 ​ ​ Maturity ​ Amortized cost ​ Unrealized ​ Unrealized ​ Estimated ​ (in years) or cost gains losses fair value U.S. government agency bonds ​ less than 3 ​ ​ 206,704 ​ ​ 223 ​ ​ (3) ​ ​ 206,924 ​ Bank certificates of deposit ​ less than 1 ​ ​ 20,700 ​ ​ 8 ​ ​ — ​ ​ 20,708 ​ Commercial paper ​ less than 1 ​ 1,500 ​ — ​ — ​ 1,500 ​ Corporate notes ​ less than 3 ​ 54,866 ​ 308 ​ (1) ​ 55,173 ​ Asset-backed securities ​ less than 2 ​ 13,290 ​ 205 ​ — ​ 13,495 ​ Municipal bonds ​ less than 3 ​ ​ 9,954 ​ ​ 21 ​ ​ (3) ​ ​ 9,972 ​ Total ​ ​ ​ $ 307,014 ​ $ 765 ​ $ (7) ​ $ 307,772 ​
Schedule of accounts receivable, net	Accounts receivable consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ ​ 2021 2020 Accounts receivable ​ $ 38,161 ​ $ 37,729 ​ Allowance for credit losses ​ ​ (1,467) ​ ​ (1,670) ​ ​ ​ $ 36,694 ​ $ 36,059 ​
Schedule of inventory	Inventory, net consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ ​ 2021 2020 Finished goods ​ $ 6,662 ​ $ 5,346 ​ Work in process ​ ​ 3,761 ​ ​ 3,584 ​ Raw material ​ ​ 4,848 ​ ​ 6,879 ​ ​ ​ $ 15,271 ​ $ 15,809 ​
Schedule of accrued liabilities	Accrued liabilities consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ March 31, ​ December 31, ​ 2021 2020 Accrued bonuses ​ $ 4,669 ​ $ 10,815 Accrued vacation benefits ​ ​ 4,175 ​ ​ 3,728 Accrued payroll taxes ​ ​ 7,568 ​ ​ 3,198 Other accrued liabilities ​ ​ 31,532 ​ ​ 27,590 ​ ​ $ 47,944 ​ $ 45,331

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2021
Fair Value Measurements
Schedule of the Company's financial assets and financial liabilities measured at fair value on a recurring basis	The following tables present information about the Company’s financial assets and liabilities measured at fair value on a recurring basis as of March 31, 2021 and December 31, 2020 and indicate the fair value hierarchy of the valuation techniques utilized by the Company to determine such fair value (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At March 31, 2021 ​ ​ ​ ​ ​ Quoted prices ​ Significant ​ ​ ​ ​ ​ ​ ​ in active ​ other ​ Significant ​ ​ ​ ​ ​ markets for ​ observable ​ unobservable ​ ​ March 31, ​ identical assets ​ inputs ​ inputs ​ 2021 (Level 1) (Level 2) (Level 3) Assets ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash equivalents: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Money market funds (i) ​ $ 3,089 ​ $ 3,089 ​ $ - ​ $ - Available for sale securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ U.S. government agency bonds (ii) ​ ​ 198,150 ​ ​ - ​ ​ 198,150 ​ ​ - Bank certificates of deposit (ii)(iii) ​ ​ 24,799 ​ ​ - ​ ​ 24,799 ​ ​ - Corporate notes (ii) ​ ​ 61,515 ​ ​ - ​ ​ 61,515 ​ ​ - Asset-backed securities (ii) ​ ​ 13,094 ​ ​ - ​ ​ 13,094 ​ ​ - Municipal bonds (ii) ​ ​ 17,197 ​ ​ - ​ ​ 17,197 ​ ​ - Investments held for deferred compensation plans ​ ​ 5,754 ​ ​ ​ ​ ​ 5,754 ​ ​ ​ Total Assets ​ $ 323,598 ​ $ 3,089 ​ $ 320,509 ​ $ - Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Deferred compensation plans ​ $ 5,689 ​ $ - ​ $ 5,689 ​ $ - Total Liabilities ​ $ 5,689 ​ ​ - ​ $ 5,689 ​ $ - ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At December 31, 2020 ​ ​ ​ ​ ​ Quoted prices ​ Significant ​ ​ ​ ​ ​ ​ ​ in active ​ other ​ Significant ​ ​ ​ ​ ​ markets for ​ observable ​ unobservable ​ ​ December 31, ​ identical assets ​ inputs ​ inputs ​ 2020 (Level 1) (Level 2) (Level 3) Assets ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash equivalents: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Money market funds (i) ​ $ 5,169 ​ $ 5,169 ​ $ - ​ $ - Available for sale securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ U.S. government agency bonds (ii) ​ ​ 206,924 ​ ​ - ​ ​ 206,924 ​ ​ - Bank certificates of deposit (ii) (iii) ​ ​ 25,708 ​ ​ - ​ ​ 25,708 ​ ​ - Commercial paper (ii) ​ ​ 1,500 ​ ​ - ​ ​ 1,500 ​ ​ - Corporate notes (ii) ​ ​ 55,173 ​ ​ - ​ ​ 55,173 ​ ​ - Asset-backed securities (ii) ​ ​ 13,495 ​ ​ - ​ ​ 13,495 ​ ​ - Municipal bonds (ii) ​ ​ 9,972 ​ ​ - ​ ​ 9,972 ​ ​ - Investments held for deferred compensation plans ​ ​ 5,331 ​ ​ ​ ​ ​ 5,331 ​ ​ - Total Assets ​ $ 323,273 ​ $ 5,169 ​ $ 318,104 ​ $ - Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Deferred compensation plans ​ $ 5,232 ​ ​ - ​ $ 5,232 ​ ​ - Total Liabilities ​ $ 5,232 ​ $ - ​ $ 5,232 ​ $ - (i) Included in cash and cash equivalents with a maturity of three months or less from date of purchase on the condensed consolidated balance sheets. (ii) Included in short-term investments on the condensed consolidated balance sheets. (iii) As of March 31, 2021 and December 31, 2020, a bank certificate of deposit totaling $4,000 and $5,000 (in thousands), respectively, is included in cash and cash equivalents on the condensed consolidated balance sheets, as the investment has a maturity of three months or less from the date of purchase on the condensed consolidated balance sheets.

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2021
Leases
Schedule of maturity of lease liability	​ ​ ​ ​ ​ ​ ​ Maturity of Lease Liabilities ​ Operating ​ Finance (in thousands) Leases (a) ​ Leases (b) Remainder of 2021 ​ $ 2,001 ​ $ — 2022 ​ ​ 2,953 ​ ​ — 2023 ​ ​ 2,555 ​ ​ 1,465 2024 ​ ​ 2,408 ​ ​ 5,184 2025 ​ ​ 2,444 ​ ​ 5,340 2026 ​ ​ 2,498 ​ ​ 5,500 Thereafter ​ ​ 20,790 ​ ​ 107,522 Total lease payments ​ $ 35,649 ​ $ 125,011 Less: imputed interest ​ ​ 13,926 ​ ​ 63,943 Total lease liabilities ​ $ 21,723 ​ $ 61,068 (a) Operating lease payments include $12.2 million related to options to extend lease terms that are reasonably certain of being exercised. (b) Finance lease payments include $75.8 million related to options to extend lease terms that are reasonably certain of being exercised.

Intangible Assets and Goodwill

Intangible Assets and Goodwill (Tables)	3 Months Ended
	Mar. 31, 2021
Intangible Assets and Goodwill
Schedule reflecting the composition of intangible assets and goodwill	The following table presents the composition of our intangible assets and goodwill (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Estimated ​ As of March 31, 2021 ​ As of December 31, 2020 ​ ​ Useful ​ Gross ​ ​ ​ ​ ​ Gross ​ ​ ​ ​ ​ ​ Life ​ Carrying ​ Accumulated ​ Net ​ Carrying ​ Accumulated ​ Net ​ (in years) Amount Amortization Amount Amount Amortization Amount Developed technology ​ 11.4 ​ $ 252,200 ​ (29,916) ​ 222,284 ​ 252,200 ​ (24,393) ​ 227,807 Customer relationships ​ 5.0 ​ ​ 14,100 ​ ​ (3,819) ​ ​ 10,281 ​ ​ 14,100 ​ ​ (3,114) ​ ​ 10,986 Intangible assets subject to amortization ​ ​ ​ ​ 266,300 ​ ​ (33,735) ​ ​ 232,565 ​ ​ 266,300 ​ ​ (27,507) ​ ​ 238,793 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ In-process research and development ​ Indefinite ​ $ 118,900 ​ ​ — ​ ​ 118,900 ​ ​ 118,900 ​ ​ — ​ ​ 118,900 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Goodwill ​ Indefinite ​ $ 66,134 ​ ​ — ​ ​ 66,134 ​ ​ 66,134 ​ ​ — ​ ​ 66,134 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ ​ ​ $ 451,334 ​ $ (33,735) ​ $ 417,599 ​ $ 451,334 ​ $ (27,507) ​ $ 423,827
Schedule of expected amortization of finite-lived intangible assets	As of March 31, 2021, expected amortization expense for unamortized finite-lived intangible assets for the next five years and thereafter is as follows (in thousands): ​ ​ ​ ​ ​ ​ Amortization Expense Remainder of 2021 ​ $ 18,684 2022 ​ ​ 24,912 2023 ​ ​ 24,912 2024 ​ ​ 24,618 2025 ​ ​ 22,092 Thereafter ​ ​ 117,347 Total amortization ​ $ 232,565

Revenue from Contracts with C_2

Revenue from Contracts with Customers (Tables)	3 Months Ended
	Mar. 31, 2021
Revenue from Contracts with Customers
Schedule of disaggregation of revenue	The Company’s revenues disaggregated by product category and geography, for the three months ended March 31, 2021 and March 31, 2020 was as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ United States ​ International ​ Total ​ ​ 2021 ​ 2020 ​ 2021 ​ 2020 ​ 2021 ​ 2020 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Glaucoma $ 39,889 ​ $ 32,577 ​ $ 13,810 ​ $ 11,556 $ 53,699 ​ $ 44,133 Corneal Health ​ 12,055 ​ 8,807 ​ ​ 2,214 ​ 2,396 ​ ​ 14,269 ​ 11,203 ​ Total $ 51,944 ​ $ 41,384 ​ $ 16,024 ​ $ 13,952 $ 67,968 ​ $ 55,336

Net Loss per Share (Tables)

Net Loss per Share (Tables)	3 Months Ended
	Mar. 31, 2021
Net Loss per Share
Schedule of potentially dilutive securities not included in the calculation of diluted net loss per share attributable to common stockholders	Potentially dilutive securities not included in the calculation of diluted net loss per share because to do so would be anti-dilutive were as follows (in common stock equivalent shares, in thousands): ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ ​ ​ March 31, ​ ​ 2021 2020 Convertible senior notes ​ 5,125 ​ - ​ Stock options outstanding ​ 3,640 ​ 4,328 ​ Unvested restricted stock units ​ 654 ​ 470 ​ Employee stock purchase plan ​ 17 ​ 6 ​ ​ ​ 9,436 ​ 4,804 ​

Convertible Senior Notes (Table

Convertible Senior Notes (Tables)	3 Months Ended
	Mar. 31, 2021
Convertible Senior Notes
Schedule of interest expense relating to the Convertible Notes	Interest expense relating to the Convertible Notes in the condensed consolidated statements of operations for the three months ended March 31, 2021 are summarized as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ ​ ​ March 31, ​ ​ 2021 Contractual interest expense ​ $ 1,977 ​ Amortization of debt issuance costs ​ ​ 343 ​ Total interest expense ​ $ 2,320 ​
Schedule of convertible senior notes	The effective interest rate for the three months ended March 31, 2021 was 3.23% . ​ As of March 31, 2021, the Convertible senior notes on the condensed consolidated balance sheets represented the carrying amount of the Convertible Notes, net of unamortized debt issuance costs, which are summarized as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ As of ​ ​ March 31, ​ 2021 Convertible Notes ​ $ 287,500 Less: Unamortized debt issuance costs ​ ​ (8,504) Carrying amount of Convertible Notes ​ $ 278,996

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2021
Stock-Based Compensation.
Schedule summarizing the allocation of stock-based compensation	The following table summarizes the allocation of stock-based compensation related to stock options and RSUs and includes Replacement Awards, as well as cash-settled stock options in the accompanying condensed consolidated statements of operations (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ ​ March 31, ​ 2021 2020 Cost of sales ​ $ 420 ​ $ 461 Selling, general and administrative ​ ​ 6,494 ​ ​ 10,257 Research and development ​ ​ 1,834 ​ ​ 3,287 Total ​ $ 8,748 ​ $ 14,005 ​ ​ (i) Of the total stock-based compensation of $14.0 million for the three months ended March 31, 2020, a $(3.2) million fair value adjustment was recorded during the three months ended March 31, 2020 related to cash-settled options.

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Cash and Cash Equivalents (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020	Mar. 31, 2020	Dec. 31, 2019
Restricted cash
Cash and cash equivalents	$ 96,625	$ 96,596
Restricted cash	9,416	9,566
cash, cash equivalents and restricted cash in the condensed consolidated statements of cash flows	$ 106,041	$ 106,162	$ 62,940	$ 71,756

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Recently Adopted Accounting Pronouncements (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Jan. 01, 2021	Dec. 31, 2020
Recent Accounting Pronouncements
Accumulated deficit	$ (332,087)		$ (310,058)
Additional paid-in capital	920,819		976,590
Deferred tax liability, net	8,323		$ 10,512
Convertible senior notes	$ 278,996
Accounting Standards Update 2020-06 | Adjustment
Recent Accounting Pronouncements
Accumulated deficit		$ (5,500)
Additional paid-in capital		(81,600)
Deferred tax liability, net		(2,200)
Convertible senior notes		$ 89,200

Balance Sheet Details - Short-T

Balance Sheet Details - Short-Term Investments (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2021	Dec. 31, 2020
Short-term investments
Amortized cost	$ 310,415	$ 307,014
Unrealized gains	482	765
Unrealized losses	(142)	(7)
Estimated fair value	310,755	307,772
U.S. Government agency bonds
Short-term investments
Amortized cost	198,062	206,704
Unrealized gains	121	223
Unrealized losses	(32)	(3)
Estimated fair value	$ 198,151	$ 206,924
U.S. Government agency bonds | Maximum
Short-term investments
Maturity	3 years	3 years
Bank certificates of deposit
Short-term investments
Amortized cost	$ 20,799	$ 20,700
Unrealized gains	5	8
Unrealized losses	(6)
Estimated fair value	$ 20,798	$ 20,708
Bank certificates of deposit | Maximum
Short-term investments
Maturity	2 years	1 year
Commercial paper
Short-term investments
Amortized cost		$ 1,500
Estimated fair value		$ 1,500
Commercial paper | Maximum
Short-term investments
Maturity		1 year
Corporate notes
Short-term investments
Amortized cost	$ 61,391	$ 54,866
Unrealized gains	198	308
Unrealized losses	(74)	(1)
Estimated fair value	$ 61,515	$ 55,173
Corporate notes | Maximum
Short-term investments
Maturity	3 years	3 years
Asset-backed securities
Short-term investments
Amortized cost	$ 12,945	$ 13,290
Unrealized gains	150	205
Unrealized losses	(1)
Estimated fair value	$ 13,094	$ 13,495
Asset-backed securities | Maximum
Short-term investments
Maturity	2 years	2 years
Municipal bonds
Short-term investments
Amortized cost	$ 17,218	$ 9,954
Unrealized gains	8	21
Unrealized losses	(29)	(3)
Estimated fair value	$ 17,197	$ 9,972
Municipal bonds | Maximum
Short-term investments
Maturity	3 years	3 years

Balance Sheet Details - Other (

Balance Sheet Details - Other (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Accounts Receivable, Net
Accounts receivable	$ 38,161	$ 37,729
Allowance for credit losses	(1,467)	(1,670)
Accounts receivable, net	36,694	36,059
Inventory
Finished goods	6,662	5,346
Work in process	3,761	3,584
Raw materials	4,848	6,879
Total inventory	15,271	15,809
Accrued Liabilities
Accrued bonuses	4,669	10,815
Accrued vacation benefits	4,175	3,728
Accrued payroll taxes	7,568	3,198
Other accrued liabilities	31,532	27,590
Total accrued liabilities	$ 47,944	$ 45,331

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value Hierarchy (Details) - USD ($)	Mar. 31, 2021	Dec. 31, 2020
Fair Value, Measurements, Recurring
Assets
Total assets	$ 323,598,000	$ 323,273,000
Liabilities
Total liabilities	5,689,000	5,232,000
Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 1
Assets
Total assets	3,089,000	5,169,000
Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	320,509,000	318,104,000
Liabilities
Total liabilities	5,689,000	5,232,000
Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 3
Assets
Total assets	0	0
Liabilities
Total liabilities	0	0
Money market funds | Fair Value, Measurements, Recurring
Assets
Total assets	3,089,000	5,169,000
Money market funds | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 1
Assets
Total assets	3,089,000	5,169,000
U.S. Government agency bonds | Fair Value, Measurements, Recurring
Assets
Total assets	198,150,000	206,924,000
U.S. Government agency bonds | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	198,150,000	206,924,000
Bank certificates of deposit
Assets
Cash equivalents	4,000,000	5,000,000
Bank certificates of deposit | Fair Value, Measurements, Recurring
Assets
Total assets	24,799,000	25,708,000
Bank certificates of deposit | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	24,799,000	25,708,000
Commercial paper. | Fair Value, Measurements, Recurring
Assets
Total assets		1,500,000
Commercial paper. | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets		1,500,000
Corporate notes | Fair Value, Measurements, Recurring
Assets
Total assets	61,515,000	55,173,000
Corporate notes | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	61,515,000	55,173,000
Asset-backed securities | Fair Value, Measurements, Recurring
Assets
Total assets	13,094,000	13,495,000
Asset-backed securities | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	13,094,000	13,495,000
Municipal bonds | Fair Value, Measurements, Recurring
Assets
Total assets	17,197,000	9,972,000
Municipal bonds | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	17,197,000	9,972,000
Investments held for deferred compensation plans | Fair Value, Measurements, Recurring
Assets
Total assets	5,754,000	5,331,000
Liabilities
Total liabilities	5,689,000	5,232,000
Investments held for deferred compensation plans | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	5,754,000	5,331,000
Liabilities
Total liabilities	$ 5,689,000	$ 5,232,000

Fair Value Measurements - Trans

Fair Value Measurements - Transfers (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Mar. 31, 2020
Fair Value Measurements, Valuation
Amount of transfers of assets and liabilities measured on a recurring basis between Levels 1, 2 and 3 of the fair value hierarchy	$ 0	$ 0
2.75% Convertible Senior Notes due 2027
Fair Value Measurements, Valuation
Fair value of convertible senior notes	$ 488,400

Leases - Terms (Details)

Leases - Terms (Details)	3 Months Ended
	Mar. 31, 2021
Leases
Operating Lease Existence of Option to Extend	true
Optional lease extension term	10 years
Operating Lease Existence of Option to Terminate	true
Operating lease period for lease termination	1 year
Minimum
Leases
Operating lease remaining lease term	1 year
Maximum
Leases
Operating lease remaining lease term	13 years

Leases - Leases Details (Detail

Leases - Leases Details (Details) $ in Millions	Nov. 14, 2020USD ($)ft²item	Jul. 31, 2020USD ($)ft²item	Mar. 31, 2021ft²item
Operating Leases
Optional lease extension term			10 years
Domestic Office Leases
Operating Leases
The number of adjacent facilities rented | item			2
Extended lease term		5 years
Number of lease renewal periods | item		1
Optional lease extension term		5 years
Area of leased space | ft²		98,000
Tenant improvement allowance and abatement | $		$ 0.5
Foreign Subsidiaries Office Leases | Maximum
Operating Leases
Area of leased space | ft²			14,000
Aliso Facility
Operating Leases
Number of properties leased | item	1
Number of buildings leased | item	3
Number of lease renewal periods | item	2
Optional lease extension term	5 years
Area of leased space | ft²	160,000
Tenant improvement allowance and abatement | $	$ 12.7
Term of lease	13 years
Waltham Massachusetts Facility
Operating Leases
Area of leased space | ft²			27,000
Burlington Massachusetts Facility
Operating Leases
Area of leased space | ft²			19,000

Leases - Maturity (Details)

Leases - Maturity (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2021USD ($)
Leases
Existence of option to extend	true
Operating Leases
Remainder of 2021	$ 2,001
2022	2,953
2023	2,555
2024	2,408
2025	2,444
2026	2,498
Thereafter	20,790
Total Operating lease payments	35,649
Less: imputed interest	13,926
Total Operating lease liabilities	21,723
Amount of operating leases with option to extend commitment	12,200
Finance Leases
2023	1,465
2024	5,184
2025	5,340
2026	5,500
Thereafter	107,522
Total Finance lease payments	125,011
Less: imputed interest	63,943
Total Finance lease liabilities	61,068
Amount of financing leases with option to extend commitment	$ 75,800

Intangible Assets and Goodwil_2

Intangible Assets and Goodwill - Other (Details) - USD ($) $ in Thousands	Nov. 21, 2019	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Intangible Assets and Goodwill
Amortization of intangible assets		$ 6,228	$ 6,228
Finite Lived - Gross Amount		266,300		$ 266,300
Finite Lived - Accumulated Amortization		(33,735)		(27,507)
Finite Lived - Net Amount		232,565		238,793
Goodwill		66,134		66,134
Intangible Assets, Gross		451,334		451,334
Intangible Assets, Net		417,599		423,827
In-Process Research and Development (IPR&D)
Intangible Assets and Goodwill
Indefinite Lived assets		$ 118,900		118,900
Developed Technology
Intangible Assets and Goodwill
Useful life/amortization period		11 years 4 months 24 days
Finite Lived - Gross Amount		$ 252,200		252,200
Finite Lived - Accumulated Amortization		(29,916)		(24,393)
Finite Lived - Net Amount		$ 222,284		227,807
Customer Relationships
Intangible Assets and Goodwill
Useful life/amortization period		5 years
Finite Lived - Gross Amount		$ 14,100		14,100
Finite Lived - Accumulated Amortization		(3,819)		(3,114)
Finite Lived - Net Amount		$ 10,281		$ 10,986
Avedro | In-Process Research and Development (IPR&D)
Intangible Assets and Goodwill
Discount Rate (as a percent)	11.50%
Avedro | Developed Technology
Intangible Assets and Goodwill
Discount Rate (as a percent)	13.00%
Useful life/amortization period		11 years
Avedro | Customer Relationships
Intangible Assets and Goodwill
Useful life/amortization period		5 years
Avedro | Cost of sales
Intangible Assets and Goodwill
Amortization of intangible assets		$ 5,500
Avedro | Selling, general and administrative
Intangible Assets and Goodwill
Amortization of intangible assets		$ 700

Intangible Assets and Goodwil_3

Intangible Assets and Goodwill - Maturity (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Estimated amortization expense
Remainder of 2021	$ 18,684
2022	24,912
2023	24,912
2024	24,618
2025	22,092
Thereafter	117,347
Finite Lived - Net Amount	$ 232,565	$ 238,793

Revenue from Contracts with C_3

Revenue from Contracts with Customers - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Revenues
Total net sales	$ 67,968	$ 55,336
United States
Revenues
Total net sales	51,944	41,384
International
Revenues
Total net sales	16,024	13,952
Glaucoma
Revenues
Total net sales	53,699	44,133
Glaucoma | United States
Revenues
Total net sales	39,889	32,577
Glaucoma | International
Revenues
Total net sales	13,810	11,556
Corneal Health
Revenues
Total net sales	14,269	11,203
Corneal Health | United States
Revenues
Total net sales	12,055	8,807
Corneal Health | International
Revenues
Total net sales	$ 2,214	$ 2,396

Revenue from Contracts with C_4

Revenue from Contracts with Customers - Other (Details)	3 Months Ended
	Mar. 31, 2021
Revenue from Contracts with Customers
Typical payment terms on invoiced amounts	30 days
Practical expedient financing component	true
Practical expedient cost of obtaining contract	true

Net Loss per Share (Details)

Net Loss per Share (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Anti-dilutive securities
Anti-dilutive securities excluded from computation of earnings per share	9,436	4,804
Common Stock Warrants
Anti-dilutive securities
Anti-dilutive securities excluded from computation of earnings per share	5,125
Stock options
Anti-dilutive securities
Anti-dilutive securities excluded from computation of earnings per share	3,640	4,328
RSU
Anti-dilutive securities
Anti-dilutive securities excluded from computation of earnings per share	654	470
ESPP
Anti-dilutive securities
Anti-dilutive securities excluded from computation of earnings per share	17	6

Convertible Senior Notes - Gene

Convertible Senior Notes - General (Details) - 2.75% Convertible Senior Notes due 2027	Jun. 11, 2020USD ($)D$ / shares	Mar. 31, 2021USD ($)D
Long-Term Debt
Convertible Notes | $	$ 287,500,000	$ 287,500,000
Interest rate (as a percent)	2.75%
Net proceeds from the debt | $	$ 242,200,000
Threshold trading days | D	20	20
Threshold consecutive trading days | D	30	30
Premium percentage on conversion price	130.00%	130.00%
Number of business days | D	5
Measurement period	10 days
Denomination for conversion of debt | $	$ 1,000
Product of sale price and conversion rate (as a percent)	98.00%
Conversion ratio	17.8269
Initial conversion price | $ / shares	$ 56.10
Redemption price percentage on principal amount to be redeemed	100.00%
Principal amount of the convertible notes to be repurchased (as a percent)	100.00%

Convertible Senior Notes - Adop

Convertible Senior Notes - Adoption of ASU (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Dec. 31, 2020	Jun. 30, 2020	Jun. 11, 2020
Long-Term Debt
Carrying amount of liability component		$ 189,416
2.75% Convertible Senior Notes due 2027
Long-Term Debt
Carrying amount of liability component	$ 278,996		$ 189,800
Discount rate (as a percent)			9.50%
Carrying amount of the equity component			$ 97,700
Face amount at time of issuance	287,500			$ 287,500
Debt issuance costs			9,600
Debt issuance costs	8,504
Debt issuance costs liability component			6,300
Debt issuance costs equity component			$ 3,300
Adjusted | 2.75% Convertible Senior Notes due 2027
Long-Term Debt
Debt issuance costs equity component	$ 8,500
Amortization period	6 years 3 months 18 days
Accounting Standards Update 2020-06 | Adjusted | 2.75% Convertible Senior Notes due 2027
Long-Term Debt
Face amount at time of issuance	$ 287,500
Debt issuance costs	$ 8,500

Convertible Senior Notes - Inte

Convertible Senior Notes - Interest expense (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2021USD ($)
Long-Term Debt
Amortization of Financing Costs and Discounts, Total	$ 343
2.75% Convertible Senior Notes due 2027
Long-Term Debt
Contractual interest expense	1,977
Amortization of debt issuance costs	343
Amortization of Financing Costs and Discounts, Total	$ 2,320
Interest rate at period end	3.23%

Convertible Senior Notes - Carr

Convertible Senior Notes - Carrying Amount (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020	Jun. 30, 2020	Jun. 11, 2020
Long-Term Debt
Carrying amount of Convertible Notes		$ 189,416
2.75% Convertible Senior Notes due 2027
Long-Term Debt
Convertible Notes	$ 287,500			$ 287,500
Less: Unamortized debt issuance costs	(8,504)
Carrying amount of Convertible Notes	$ 278,996		$ 189,800

Convertible Senior Notes - Capp

Convertible Senior Notes - Capped Call Transactions (Details) - Capped Call Transactions $ / shares in Units, shares in Millions, $ in Millions	Jun. 08, 2020$ / instrument	Mar. 31, 2021USD ($)$ / sharesshares
Long-Term Debt
Payment for capped call options		$ 35.7
Initial strike price (in dollars per share) | $ / shares		$ 56.10
Number of shares of common stock initially underlying the Convertible Notes | shares		5.1
Reduction in additional paid-in capital		$ (35.7)
Common Stock
Long-Term Debt
Cap price (in dollars per share) | $ / instrument	86.30
Percentage of premium on share price	100.00%

Stock-Based Compensation - Plan

Stock-Based Compensation - Plan Information (Details) $ in Thousands	Nov. 21, 2019USD ($)shares	Mar. 31, 2021USD ($)Voteitemshares	Mar. 31, 2020USD ($)	Dec. 31, 2020Voteshares
Stock-based compensation
Preferred stock, shares authorized		5,000,000		5,000,000
Preferred stock, shares outstanding		0		0
Number of votes per common share | Vote		1		1
Number of stock plans | item		4
Expiration period		10 years
Vesting percentage on first anniversary of grant date		25.00%
Remaining vesting period		3 years
Stock-based compensation expense | $		$ 8,748	$ 14,005
Replacement Awards
Stock-based compensation
Stock-based compensation expense | $		$ 500	$ 9,300
Employee Stock Purchase Plan 2015
Stock-based compensation
Maximum employee contributions as a percentage of earnings under the ESPP		15.00%
Purchase price per share expressed as a percentage of the lower of the stock's fair market value on the offering date or purchase date under the ESPP		85.00%
First anniversary | RSU
Stock-based compensation
Vesting (as a percent)		25.00%
Second anniversary | RSU
Stock-based compensation
Vesting (as a percent)		25.00%
Third anniversary | RSU
Stock-based compensation
Vesting (as a percent)		25.00%
Fourth anniversary | RSU
Stock-based compensation
Vesting (as a percent)		25.00%
Avedro
Stock-based compensation
Fair value of Replacement Awards attributable to pre-combination services | $	$ 30,800
Fair value of Replacement Awards attributable to post-combination services | $		$ 26,000
Avedro | RSU
Stock-based compensation
Shares issued in connection with Acquisition	5,500
Avedro | Cash-Settled Stock Option
Stock-based compensation
Shares issued in connection with Acquisition	200,000
Avedro | Stock options
Stock-based compensation
Shares issued in connection with Acquisition	100,000
Avedro | Time Vesting | RSU
Stock-based compensation
Shares issued in connection with Acquisition	100,000
Avedro | Time Vesting | Stock options
Stock-based compensation
Shares issued in connection with Acquisition	700,000

Stock-Based Compensation - Allo

Stock-Based Compensation - Allocation of Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Allocation of stock-based compensation
Stock-based compensation expense	$ 8,748	$ 14,005
Fair value adjustment excluded from APIC		(3,200)
Cost of sales
Allocation of stock-based compensation
Stock-based compensation expense	420	461
Selling, general and administrative
Allocation of stock-based compensation
Stock-based compensation expense	6,494	10,257
Research and development
Allocation of stock-based compensation
Stock-based compensation expense	$ 1,834	$ 3,287

Stock-Based Compensation - Fair

Stock-Based Compensation - Fair Value Assumptions (Details) $ in Millions	3 Months Ended
	Mar. 31, 2021USD ($)
Stock-based compensation
Unamortized stock-based compensation expense not yet recognized	$ 50.9
RSU
Stock-based compensation
Unamortized stock-based compensation expense not yet recognized	$ 37.3
Options remaining vesting period	4 years
Weighted average period of recognition	2 years 10 months 24 days
Stock options
Stock-based compensation
Unamortized stock-based compensation expense not yet recognized	$ 13.6
Options remaining vesting period	4 years
Weighted average period of recognition	2 years 1 month 6 days

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Income Taxes
Effective tax rate (as a percent)	(0.88%)
Provision for income taxes	$ 279	$ (450)
Unrecognized tax benefits	$ 23,500	$ 17,800

Commitments and Contingencies -

Commitments and Contingencies - Other (Details)	3 Months Ended
	Mar. 31, 2021USD ($)item	Mar. 31, 2020USD ($)	Dec. 31, 2020USD ($)
Other commitments
Letter of Credit outstanding	$ 8,800,000
Restricted cash pledged for letter of credit	$ 8,800,000		$ 8,800,000
Number of Months from start of lease for adjustments to Letter of Credit | item	37
Frequency of adjustment to Letter of Credit	12 months
Adjustment rate of Letter of Credit (as a percent)	20.00%
Amount of Letter of Credit outstanding after adjustments	$ 2,000,000
Number of other irrevocable letters of credit outstanding | item	1
Restricted cash pledged for office lease agreement	$ 600,000
Deferred compensation plan liability	5,700,000		5,200,000
Deferred compensation plan assets	5,800,000		$ 5,300,000
Purchase commitment obligation	1,300,000
Agreement with the Regents
Other commitments
Minimum required annual payment of the commitment obligation, based on net sales of current and future products	500,000
Maximum | Buyout Agreement with GMP Vision Solutions, Inc.
Other commitments
Buyout amount upon sale of Company.	2,000,000
Cost of sales | Agreement with the Regents
Other commitments
Commitment obligation payments	900,000	$ 1,100,000
Patent Litigation | Pending Litigation
Other commitments
Accrual for loss contingency	$ 0

Business Segment Information (D

Business Segment Information (Details)	3 Months Ended
	Mar. 31, 2021itemsegment
Business Segment Information
Number Of Business Activities | item	1
Number of Operating Segments | segment	1

Subsequent Event (Details)

Subsequent Event (Details) $ in Millions	Apr. 22, 2021USD ($)
Licensing Agreement With Intratus, Inc. | Subsequent Event
Subsequent Events
Upfront payment made	$ 5