Glaukos (GKOS) 10-Q 4 Nov 24 2024 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2024	Oct. 31, 2024
Document and Entity Information
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2024
Document Transition Report	false
Securities Act File Number	001-37463
Entity Registrant Name	GLAUKOS Corp
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	33-0945406
Entity Address, Address Line One	One Glaukos Way
Entity Address, City or Town	Aliso Viejo
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92656
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
Entity Central Index Key	0001192448
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Entity Common Stock, Shares Outstanding		55,137,429

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 100,143	$ 93,467
Short-term investments	162,330	201,964
Accounts receivable, net	56,408	39,850
Inventory	59,895	41,986
Prepaid expenses and other current assets	18,506	18,194
Total current assets	397,282	395,461
Restricted cash	4,733	5,856
Property and equipment, net	98,581	103,212
Operating lease right-of-use assets	27,321	27,146
Finance lease right-of-use asset	42,365	44,180
Intangible assets, net	269,418	282,956
Goodwill	66,134	66,134
Deposits and other assets	20,709	15,469
Total assets	926,543	940,414
Current liabilities:
Accounts payable	11,103	13,440
Accrued liabilities	60,581	60,574
Total current liabilities	71,684	74,014
Convertible senior notes	56,759	282,773
Operating lease liability	30,656	30,427
Finance lease liability	69,712	70,538
Deferred tax liability, net	7,143	7,144
Other liabilities	22,080	13,752
Total liabilities	258,034	478,648
Commitments and contingencies (Note 12)
Stockholders' equity:
Preferred stock, $0.001 par value; 5,000 shares authorized; no shares issued or outstanding
Common stock, $0.001 par value; 150,000 shares authorized; 55,122 and 49,148 shares issued and 55,094 and 49,120 shares outstanding as of September 30, 2024 and December 31, 2023, respectively	55	49
Additional paid-in capital	1,377,825	1,059,751
Accumulated other comprehensive income	2,620	1,165
Accumulated deficit	(711,859)	(599,067)
Less treasury stock (28 shares as of September 30, 2024 and December 31, 2023)	(132)	(132)
Total stockholders' equity	668,509	461,766
Total liabilities and stockholders' equity	$ 926,543	$ 940,414

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (PARENTHETICAL) - $ / shares shares in Thousands	Sep. 30, 2024	Dec. 31, 2023
CONDENSED CONSOLIDATED BALANCE SHEETS
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized	5,000	5,000
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	150,000
Common stock, shares issued	55,122	49,148
Common stock, shares outstanding	55,094	49,120
Treasury stock, shares	28	28

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
Net sales	$ 96,670,000	$ 78,048,000	$ 277,982,000	$ 232,346,000
Cost of sales	22,584,000	18,510,000	65,392,000	56,684,000
Gross profit	74,086,000	59,538,000	212,590,000	175,662,000
Operating expenses:
Selling, general and administrative	64,000,000	54,247,000	192,163,000	161,034,000
Research and development	34,746,000	33,301,000	99,898,000	101,706,000
Acquired in-process research and development			14,229,000	3,000,000
Total operating expenses	98,746,000	87,548,000	306,290,000	265,740,000
Loss from operations	(24,660,000)	(28,010,000)	(93,700,000)	(90,078,000)
Non-operating income (expense):
Interest income	2,700,000	2,710,000	8,611,000	6,252,000
Interest expense	(1,663,000)	(3,398,000)	(8,468,000)	(10,205,000)
Charges associated with convertible senior notes			(18,012,000)
Other income (expense), net	2,391,000	(1,709,000)	(338,000)	(2,978,000)
Total non-operating income (expense)	3,428,000	(2,397,000)	(18,207,000)	(6,931,000)
Loss before taxes	(21,232,000)	(30,407,000)	(111,907,000)	(97,009,000)
Income tax provision	177,000	37,000	885,000	873,000
Net loss	$ (21,409,000)	$ (30,444,000)	$ (112,792,000)	$ (97,882,000)
Basic net loss per share (in dollar per share)	$ (0.39)	$ (0.63)	$ (2.18)	$ (2.03)
Diluted net loss per share (in dollar per share)	$ (0.39)	$ (0.63)	$ (2.18)	$ (2.03)
Weighted average shares outstanding used to compute basic net loss per share	55,037	48,675	51,804	48,284
Weighted average shares outstanding used to compute diluted net loss per share	55,037	48,675	51,804	48,284

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS
Net loss	$ (21,409)	$ (30,444)	$ (112,792)	$ (97,882)
Other comprehensive income:
Foreign currency translation (loss) income	(510)	561	478	822
Unrealized income on short-term investments	939	590	977	2,917
Other comprehensive income	429	1,151	1,455	3,739
Total comprehensive loss	$ (20,980)	$ (29,293)	$ (111,337)	$ (94,143)

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands	Common stock	Additional paid-in-capital	Accumulated other comprehensive (loss) income	Accumulated deficit	Treasury stock	Total
Balance at Dec. 31, 2022	$ 48	$ 997,470	$ (2,975)	$ (464,406)	$ (132)	$ 530,005
Balance (in shares) at Dec. 31, 2022	47,782
Treasury Stock, Shares, Beginning Balance at Dec. 31, 2022					(28)
Stockholders' Deficit
Common stock issued under stock plans, net		1,301				1,301
Common stock issued under stock plans, net (in shares)	187
Stock-based compensation		10,184				10,184
Other comprehensive income (loss)			1,650			1,650
Net loss				(34,626)		(34,626)
Balance at Mar. 31, 2023	$ 48	1,008,955	(1,325)	(499,032)	$ (132)	508,514
Balance (in shares) at Mar. 31, 2023	47,969
Treasury Stock, Shares, Ending Balance at Mar. 31, 2023					(28)
Balance at Dec. 31, 2022	$ 48	997,470	(2,975)	(464,406)	$ (132)	530,005
Balance (in shares) at Dec. 31, 2022	47,782
Treasury Stock, Shares, Beginning Balance at Dec. 31, 2022					(28)
Stockholders' Deficit
Other comprehensive income (loss)						3,739
Net loss						(97,882)
Balance at Sep. 30, 2023	$ 49	1,039,266	764	(562,288)	$ (132)	477,659
Balance (in shares) at Sep. 30, 2023	48,748				(28)
Balance at Mar. 31, 2023	$ 48	1,008,955	(1,325)	(499,032)	$ (132)	508,514
Balance (in shares) at Mar. 31, 2023	47,969
Treasury Stock, Shares, Beginning Balance at Mar. 31, 2023					(28)
Stockholders' Deficit
Common stock issued under stock plans, net		(702)				(702)
Common stock issued under stock plans, net (in shares)	444
Acquired in-process R&D acquired through the issuance of common stock		3,000				3,000
Stock-based compensation		9,873				9,873
Other comprehensive income (loss)			938			938
Net loss				(32,812)		(32,812)
Balance at Jun. 30, 2023	$ 48	1,021,126	(387)	(531,844)	$ (132)	488,811
Balance (in shares) at Jun. 30, 2023	48,413
Treasury Stock, Shares, Ending Balance at Jun. 30, 2023					(28)
Stockholders' Deficit
Common stock issued under stock plans, net	$ 1	7,656				7,657
Common stock issued under stock plans, net (in shares)	335
Stock-based compensation		10,484				10,484
Other comprehensive income (loss)			1,151			1,151
Net loss				(30,444)		(30,444)
Balance at Sep. 30, 2023	$ 49	1,039,266	764	(562,288)	$ (132)	477,659
Balance (in shares) at Sep. 30, 2023	48,748				(28)
Balance at Dec. 31, 2023	$ 49	1,059,751	1,165	(599,067)	$ (132)	$ 461,766
Balance (in shares) at Dec. 31, 2023	49,148					49,120
Treasury Stock, Shares, Beginning Balance at Dec. 31, 2023					(28)	(28)
Stockholders' Deficit
Common stock issued under stock plans, net	$ 1	13,364				$ 13,365
Common stock issued under stock plans, net (in shares)	672
Asset acquisition through issuance of common stock		5,000				5,000
Asset acquisition through issuance of common stock (in shares)	55
Stock-based compensation		11,165				11,165
Other comprehensive income (loss)			272			272
Net loss				(40,838)		(40,838)
Balance at Mar. 31, 2024	$ 50	1,089,280	1,437	(639,905)	$ (132)	450,730
Balance (in shares) at Mar. 31, 2024	49,875
Treasury Stock, Shares, Ending Balance at Mar. 31, 2024					(28)
Balance at Dec. 31, 2023	$ 49	1,059,751	1,165	(599,067)	$ (132)	$ 461,766
Balance (in shares) at Dec. 31, 2023	49,148					49,120
Treasury Stock, Shares, Beginning Balance at Dec. 31, 2023					(28)	(28)
Stockholders' Deficit
Other comprehensive income (loss)						$ 1,455
Net loss						(112,792)
Balance at Sep. 30, 2024	$ 55	1,377,825	2,620	(711,859)	$ (132)	$ 668,509
Balance (in shares) at Sep. 30, 2024	55,122				(28)	55,094
Treasury Stock, Shares, Ending Balance at Sep. 30, 2024						(28)
Balance at Mar. 31, 2024	$ 50	1,089,280	1,437	(639,905)	$ (132)	$ 450,730
Balance (in shares) at Mar. 31, 2024	49,875
Treasury Stock, Shares, Beginning Balance at Mar. 31, 2024					(28)
Stockholders' Deficit
Common stock issued under stock plans, net	$ 1	8,818				8,819
Common stock issued under stock plans, net (in shares)	724
Issuance of common stock in exchange for convertible senior notes	$ 4	244,084				244,088
Issuance of common stock in exchange for convertible senior notes (in shares)	4,253
Stock-based compensation		11,313				11,313
Other comprehensive income (loss)			754			754
Net loss				(50,545)		(50,545)
Balance at Jun. 30, 2024	$ 55	1,353,495	2,191	(690,450)	$ (132)	665,159
Balance (in shares) at Jun. 30, 2024	54,852
Treasury Stock, Shares, Ending Balance at Jun. 30, 2024					(28)
Stockholders' Deficit
Common stock issued under stock plans, net		9,910				9,910
Common stock issued under stock plans, net (in shares)	270
Stock-based compensation		14,420				14,420
Other comprehensive income (loss)			429			429
Net loss				(21,409)		(21,409)
Balance at Sep. 30, 2024	$ 55	$ 1,377,825	$ 2,620	$ (711,859)	$ (132)	$ 668,509
Balance (in shares) at Sep. 30, 2024	55,122				(28)	55,094
Treasury Stock, Shares, Ending Balance at Sep. 30, 2024						(28)

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Operating Activities
Net loss	$ (112,792)	$ (97,882)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation	8,181	6,455
Amortization of intangible assets	18,729	18,684
Noncash lease expense	3,194	3,218
Amortization of debt issuance costs	662	1,030
Deferred income tax benefit	(1)	(15)
Loss on disposal of fixed assets	64	881
Stock-based compensation	36,898	30,541
Unrealized foreign currency losses	490	991
Amortization of premium on short-term investments	(3,187)	(1,041)
Other liabilities	4,894	2,231
Acquired in-process R&D acquired through the issuance of common stock	5,000	3,000
Inducement expense related to exchange of convertible senior notes	17,412
Changes in operating assets and liabilities:
Accounts receivable, net	(16,476)	(3,535)
Inventory	(18,161)	(2,903)
Prepaid expenses and other current assets	(318)	(2,355)
Accounts payable and accrued liabilities	(4,406)	(6,149)
Other assets	(2,008)	(244)
Net cash used in operating activities	(61,825)	(47,093)
Investing activities
Purchases of short-term investments	(123,091)	(193,538)
Proceeds from sales and maturities of short-term investments	166,891	238,735
Purchases of property and equipment	(4,567)	(16,034)
Proceeds from disposal of property and equipment	38
Investment in company-owned life insurance	(3,227)	(2,147)
Net cash provided by investing activities	36,044	27,016
Financing activities
Proceeds from exercise of stock options	29,509	6,624
Proceeds from share purchases under Employee Stock Purchase Plan	7,416	6,278
Payment of employee taxes related to vested restricted stock units	(4,833)	(4,646)
Principal paid on finance lease	(665)	(517)
Net cash provided by financing activities	31,427	7,739
Effect of exchange rate changes on cash and cash equivalents	(93)	520
Net increase (decrease) in cash, cash equivalents and restricted cash	5,553	(11,818)
Cash, cash equivalents and restricted cash at beginning of period	99,323	126,603
Cash, cash equivalents and restricted cash at end of period	104,876	114,785
Supplemental disclosures of cash flow information
Taxes paid, net of refunds	1,165	1,218
Interest paid on convertible senior notes	3,953	3,953
Other interest paid	3,393	3,237
Supplemental schedule of noncash investing and financing activities
Convertible senior notes exchanged for common stock, net of debt issuance costs	226,676
Purchases of property and equipment included in accounts payable and accrued liabilities	$ 114	$ 3,201

Organization and Basis of Prese

Organization and Basis of Presentation	9 Months Ended
	Sep. 30, 2024
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 pharmaceutical and medical technology company focused on developing novel dropless platform therapies and commercializing associated products for the treatment of glaucoma, corneal disorders, and retinal diseases. The Company first developed Micro-Invasive Glaucoma Surgery (MIGS) as an alternative to the traditional glaucoma treatment paradigm, launching its first MIGS device commercially in 2012. The Company also offers commercially a proprietary bio-activated pharmaceutical therapy for the treatment of a rare corneal disorder, keratoconus, that was approved by the United States (U.S.) Food and Drug Administration (FDA) in 2016. The Company received FDA approval in December 2023 of its first procedural pharmaceutical product, the iDose TR The accompanying condensed consolidated financial statements include the accounts of Glaukos and its wholly-owned subsidiaries. The Company translates the financial statements of its foreign subsidiaries using end-of-period exchange rates for assets and liabilities and average exchange rates during each reporting period for results of operations. All 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 (GAAP) in the U.S. for interim financial information and pursuant to the instructions to Form 10-Q and Article 10 of Regulation S-X. As permitted by Form 10-Q and Article 10 of Regulation S-X, under those rules, certain footnotes and other financial information that are normally required by GAAP have been condensed or omitted. The unaudited interim financial statements have been prepared on a basis consistent with the audited financial statements. 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, 2023 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, 2023, which are contained in the Company’s Annual Report on Form 10-K filed with the U.S. Securities and Exchange Commission (SEC) on February 23, 2024. The Company’s results of operations for the three and nine months ended September 30, 2024 are not necessarily indicative of the results to be expected for the year ending December 31, 2024 or for any other interim period. Recent developments On June 14, 2024, the Company announced it had entered into separate, privately negotiated exchange agreements (Exchange Agreements) with certain holders of its 2.75% Convertible Senior Notes due 2027 (Convertible Notes), pursuant to which the Company agreed, subject to customary closing conditions, to repurchase an aggregate of $230.0 million principal amount of Convertible Notes for aggregate consideration consisting of a number of shares of the Company’s common stock, par value $0.001 per share, to be determined over an averaging period commencing on June 14, 2024, and cash in lieu of fractional shares and in respect of accrued interest on the Convertible Notes (Convertible Notes Exchange). On June 28, 2024, the Company closed the transactions contemplated by the Exchange Agreements, and the holders exchanged $230.0 million in aggregate principal amount of the Convertible Notes for consideration consisting of an aggregate of 4,253,423 shares of the Company’s common stock, and cash in lieu of fractional shares and in respect of accrued interest on the Convertible Notes. The Company accounted for the Convertible Notes Exchange as an induced conversion based on the nature of the conversion offer and the period of time it was offered. The Company accounted for the Convertible Notes Exchange by expensing the fair value of the common shares that were issued in excess of the original terms of the Convertible Notes. The Company reduced the balance of the Convertible Notes on the condensed consolidated balance sheets by $226.7 million, which is comprised of the reduction in Convertible Notes principal of $230.0 million, less $3.3 million in unamortized debt issuance costs. The Company also recognized a non-cash inducement charge of $17.4 million and direct transaction costs of $0.6 million recorded within charges associated with convertible senior notes on the condensed consolidated statements of operations and increased additional paid-in capital on the condensed consolidated balance sheets of $244.1 million. ​ On May 14, 2024, the Company entered into a License Agreement (License Agreement), pursuant to which the Company obtained an exclusive, worldwide license to develop and commercialize drug products incorporating certain proprietary technology. Per the terms of the License Agreement, the Company made a one-time upfront payment of $2.0 million and may have ongoing milestone and royalty payment obligations depending on the success of the development, regulatory approval and commercialization of the drug products. The Company also made a one-time payment of $0.5 million to obtain an option to license additional rights related to the proprietary technology. Both the $2.0 million upfront payment and the $0.5 million option payment are recorded in acquired in-process research and development (IPR&D) in the condensed consolidated statements of operations. On March 7, 2024, the Company issued $5.0 million of its common stock and paid approximately $5.1 million in cash in connection with the acquisition of 100% of the outstanding equity interests in a clinical stage biopharma company (the Seller) focused on developing novel therapeutics for rare ophthalmic diseases, including all related patents and patent applications, technology and know-how. The Company accounted for the transaction as an asset acquisition as the set of acquired assets did not constitute a business, and the acquisition costs are recorded within acquired in-process research and development on the condensed consolidated statement of operations. Under the terms of the agreement, if these proprietary technologies are commercialized, the Company may have to make potential payments of up to $51.0 million upon the achievement of certain event-based development milestones, potential payments of up to $150.0 million upon the achievement of certain commercial sales-based milestones should annual net sales of a licensed product eventually exceed various levels, and up to a low double digit royalty on net sales. Furthermore, because the first two development milestones are payable in either cash or Company shares at the Company’s sole discretion, the Company has accrued a liability in the amount of $1.5 million related to these two milestones, which is classified as other liabilities within the condensed consolidated balance sheets, as the contingent consideration is not expected to be paid within the next twelve months. See also Note 4, Fair Value Measurements Effective March 17, 2023, the Company entered into a sales agreement (Sales Agreement) with Celanese Canada ULC (Celanese) under which Celanese will make available and supply to the Company certain raw materials used to create a nanoporous membrane utilized in the iDose TR iDose TR iDose TR iDose TR iDose TR

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2024
Summary of Significant Accounting Policies
Summary of Significant Accounting Policies	Note 2. Summary of Significant Accounting Policies Use of Estimates The preparation of the condensed consolidated financial statements in conformity with GAAP requires management to make estimates, judgments 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 used in the preparation of the accompanying condensed consolidated financial statements. ​ ​ 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 statements of cash flows as of the beginning and end of nine months ended September 30, 2024 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ ​ ​ 2024 ​ 2023 ​ Cash and cash equivalents ​ $ 100,143 ​ $ 93,467 ​ Restricted cash ​ ​ 4,733 ​ ​ 5,856 ​ Cash, cash equivalents and restricted cash ​ $ 104,876 ​ $ 99,323 ​ ​ The Company’s cash and cash equivalents include cash in readily available checking and money market accounts, as well as certificates of deposit. The Company maintains balances of cash and cash equivalents at one or more financial institutions that are in excess of federally insured limits. Recently Adopted Accounting Pronouncements The Company has not adopted any recent accounting pronouncements that had a material impact on its condensed consolidated financial statements. Recently Issued Accounting Pronouncements Not Yet Adopted In December 2023, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures In November 2023, the FASB issued ASU No. 2023-07, Improvements to Reportable Segments Disclosures

Balance Sheet Details

Balance Sheet Details	9 Months Ended
	Sep. 30, 2024
Balance Sheet Details
Balance Sheet Details	Note 3. Balance Sheet Details Short-term Investments Short-term investments consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At September 30, 2024 ​ ​ Maturity ​ Amortized cost ​ Unrealized ​ Unrealized ​ Estimated ​ (in years) or cost gains losses fair value U.S. treasury securities ​ less than 2 ​ $ 122,436 ​ $ 495 ​ $ (12) ​ $ 122,919 ​ Bank certificates of deposit ​ less than 2 ​ ​ 6,420 ​ ​ 10 ​ ​ - ​ ​ 6,430 ​ Corporate notes ​ less than 3 ​ 18,862 ​ 201 ​ (31) ​ 19,032 ​ Asset-backed securities ​ less than 2 ​ 10,932 ​ 24 ​ (36) ​ 10,920 ​ Municipal bonds ​ less than 3 ​ ​ 3,010 ​ ​ 19 ​ ​ - ​ ​ 3,029 ​ Total ​ ​ ​ $ 161,660 ​ $ 749 ​ $ (79) ​ $ 162,330 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At December 31, 2023 ​ ​ Maturity ​ Amortized cost ​ Unrealized ​ Unrealized ​ Estimated ​ (in years) or cost gains losses fair value U.S. government agency bonds ​ less than 3 ​ $ 25,995 ​ $ 2 ​ $ (347) ​ $ 25,650 ​ U.S. treasury securities ​ less than 2 ​ ​ 124,780 ​ ​ 274 ​ ​ (36) ​ ​ 125,018 ​ Bank certificates of deposit ​ less than 1 ​ ​ 7,100 ​ ​ 9 ​ ​ - ​ ​ 7,109 ​ Commercial paper ​ less than 1 ​ 5,679 ​ 4 ​ (1) ​ 5,682 ​ Corporate notes ​ less than 3 ​ 21,292 ​ 77 ​ (229) ​ 21,140 ​ Asset-backed securities ​ less than 2 ​ 12,415 ​ 41 ​ (135) ​ 12,321 ​ Municipal bonds ​ less than 3 ​ ​ 5,010 ​ ​ 34 ​ ​ - ​ ​ 5,044 ​ Total ​ ​ ​ $ 202,271 ​ $ 441 ​ $ (748) ​ $ 201,964 ​ ​ At each reporting date, the Company performs an evaluation of impairment to determine if any unrealized losses are the result of credit losses. Impairment is assessed at the individual security level. Factors considered in determining whether a loss resulted from a credit loss or other factors include the Company’s intent and ability to hold the investment until the recovery of its amortized cost basis, the extent to which the fair value is less than the amortized cost basis, the length of time and extent to which fair value has been less than the cost basis, the financial condition of the issuer, any historical failure of the issuer to make scheduled interest or principal payments, any changes to the rating of the security by a rating agency, any adverse legal or regulatory events affecting the issuer or issuer’s industry, and any significant deterioration in economic conditions. The credit-related portion of unrealized losses, and any subsequent improvements, are recorded in interest expense in the condensed consolidated statements of operations through an allowance for credit losses. Unrealized gains and losses that are not credit-related are included in accumulated other comprehensive loss. Unrealized losses on available-for-sale debt securities as of September 30, 2024 and December 31, 2023 were not significant and were primarily due to changes in interest rates, including market credit spreads, and not due to increased credit risks associated with specific securities. Further, the Company does not intend to sell these investments prior to maturity and it is not more likely than not that the Company will be required to sell these investments before recovery of their amortized cost basis. Accordingly, the Company did not record an allowance for credit losses with these investments as of September 30, 2024 and December 31, 2023. Accounts Receivable, Net Accounts receivable consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ ​ 2024 2023 Accounts receivable ​ $ 57,627 ​ $ 41,051 ​ Allowance for credit losses ​ ​ (1,219) ​ ​ (1,201) ​ ​ ​ $ 56,408 ​ $ 39,850 ​ ​ The Company’s allowance for credit losses represents management’s estimate of current expected credit losses related to customer receivables. There were immaterial bad-debt write offs charged during the nine months ended September 30, 2024. ​ Additionally, no customers accounted for more than 10% of net accounts receivable as of September 30, 2024 or December 31, 2023. Inventory Inventory consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ ​ 2024 2023 Finished goods ​ $ 26,868 ​ $ 16,699 ​ Work in process ​ ​ 14,836 ​ ​ 12,870 ​ Raw material ​ ​ 18,191 ​ ​ 12,417 ​ ​ ​ $ 59,895 ​ $ 41,986 ​ ​ Accrued Liabilities Accrued liabilities consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ 2024 2023 Accrued bonuses ​ $ 15,646 ​ $ 20,588 Accrued payroll taxes ​ ​ 1,941 ​ ​ 2,365 Accrued vacation benefits ​ ​ 5,685 ​ ​ 5,269 Accrued sales rebates ​ ​ 13,297 ​ ​ 8,935 Other accrued liabilities ​ ​ 24,012 ​ ​ 23,417 ​ ​ $ 60,581 ​ $ 60,574 ​

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2024
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 September 30, 2024 and December 31, 2023 and indicate the fair value hierarchy of the valuation techniques utilized by the Company to determine such fair value (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At September 30, 2024 ​ ​ ​ ​ ​ Quoted prices ​ Significant ​ ​ ​ ​ ​ ​ ​ in active ​ other ​ Significant ​ ​ ​ ​ ​ markets for ​ observable ​ unobservable ​ ​ September 30, ​ identical assets ​ inputs ​ inputs ​ 2024 (Level 1) (Level 2) (Level 3) Assets ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash equivalents: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Money market funds (i) ​ $ 44,519 ​ $ 44,519 ​ $ - ​ $ - Available for sale securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ U.S. treasury securities (ii)(v) ​ ​ 132,200 ​ ​ - ​ ​ 132,200 ​ ​ - Commercial paper (ii) ​ ​ - ​ ​ - ​ ​ - ​ ​ - Bank certificates of deposit (ii) ​ ​ 6,430 ​ ​ - ​ ​ 6,430 ​ ​ - Corporate notes (ii) ​ ​ 19,032 ​ ​ - ​ ​ 19,032 ​ ​ - Asset-backed securities (ii) ​ ​ 10,920 ​ ​ - ​ ​ 10,920 ​ ​ - Municipal bonds (ii) ​ ​ 3,029 ​ ​ - ​ ​ 3,029 ​ ​ - Investments held for deferred compensation plans (iii) ​ ​ 14,816 ​ ​ - ​ ​ 14,816 ​ ​ - Total Assets ​ $ 230,946 ​ $ 44,519 ​ $ 186,427 ​ $ - Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Deferred compensation plans (iv) ​ $ 14,559 ​ $ - ​ $ 14,559 ​ $ - Contingent consideration (iv) ​ $ 1,500 ​ $ - ​ $ - ​ $ 1,500 Total Liabilities ​ $ 16,059 ​ $ - ​ $ 14,559 ​ $ 1,500 ​ (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) Included in deposits and other assets on the condensed consolidated balance sheets. (iv) Included in other liabilities on the condensed consolidated balance sheets. (v) One U.S. treasury security totaling $9,281 (in thousands) is included in cash and cash equivalents on the consolidated balance sheets, as the investment has a maturity of three months or less from the date of purchase on the consolidated balance sheets. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At December 31, 2023 ​ ​ ​ ​ ​ Quoted prices ​ Significant ​ ​ ​ ​ ​ ​ ​ in active ​ other ​ Significant ​ ​ ​ ​ ​ markets for ​ observable ​ unobservable ​ ​ December 31, ​ identical assets ​ inputs ​ inputs ​ 2023 (Level 1) (Level 2) (Level 3) Assets ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash equivalents: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Money market funds (i) ​ $ 52,156 ​ $ 52,156 ​ $ - ​ $ - Available for sale securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ U.S. government agency bonds (ii) ​ $ 25,650 ​ $ - ​ $ 25,650 ​ $ - U.S. treasury securities (ii) ​ ​ 125,018 ​ ​ - ​ ​ 125,018 ​ ​ - Commercial paper (ii) ​ ​ 5,682 ​ ​ - ​ ​ 5,682 ​ ​ - Bank certificates of deposit (ii) ​ ​ 7,109 ​ ​ - ​ ​ 7,109 ​ ​ - Corporate notes (ii) ​ ​ 21,140 ​ ​ - ​ ​ 21,140 ​ ​ - Asset-backed securities (ii) ​ ​ 12,321 ​ ​ - ​ ​ 12,321 ​ ​ - Municipal bonds (ii) ​ ​ 5,044 ​ ​ - ​ ​ 5,044 ​ ​ - Investments held for deferred compensation plans (iii) ​ ​ 11,589 ​ ​ - ​ ​ 11,589 ​ ​ - Total Assets ​ $ 265,709 ​ $ 52,156 ​ $ 213,553 ​ $ - Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Deferred compensation plans (iv) ​ $ 11,294 ​ $ - ​ $ 11,294 ​ $ - Total Liabilities ​ $ 11,294 ​ $ - ​ $ 11,294 ​ $ - (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) Included in deposits and other assets on the condensed consolidated balance sheets. (iv) Included in other liabilities on the condensed consolidated balance sheets. ​ Money market funds 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. treasury securities, 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. The Company recorded a contingent consideration liability upon the asset acquisition described in Recent Developments within Note 1, Organization and Basis of Presentation There were no transfers between levels within the fair value hierarchy during the periods presented. The Company did Convertible Senior Notes As of September 30, 2024 and December 31, 2023, the fair value of the Convertible Notes was $135.3 million and $444.0 million, respectively. 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 1, Organization and Basis of Presentation Note 9, Convertible Senior Notes

Leases

Leases	9 Months Ended
	Sep. 30, 2024
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 expensed and not recorded on the condensed consolidated balance sheet. Lease expense for operating leases is recognized on a straight-line basis over the lease term. The Company’s leases have non-cancelable lease terms of approximately one year to thirteen years, some of which include options to extend the leases for up to ten years. The exercise of lease renewal options is at the Company’s sole discretion. In certain of the Company’s lease agreements, the rental payments are adjusted periodically to reflect actual charges incurred for common area maintenance, landlord incentives and/or inflation. The Company’s office building lease in Aliso Viejo, California (Aliso Facility) is one property containing three existing office buildings, comprising approximately 160,000 rentable square feet of space, which was accounted for as a finance lease. The term of the Aliso Facility commenced on April 1, 2019 for expense recognition and continues for thirteen years. The lease agreement contains an option to extend the lease for two additional five year periods at market rates. The Company also leases two adjacent buildings, two office suites and a warehouse located in San Clemente, California and a facility in Burlington, Massachusetts. The total leased square footage of the San Clemente facilities equals approximately 120,000 and the two most significant leases expire on May 31, 2030. Each of these two leases contain an option to extend the lease for one additional five-year period at market rates. The total leased square footage of the Burlington facility is approximately 60,000 square feet, and the lease expires on July 31, 2033. The Burlington facility lease contains an option to extend the lease for one additional five-year period at market rates. The Company’s remaining foreign subsidiaries’ leased office and warehouse space totals less than 35,000 square feet. The following table presents the maturity of the Company’s operating and finance lease liabilities within the condensed consolidated balance sheets: ​ ​ ​ ​ ​ ​ ​ ​ ​ Maturity of Lease Liabilities ​ Operating ​ Finance (in thousands) Leases (a) ​ Leases (b) Remainder of 2024 ​ $ 1,018 ​ $ 1,306 2025 ​ ​ 4,034 ​ ​ 5,340 2026 ​ ​ 4,034 ​ ​ 5,500 2027 ​ ​ 4,074 ​ ​ 5,665 2028 ​ ​ 4,152 ​ ​ 5,835 2029 ​ ​ 4,222 ​ ​ 6,010 Thereafter ​ ​ 29,346 ​ ​ 90,060 Total lease payments ​ $ 50,880 ​ $ 119,716 Less: imputed interest ​ ​ 18,681 ​ ​ 48,919 Total lease liabilities ​ $ 32,199 ​ $ 70,797 (a) Operating lease payments include $ 23.2 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	9 Months Ended
	Sep. 30, 2024
Intangible Assets and Goodwill
Intangible Assets and Goodwill	Note 6. Intangible Assets and Goodwill Intangible assets For the three months ended September 30, 2024 and September 30, 2023, amortization expense related to the Company’s finite-lived intangible assets was approximately $5.5 million and $0.7 million, respectively, recorded in cost of sales and selling, general and administrative expenses, respectively, in the condensed consolidated statements of operations and for the nine months ended September 30, 2024 and September 30, 2023, amortization expense related to the Company’s finite-lived intangible assets was approximately $16.6 million and $2.1 million, respectively, recorded in cost of sales and selling, general and administrative expenses, respectively, in the condensed consolidated statements of operations. The Company evaluated its indefinite-lived intangible assets for impairment and concluded there were no indicators of impairment as of September 30, 2024. 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 and its impact on the Company’s reporting unit. ​ The following table presents the composition of the Company’s intangible assets and goodwill (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ As of September 30, 2024 ​ As of December 31, 2023 ​ ​ Average ​ Gross ​ ​ ​ ​ ​ Gross ​ ​ ​ ​ ​ ​ Amortization ​ Carrying ​ Accumulated ​ Net ​ Carrying ​ Accumulated ​ Net ​ Period (in years) Amount Amortization Amount Amount Amortization Amount Developed technology ​ 11.4 ​ $ 252,200 ​ $ (107,238) ​ $ 144,962 ​ $ 252,200 ​ $ (90,670) ​ $ 161,530 Customer relationships ​ 5.0 ​ ​ 14,100 ​ ​ (13,689) ​ ​ 411 ​ ​ 14,100 ​ ​ (11,574) ​ ​ 2,526 License ​ 4.0 ​ ​ 5,190 ​ ​ (45) ​ ​ 5,145 ​ ​ - ​ ​ - ​ ​ - Intangible assets subject to amortization ​ ​ ​ ​ 271,490 ​ ​ (120,972) ​ ​ 150,518 ​ ​ 266,300 ​ ​ (102,244) ​ ​ 164,056 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ In-process research and development ​ Indefinite ​ $ 118,900 ​ $ - ​ $ 118,900 ​ $ 118,900 ​ $ - ​ $ 118,900 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ ​ ​ $ 390,390 ​ $ (120,972) ​ $ 269,418 ​ $ 385,200 ​ $ (102,244) ​ $ 282,956 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Goodwill ​ Indefinite ​ $ 66,134 ​ $ - ​ $ 66,134 ​ $ 66,134 ​ $ - ​ $ 66,134 ​ As of September 30, 2024, 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 2024 ​ $ 5,970 2025 ​ ​ 22,979 2026 ​ ​ 23,736 2027 ​ ​ 24,312 2028 ​ ​ 21,896 Thereafter ​ ​ 51,625 Total amortization ​ $ 150,518 ​ 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	9 Months Ended
	Sep. 30, 2024
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 its iStent Photrexa iDose TR The Company concluded that one performance obligation exists for the majority of its contracts with customers which is to deliver products in accordance with the Company’s normal delivery times. Revenue is recognized when this performance obligation is satisfied, which is the point in time when the Company considers control of a product to have transferred to the customer. Revenue recognized reflects the consideration to which the Company expects to be entitled in exchange for those products or services. The Company has determined the transaction price to be the invoice price, net of adjustments that reduce revenue, which included estimates of commercial and governmental rebates owed, variable consideration for product returns and warranty replacements and other discounts and incentives that reduce revenue. Our process for estimating reserves established for these variable consideration components does not differ materially from historical practices. The transaction price, which includes variable consideration reflecting the impact of discounts and allowances, may be subject to constraint and is included in the net sales price only to the extent that it is probable that a significant reversal of the amount of the cumulative revenue recognized will not occur in a future period. Actual amounts may ultimately differ from our estimates. If actual results vary, we adjust these estimates, which could have an effect on earnings in the period of adjustment. ​ ​ Revenue is recognized at an amount that reflects the consideration the Company expects to be entitled to in exchange for goods or services, and substantially all of the Company’s net sales for the three and nine months ended September 30, 2024 are considered revenue from contracts with customers. Disaggregation of Revenue ​ The Company’s revenues disaggregated by product category and geography for the three and nine months ended September 30, 2024 and September 30, 2023 were as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ ​ September 30, ​ ​ United States ​ International ​ Total ​ 2024 ​ 2023 2024 ​ 2023 2024 ​ 2023 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Glaucoma ​ $ 51,565 ​ $ 38,060 ​ $ 24,467 ​ $ 20,280 $ 76,032 ​ $ 58,340 Corneal Health ​ ​ 18,452 ​ 17,338 ​ ​ 2,186 ​ 2,370 ​ ​ 20,638 ​ 19,708 Total ​ $ 70,017 ​ $ 55,398 ​ $ 26,653 ​ $ 22,650 $ 96,670 ​ $ 78,048 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ ​ September 30, ​ ​ United States ​ International ​ Total ​ 2024 ​ 2023 2024 ​ 2023 2024 ​ 2023 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Glaucoma ​ $ 143,297 ​ $ 112,765 ​ $ 75,836 ​ $ 63,703 $ 219,133 ​ $ 176,468 Corneal Health ​ ​ 51,228 ​ 48,227 ​ ​ 7,621 ​ 7,651 ​ ​ 58,849 ​ 55,878 Total ​ $ 194,525 ​ $ 160,992 ​ $ 83,457 ​ $ 71,354 $ 277,982 ​ $ 232,346 ​ 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 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 September 30, 2024 and December 31, 2023, substantially all amounts included in accounts receivable, net on the condensed consolidated balance sheets are related to contracts with customers. ​ 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 products are expensed within selling, general and administrative expenses within the condensed consolidated statements 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 performance obligations to issue volume-based rebates to eligible commercial and governmental entities that may be eligible for a rebate at the conclusion of their contract terms. These performance obligations are 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. Additionally, effective in the first quarter 2024, certain product sales, primarily the Company’s pharmaceutical products made under governmental pricing programs in the U.S., are subject to rebates under the Medicaid Drug Rebate Program (MDRP). The rebate accrual calculation requires management to project the volume of net sales that will be subject to these rebates. There is a significant time-lag in receiving rebate notices from each state (generally, several months or longer after a sale is recognized). Estimated MDRP rebates are recorded as a reduction of revenue in the period the related sale is recognized and were not material for the three and nine months ended September 30, 2024. The Company’s total volume-based and MDRP allowances are included in accrued liabilities in the condensed consolidated balance sheets and totaled $13.3 million and $8.9 million as of September 30, 2024 and December 31, 2023, respectively, as detailed below: ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months ​ ​ ​ ​ Ended ​ ​ ​ September 30, ​ ​ 2024 ​ Sales rebate balance, January 1, 2024 ​ $ 8,935 ​ Current period provision ​ ​ 9,280 ​ Payments and credits ​ ​ (4,918) ​ Reserve balance, September 30, 2024 ​ $ 13,297 ​ ​ During the three and nine months ended September 30, 2024 and September 30, 2023, 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	9 Months Ended
	Sep. 30, 2024
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). Due to the Company’s net loss position, basic and diluted net loss per share for each of the three and nine months ended September 30, 2024 and September 30, 2023 are the same. The following potentially dilutive securities were not included in the calculation of diluted net loss per share because to do so would be anti-dilutive (in common stock equivalent shares, in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ 2024 2023 2024 2023 ​ Convertible senior notes ​ 1,025 ​ 5,125 ​ 1,025 ​ 5,125 ​ Stock options outstanding ​ 2,349 ​ 2,492 ​ 2,294 ​ 2,574 ​ Unvested restricted stock units ​ 977 ​ 748 ​ 968 ​ 676 ​ Employee stock purchase plan ​ 5 ​ 9 ​ 2 ​ 1 ​ ​ ​ 4,356 ​ 8,374 ​ 4,289 ​ 8,376 ​ ​

Convertible Senior Notes

Convertible Senior Notes	9 Months Ended
	Sep. 30, 2024
Convertible Senior Notes
Convertible Senior Notes	​ Note 9. Convertible Senior Notes The Company accounts for its convertible senior notes as a single unit of accounting, a liability, because the Company concluded that there were no material conversion features that require bifurcation as a derivative and its convertible debt instruments were not issued at a substantial premium. 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. 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. As described in Recent Developments , the Company executed a Convertible Notes Exchange in June 2024, whereby certain of the above-mentioned qualified institutional investors exchanged approximately $230.0 million in aggregate principal of Convertible Notes held for an aggregate of 4,253,423 shares of the Company’s common stock, leaving approximately $57.5 million aggregate principal amount of remaining Convertible Notes outstanding As of September 30, 2024, one of the conditions allowing holders of the Convertible Notes to convert had been met. The trading price of the Company’s common stock remained above 130% of the applicable $56.10 conversion price for at least 20 trading days during the 30 consecutive trading-day period ending on, and including, September 30, 2024 resulting in the right of holders of the Convertible Notes to convert their Convertible Notes beginning October 1, 2024 through December 31, 2024. The remaining Convertible Notes outstanding will mature on June 15, 2027, unless earlier converted, redeemed or repurchased in accordance with their terms. On October 4, 2024, the Company issued a notice of redemption (Redemption Notice) for the $57.5 million aggregate principal amount outstanding of its Convertible Notes (the Redemption). The Convertible Notes that are called for redemption may be converted by holders into Shares pursuant to physical settlement. The conversion rate for the Convertible Notes is 17.8269 Shares per $1,000 principal amount, plus additional Shares of 0.3501 per $1,000 principal amount. The Convertible Notes are therefore convertible into 18.1770 Shares per $1,000 principal amount surrendered for conversion thereunder. ​ Pursuant to the Redemption Notice, on December 16, 2024 (the Redemption Date), the Company will redeem all Convertible Notes that have not been converted prior to such date at a redemption price equal to 100% of the principal amount of such Convertible Notes (Redemption Price) together with accrued and unpaid interest from December 1, 2024 to, but excluding, the Redemption Date. On the Redemption Date, the Redemption Price will become due and payable upon each Convertible Note to be redeemed and interest thereon will cease to accrue on and after the Redemption Date. ​ Interest expense relating to the Convertible Notes in the condensed consolidated statements of operations for the three and nine months ended September 30, 2024 and September 30, 2023 is summarized as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ ​ September 30, ​ 2024 2023 Contractual interest expense ​ $ 395 ​ $ 1,977 Amortization of debt issuance costs ​ ​ 67 ​ ​ 343 Total interest expense ​ $ 462 ​ $ 2,320 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine months ended ​ ​ September 30, ​ 2024 2023 Contractual interest expense ​ $ 4,590 ​ $ 5,930 Amortization of debt issuance costs ​ ​ 662 ​ ​ 1,030 Total interest expense ​ $ 5,252 ​ $ 6,960 ​ The effective interest rate on the Convertible Notes for the three and nine months ended September 30, 2024 and September 30, 2023 was 3.2% . ​ As of September 30, 2024 and December 31, 2023, the Convertible 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 ​ ​ September 30, ​ December 31, ​ 2024 2023 Convertible Notes ​ $ 57,500 ​ $ 287,500 Less: Unamortized debt issuance costs ​ ​ (741) ​ ​ (4,727) Carrying amount of Convertible Notes ​ $ 56,759 ​ $ 282,773 ​ 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 consolidated balance sheets and will not be remeasured to fair value as long as the accounting criteria continue to be met. As of September 30, 2024, the Company had not purchased any shares under the capped call transactions.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2024
Stock-Based Compensation
Stock-Based Compensation	Note 10. Stock-Based Compensation The following table summarizes the allocation of stock-based compensation related to stock options and RSUs in the accompanying condensed consolidated statements of operations (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ ​ 2024 2023 2024 2023 Cost of sales ​ $ 863 ​ $ 591 ​ $ 2,427 ​ $ 1,579 ​ Selling, general and administrative ​ ​ 9,670 ​ ​ 6,802 ​ ​ 23,957 ​ ​ 19,868 ​ Research and development ​ ​ 3,887 ​ ​ 3,091 ​ ​ 10,514 ​ ​ 9,094 ​ Total ​ $ 14,420 ​ $ 10,484 ​ $ 36,898 ​ $ 30,541 ​ ​ ​ At September 30, 2024, the total unamortized stock-based compensation expense was approximately $83.9 million, of which $8.6 million and $75.3 million was attributable to stock options and RSUs, respectively. The Company currently issues its annual stock option and RSU grants to eligible employees during the second quarter of each year. Of the $8.6 million related to stock options, $8.3 million is attributable to time-based stock options and will be recognized over the time-based stock options’ remaining vesting terms of approximately 4.0 years (2.6 years on a weighted average basis). The remaining $0.3 million is attributable to performance-based options and will be recognized over the performance-based stock options’ remaining vesting terms of less than one year (0.9 years on a weighted average basis). Of the $75.3 million related to RSUs, $74.7 million is attributable to time-based RSUs and will be recognized over the RSUs’ vesting terms of approximately 4.0 years (2.7 years on a weighted-average basis). The remaining $0.6 million is attributable to performance-based RSUs and will be recognized over the performance-based RSUs’ remaining vesting terms of less than two years (1.7 years on a weighted average basis). The total stock-based compensation cost capitalized in inventory was not material for the three and nine months ended September 30, 2024 and September 30, 2023.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2024
Income Taxes
Income Taxes	Note 11. Income Taxes The provision for income taxes is determined using an effective tax rate. For the three and nine months ended September 30, 2024, the Company’s estimated effective tax rate of (0.83)% and (0.79)%, respectively, was lower than the U.S. federal statutory rate primarily due to the generation of U.S. net operating loss (NOL) and R&D tax credit carryforwards that 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 that 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, expansion of the Company’s taxable presence in domestic and foreign markets, and the amount of valuation allowances against deferred tax assets. For the three and nine months ended September 30, 2024, the Company recorded a provision for income taxes of $0.2 million and $0.9 million, respectively. For the three and nine months ended September 30, 2023, the Company recorded a provision for income taxes of $0.1 ​ 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 September 30, 2024 and December 31, 2023, the Company had gross unrecognized tax benefits of $35.3 million and $32.8 million, respectively. ​ ​

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies.
Commitments and Contingencies	Note 12. Commitments and Contingencies Secured Letters of Credit The Company has a letter of credit 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 $4.7 million as of September 30, 2024 and $5.9 million as of December 31, 2023, respectively. Beginning May 2022 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. ​ 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 $14.6 million and $11.3 million as of September 30, 2024 and December 31, 2023, 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 $14.8 million and $11.6 million as of September 30, 2024 and December 31, 2023, respectively.

Business Segment Information

Business Segment Information	9 Months Ended
	Sep. 30, 2024
Business Segment Information
Business Segment Information	Note 13. Business Segment Information The Company has one business activity and operates as one operating segment: the development and commercialization of ophthalmic therapies designed to treat glaucoma, corneal disorders and retinal diseases. 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

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2024
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 (GAAP) in the U.S. for interim financial information and pursuant to the instructions to Form 10-Q and Article 10 of Regulation S-X. As permitted by Form 10-Q and Article 10 of Regulation S-X, under those rules, certain footnotes and other financial information that are normally required by GAAP have been condensed or omitted. The unaudited interim financial statements have been prepared on a basis consistent with the audited financial statements. 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, 2023 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, 2023, which are contained in the Company’s Annual Report on Form 10-K filed with the U.S. Securities and Exchange Commission (SEC) on February 23, 2024. The Company’s results of operations for the three and nine months ended September 30, 2024 are not necessarily indicative of the results to be expected for the year ending December 31, 2024 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, judgments 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 used in the preparation of the accompanying condensed consolidated financial statements. ​
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 statements of cash flows as of the beginning and end of nine months ended September 30, 2024 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ ​ ​ 2024 ​ 2023 ​ Cash and cash equivalents ​ $ 100,143 ​ $ 93,467 ​ Restricted cash ​ ​ 4,733 ​ ​ 5,856 ​ Cash, cash equivalents and restricted cash ​ $ 104,876 ​ $ 99,323 ​ ​ The Company’s cash and cash equivalents include cash in readily available checking and money market accounts, as well as certificates of deposit. The Company maintains balances of cash and cash equivalents at one or more financial institutions that are in excess of federally insured limits.
Recently Adopted Accounting Pronouncements and Recently Issued Accounting Pronouncements Not Yet Adopted	Recently Adopted Accounting Pronouncements The Company has not adopted any recent accounting pronouncements that had a material impact on its condensed consolidated financial statements. Recently Issued Accounting Pronouncements Not Yet Adopted In December 2023, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures In November 2023, the FASB issued ASU No. 2023-07, Improvements to Reportable Segments Disclosures

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2024
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 statements of cash flows as of the beginning and end of nine months ended September 30, 2024 (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ ​ ​ 2024 ​ 2023 ​ Cash and cash equivalents ​ $ 100,143 ​ $ 93,467 ​ Restricted cash ​ ​ 4,733 ​ ​ 5,856 ​ Cash, cash equivalents and restricted cash ​ $ 104,876 ​ $ 99,323 ​

Balance Sheet Details (Tables)

Balance Sheet Details (Tables)	9 Months Ended
	Sep. 30, 2024
Balance Sheet Details
Schedule of short-term investments	Short-term investments consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At September 30, 2024 ​ ​ Maturity ​ Amortized cost ​ Unrealized ​ Unrealized ​ Estimated ​ (in years) or cost gains losses fair value U.S. treasury securities ​ less than 2 ​ $ 122,436 ​ $ 495 ​ $ (12) ​ $ 122,919 ​ Bank certificates of deposit ​ less than 2 ​ ​ 6,420 ​ ​ 10 ​ ​ - ​ ​ 6,430 ​ Corporate notes ​ less than 3 ​ 18,862 ​ 201 ​ (31) ​ 19,032 ​ Asset-backed securities ​ less than 2 ​ 10,932 ​ 24 ​ (36) ​ 10,920 ​ Municipal bonds ​ less than 3 ​ ​ 3,010 ​ ​ 19 ​ ​ - ​ ​ 3,029 ​ Total ​ ​ ​ $ 161,660 ​ $ 749 ​ $ (79) ​ $ 162,330 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At December 31, 2023 ​ ​ Maturity ​ Amortized cost ​ Unrealized ​ Unrealized ​ Estimated ​ (in years) or cost gains losses fair value U.S. government agency bonds ​ less than 3 ​ $ 25,995 ​ $ 2 ​ $ (347) ​ $ 25,650 ​ U.S. treasury securities ​ less than 2 ​ ​ 124,780 ​ ​ 274 ​ ​ (36) ​ ​ 125,018 ​ Bank certificates of deposit ​ less than 1 ​ ​ 7,100 ​ ​ 9 ​ ​ - ​ ​ 7,109 ​ Commercial paper ​ less than 1 ​ 5,679 ​ 4 ​ (1) ​ 5,682 ​ Corporate notes ​ less than 3 ​ 21,292 ​ 77 ​ (229) ​ 21,140 ​ Asset-backed securities ​ less than 2 ​ 12,415 ​ 41 ​ (135) ​ 12,321 ​ Municipal bonds ​ less than 3 ​ ​ 5,010 ​ ​ 34 ​ ​ - ​ ​ 5,044 ​ Total ​ ​ ​ $ 202,271 ​ $ 441 ​ $ (748) ​ $ 201,964 ​
Schedule of accounts receivable, net	Accounts receivable consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ ​ 2024 2023 Accounts receivable ​ $ 57,627 ​ $ 41,051 ​ Allowance for credit losses ​ ​ (1,219) ​ ​ (1,201) ​ ​ ​ $ 56,408 ​ $ 39,850 ​
Schedule of inventory	Inventory consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ ​ 2024 2023 Finished goods ​ $ 26,868 ​ $ 16,699 ​ Work in process ​ ​ 14,836 ​ ​ 12,870 ​ Raw material ​ ​ 18,191 ​ ​ 12,417 ​ ​ ​ $ 59,895 ​ $ 41,986 ​
Schedule of accrued liabilities	Accrued liabilities consisted of the following (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ September 30, ​ December 31, ​ 2024 2023 Accrued bonuses ​ $ 15,646 ​ $ 20,588 Accrued payroll taxes ​ ​ 1,941 ​ ​ 2,365 Accrued vacation benefits ​ ​ 5,685 ​ ​ 5,269 Accrued sales rebates ​ ​ 13,297 ​ ​ 8,935 Other accrued liabilities ​ ​ 24,012 ​ ​ 23,417 ​ ​ $ 60,581 ​ $ 60,574 ​

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2024
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 September 30, 2024 and December 31, 2023 and indicate the fair value hierarchy of the valuation techniques utilized by the Company to determine such fair value (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At September 30, 2024 ​ ​ ​ ​ ​ Quoted prices ​ Significant ​ ​ ​ ​ ​ ​ ​ in active ​ other ​ Significant ​ ​ ​ ​ ​ markets for ​ observable ​ unobservable ​ ​ September 30, ​ identical assets ​ inputs ​ inputs ​ 2024 (Level 1) (Level 2) (Level 3) Assets ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash equivalents: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Money market funds (i) ​ $ 44,519 ​ $ 44,519 ​ $ - ​ $ - Available for sale securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ U.S. treasury securities (ii)(v) ​ ​ 132,200 ​ ​ - ​ ​ 132,200 ​ ​ - Commercial paper (ii) ​ ​ - ​ ​ - ​ ​ - ​ ​ - Bank certificates of deposit (ii) ​ ​ 6,430 ​ ​ - ​ ​ 6,430 ​ ​ - Corporate notes (ii) ​ ​ 19,032 ​ ​ - ​ ​ 19,032 ​ ​ - Asset-backed securities (ii) ​ ​ 10,920 ​ ​ - ​ ​ 10,920 ​ ​ - Municipal bonds (ii) ​ ​ 3,029 ​ ​ - ​ ​ 3,029 ​ ​ - Investments held for deferred compensation plans (iii) ​ ​ 14,816 ​ ​ - ​ ​ 14,816 ​ ​ - Total Assets ​ $ 230,946 ​ $ 44,519 ​ $ 186,427 ​ $ - Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Deferred compensation plans (iv) ​ $ 14,559 ​ $ - ​ $ 14,559 ​ $ - Contingent consideration (iv) ​ $ 1,500 ​ $ - ​ $ - ​ $ 1,500 Total Liabilities ​ $ 16,059 ​ $ - ​ $ 14,559 ​ $ 1,500 ​ (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) Included in deposits and other assets on the condensed consolidated balance sheets. (iv) Included in other liabilities on the condensed consolidated balance sheets. (v) One U.S. treasury security totaling $9,281 (in thousands) is included in cash and cash equivalents on the consolidated balance sheets, as the investment has a maturity of three months or less from the date of purchase on the consolidated balance sheets. ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ At December 31, 2023 ​ ​ ​ ​ ​ Quoted prices ​ Significant ​ ​ ​ ​ ​ ​ ​ in active ​ other ​ Significant ​ ​ ​ ​ ​ markets for ​ observable ​ unobservable ​ ​ December 31, ​ identical assets ​ inputs ​ inputs ​ 2023 (Level 1) (Level 2) (Level 3) Assets ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Cash equivalents: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Money market funds (i) ​ $ 52,156 ​ $ 52,156 ​ $ - ​ $ - Available for sale securities: ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ U.S. government agency bonds (ii) ​ $ 25,650 ​ $ - ​ $ 25,650 ​ $ - U.S. treasury securities (ii) ​ ​ 125,018 ​ ​ - ​ ​ 125,018 ​ ​ - Commercial paper (ii) ​ ​ 5,682 ​ ​ - ​ ​ 5,682 ​ ​ - Bank certificates of deposit (ii) ​ ​ 7,109 ​ ​ - ​ ​ 7,109 ​ ​ - Corporate notes (ii) ​ ​ 21,140 ​ ​ - ​ ​ 21,140 ​ ​ - Asset-backed securities (ii) ​ ​ 12,321 ​ ​ - ​ ​ 12,321 ​ ​ - Municipal bonds (ii) ​ ​ 5,044 ​ ​ - ​ ​ 5,044 ​ ​ - Investments held for deferred compensation plans (iii) ​ ​ 11,589 ​ ​ - ​ ​ 11,589 ​ ​ - Total Assets ​ $ 265,709 ​ $ 52,156 ​ $ 213,553 ​ $ - Liabilities ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Deferred compensation plans (iv) ​ $ 11,294 ​ $ - ​ $ 11,294 ​ $ - Total Liabilities ​ $ 11,294 ​ $ - ​ $ 11,294 ​ $ - (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) Included in deposits and other assets on the condensed consolidated balance sheets. (iv) Included in other liabilities on the condensed consolidated balance sheets. ​

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2024
Leases
Schedule of maturity of lease liability	​ ​ ​ ​ ​ ​ ​ Maturity of Lease Liabilities ​ Operating ​ Finance (in thousands) Leases (a) ​ Leases (b) Remainder of 2024 ​ $ 1,018 ​ $ 1,306 2025 ​ ​ 4,034 ​ ​ 5,340 2026 ​ ​ 4,034 ​ ​ 5,500 2027 ​ ​ 4,074 ​ ​ 5,665 2028 ​ ​ 4,152 ​ ​ 5,835 2029 ​ ​ 4,222 ​ ​ 6,010 Thereafter ​ ​ 29,346 ​ ​ 90,060 Total lease payments ​ $ 50,880 ​ $ 119,716 Less: imputed interest ​ ​ 18,681 ​ ​ 48,919 Total lease liabilities ​ $ 32,199 ​ $ 70,797 (a) Operating lease payments include $ 23.2 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)	9 Months Ended
	Sep. 30, 2024
Intangible Assets and Goodwill
Schedule reflecting the composition of intangible assets and goodwill	​ The following table presents the composition of the Company’s intangible assets and goodwill (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Weighted- ​ As of September 30, 2024 ​ As of December 31, 2023 ​ ​ Average ​ Gross ​ ​ ​ ​ ​ Gross ​ ​ ​ ​ ​ ​ Amortization ​ Carrying ​ Accumulated ​ Net ​ Carrying ​ Accumulated ​ Net ​ Period (in years) Amount Amortization Amount Amount Amortization Amount Developed technology ​ 11.4 ​ $ 252,200 ​ $ (107,238) ​ $ 144,962 ​ $ 252,200 ​ $ (90,670) ​ $ 161,530 Customer relationships ​ 5.0 ​ ​ 14,100 ​ ​ (13,689) ​ ​ 411 ​ ​ 14,100 ​ ​ (11,574) ​ ​ 2,526 License ​ 4.0 ​ ​ 5,190 ​ ​ (45) ​ ​ 5,145 ​ ​ - ​ ​ - ​ ​ - Intangible assets subject to amortization ​ ​ ​ ​ 271,490 ​ ​ (120,972) ​ ​ 150,518 ​ ​ 266,300 ​ ​ (102,244) ​ ​ 164,056 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ In-process research and development ​ Indefinite ​ $ 118,900 ​ $ - ​ $ 118,900 ​ $ 118,900 ​ $ - ​ $ 118,900 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Total ​ ​ ​ $ 390,390 ​ $ (120,972) ​ $ 269,418 ​ $ 385,200 ​ $ (102,244) ​ $ 282,956 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Goodwill ​ Indefinite ​ $ 66,134 ​ $ - ​ $ 66,134 ​ $ 66,134 ​ $ - ​ $ 66,134
Schedule of expected amortization of finite-lived intangible assets	As of September 30, 2024, 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 2024 ​ $ 5,970 2025 ​ ​ 22,979 2026 ​ ​ 23,736 2027 ​ ​ 24,312 2028 ​ ​ 21,896 Thereafter ​ ​ 51,625 Total amortization ​ $ 150,518

Revenue from Contracts with C_2

Revenue from Contracts with Customers (Tables)	9 Months Ended
	Sep. 30, 2024
Revenue from Contracts with Customers
Schedule of disaggregation of revenue	The Company’s revenues disaggregated by product category and geography for the three and nine months ended September 30, 2024 and September 30, 2023 were as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ ​ September 30, ​ ​ United States ​ International ​ Total ​ 2024 ​ 2023 2024 ​ 2023 2024 ​ 2023 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Glaucoma ​ $ 51,565 ​ $ 38,060 ​ $ 24,467 ​ $ 20,280 $ 76,032 ​ $ 58,340 Corneal Health ​ ​ 18,452 ​ 17,338 ​ ​ 2,186 ​ 2,370 ​ ​ 20,638 ​ 19,708 Total ​ $ 70,017 ​ $ 55,398 ​ $ 26,653 ​ $ 22,650 $ 96,670 ​ $ 78,048 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months Ended ​ ​ September 30, ​ ​ United States ​ International ​ Total ​ 2024 ​ 2023 2024 ​ 2023 2024 ​ 2023 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Glaucoma ​ $ 143,297 ​ $ 112,765 ​ $ 75,836 ​ $ 63,703 $ 219,133 ​ $ 176,468 Corneal Health ​ ​ 51,228 ​ 48,227 ​ ​ 7,621 ​ 7,651 ​ ​ 58,849 ​ 55,878 Total ​ $ 194,525 ​ $ 160,992 ​ $ 83,457 ​ $ 71,354 $ 277,982 ​ $ 232,346
Schedule of accrued sale rebate liability activity	​ ​ ​ ​ ​ ​ ​ ​ ​ Nine Months ​ ​ ​ ​ Ended ​ ​ ​ September 30, ​ ​ 2024 ​ Sales rebate balance, January 1, 2024 ​ $ 8,935 ​ Current period provision ​ ​ 9,280 ​ Payments and credits ​ ​ (4,918) ​ Reserve balance, September 30, 2024 ​ $ 13,297 ​

Net Loss per Share (Tables)

Net Loss per Share (Tables)	9 Months Ended
	Sep. 30, 2024
Net Loss per Share
Schedule of potentially dilutive securities not included in the calculation of diluted net loss per share attributable to common stockholders	The following potentially dilutive securities were not included in the calculation of diluted net loss per share because to do so would be anti-dilutive (in common stock equivalent shares, in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ 2024 2023 2024 2023 ​ Convertible senior notes ​ 1,025 ​ 5,125 ​ 1,025 ​ 5,125 ​ Stock options outstanding ​ 2,349 ​ 2,492 ​ 2,294 ​ 2,574 ​ Unvested restricted stock units ​ 977 ​ 748 ​ 968 ​ 676 ​ Employee stock purchase plan ​ 5 ​ 9 ​ 2 ​ 1 ​ ​ ​ 4,356 ​ 8,374 ​ 4,289 ​ 8,376 ​ ​

Convertible Senior Notes (Table

Convertible Senior Notes (Tables)	9 Months Ended
	Sep. 30, 2024
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 and nine months ended September 30, 2024 and September 30, 2023 is summarized as follows (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three months ended ​ ​ September 30, ​ 2024 2023 Contractual interest expense ​ $ 395 ​ $ 1,977 Amortization of debt issuance costs ​ ​ 67 ​ ​ 343 Total interest expense ​ $ 462 ​ $ 2,320 ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Nine months ended ​ ​ September 30, ​ 2024 2023 Contractual interest expense ​ $ 4,590 ​ $ 5,930 Amortization of debt issuance costs ​ ​ 662 ​ ​ 1,030 Total interest expense ​ $ 5,252 ​ $ 6,960
Schedule of convertible senior notes	As of September 30, 2024 and December 31, 2023, the Convertible 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 ​ ​ September 30, ​ December 31, ​ 2024 2023 Convertible Notes ​ $ 57,500 ​ $ 287,500 Less: Unamortized debt issuance costs ​ ​ (741) ​ ​ (4,727) Carrying amount of Convertible Notes ​ $ 56,759 ​ $ 282,773

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2024
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 in the accompanying condensed consolidated statements of operations (in thousands): ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ Three Months Ended ​ Nine Months Ended ​ ​ ​ September 30, ​ September 30, ​ ​ 2024 2023 2024 2023 Cost of sales ​ $ 863 ​ $ 591 ​ $ 2,427 ​ $ 1,579 ​ Selling, general and administrative ​ ​ 9,670 ​ ​ 6,802 ​ ​ 23,957 ​ ​ 19,868 ​ Research and development ​ ​ 3,887 ​ ​ 3,091 ​ ​ 10,514 ​ ​ 9,094 ​ Total ​ $ 14,420 ​ $ 10,484 ​ $ 36,898 ​ $ 30,541 ​

Organization and Basis of Pre_2

Organization and Basis of Presentation - Recent Developments (Details) $ / shares in Units, $ in Thousands					3 Months Ended	9 Months Ended
	Jun. 28, 2024 USD ($) shares	May 14, 2024 USD ($)	Mar. 07, 2024 USD ($) item	Mar. 17, 2023 USD ($)	Jun. 30, 2024 USD ($)	Sep. 30, 2024 USD ($) $ / shares	Jun. 14, 2024 USD ($) $ / shares	Dec. 31, 2023 USD ($) $ / shares	Jun. 11, 2020
Organization and Basis of Presentation
Finite Lived - Net Amount						$ 150,518		$ 164,056
Common stock, par value (in dollars per share) | $ / shares						$ 0.001		$ 0.001
Inducement expense related to exchange of convertible senior notes						$ 17,412
Issuance of common stock in exchange for convertible senior notes					$ 244,088
One-time upfront payment		$ 2,000
Upfront payments made to acquire license additional rights		$ 500
2.75% Convertible Senior Notes due 2027
Organization and Basis of Presentation
Interest rate (as a percent)							2.75%		2.75%
Repurchase amount							$ 230,000
Common stock, par value (in dollars per share) | $ / shares							$ 0.001
Amount of debt converted	$ 230,000					230,000
Common shares issued upon the conversion of convertible senior notes (in shares) | shares	4,253,423
Decrease in Conversion Notes upon conversion						226,700
Unamortized debt issuance costs						3,300
Inducement expense related to exchange of convertible senior notes						17,400
Direct transaction costs						600
License Agreement with Celanese
Organization and Basis of Presentation
Term of agreement				4 years
Minimum compensation amount				$ 6,300
Finite Lived - Net Amount				$ 5,200
Amortization period of finite-lived intangible assets				4 years
Additional paid-in-capital
Organization and Basis of Presentation
Issuance of common stock in exchange for convertible senior notes					$ 244,084
Additional paid-in-capital | 2.75% Convertible Senior Notes due 2027
Organization and Basis of Presentation
Issuance of common stock in exchange for convertible senior notes						244,100
Equity Interests in a Clinical Stage Biopharma Company
Organization and Basis of Presentation
Common stock issued in connection with acquisition			$ 5,000
Cash payments to acquire productive assets			$ 5,100
Asset acquisition, percentage of voting interests acquired			100%
Number of first development milestones that are payable in cash or Company shares | item			2
Acquisition consideration accrued						$ 1,500
Equity Interests in a Clinical Stage Biopharma Company | Maximum | Upon Achievement Of Certain Event Based Development Milestones
Organization and Basis of Presentation
Potential contingent consideration			$ 51,000
Equity Interests in a Clinical Stage Biopharma Company | Maximum | Upon Achievement Of Certain Commercial Sales Based Milestones
Organization and Basis of Presentation
Potential contingent consideration			$ 150,000

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Cash and Cash Equivalents (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023	Sep. 30, 2023	Dec. 31, 2022
Restricted cash
Cash and cash equivalents	$ 100,143	$ 93,467
Restricted cash	4,733	5,856
cash, cash equivalents and restricted cash	$ 104,876	$ 99,323	$ 114,785	$ 126,603

Balance Sheet Details - Short-T

Balance Sheet Details - Short-Term Investments (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Short-term investments
Amortized cost	$ 161,660	$ 202,271
Unrealized gains	749	441
Unrealized losses	(79)	(748)
Estimated fair value	162,330	201,964
U.S. government agency bonds
Short-term investments
Amortized cost		25,995
Unrealized gains		2
Unrealized losses		(347)
Estimated fair value		$ 25,650
U.S. government agency bonds | Maximum
Short-term investments
Maturity		3 years
U.S. treasury securities
Short-term investments
Amortized cost	122,436	$ 124,780
Unrealized gains	495	274
Unrealized losses	(12)	(36)
Estimated fair value	$ 122,919	$ 125,018
U.S. treasury securities | Maximum
Short-term investments
Maturity	2 years	2 years
Bank certificates of deposit
Short-term investments
Amortized cost	$ 6,420	$ 7,100
Unrealized gains	10	9
Estimated fair value	$ 6,430	$ 7,109
Bank certificates of deposit | Maximum
Short-term investments
Maturity	2 years	1 year
Commercial paper
Short-term investments
Amortized cost		$ 5,679
Unrealized gains		4
Unrealized losses		(1)
Estimated fair value		$ 5,682
Commercial paper | Maximum
Short-term investments
Maturity		1 year
Corporate notes
Short-term investments
Amortized cost	$ 18,862	$ 21,292
Unrealized gains	201	77
Unrealized losses	(31)	(229)
Estimated fair value	$ 19,032	$ 21,140
Corporate notes | Maximum
Short-term investments
Maturity	3 years	3 years
Asset-backed securities
Short-term investments
Amortized cost	$ 10,932	$ 12,415
Unrealized gains	24	41
Unrealized losses	(36)	(135)
Estimated fair value	$ 10,920	$ 12,321
Asset-backed securities | Maximum
Short-term investments
Maturity	2 years	2 years
Municipal bonds
Short-term investments
Amortized cost	$ 3,010	$ 5,010
Unrealized gains	19	34
Estimated fair value	$ 3,029	$ 5,044
Municipal bonds | Maximum
Short-term investments
Maturity	3 years	3 years

Balance Sheet Details - Other (

Balance Sheet Details - Other (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Accounts Receivable, Net
Accounts receivable	$ 57,627	$ 41,051
Allowance for credit losses	(1,219)	(1,201)
Accounts receivable, net	56,408	39,850
Inventory
Finished goods	26,868	16,699
Work in process	14,836	12,870
Raw materials	18,191	12,417
Total inventory	59,895	41,986
Accrued Liabilities
Accrued bonuses	15,646	20,588
Accrued payroll taxes	1,941	2,365
Accrued vacation benefits	5,685	5,269
Accrued sales rebates	13,297	8,935
Other accrued liabilities	24,012	23,417
Total accrued liabilities	$ 60,581	$ 60,574

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value Hierarchy (Details) - USD ($)	Sep. 30, 2024	Dec. 31, 2023
Fair Value, Measurements, Recurring
Assets
Total assets	$ 230,946,000	$ 265,709,000
Liabilities
Total liabilities	16,059,000	11,294,000
Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 1
Assets
Total assets	44,519,000	52,156,000
Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	186,427,000	213,553,000
Liabilities
Total liabilities	14,559,000	11,294,000
Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 3
Assets
Total assets		0
Liabilities
Total liabilities	1,500,000	0
Money market funds | Fair Value, Measurements, Recurring
Assets
Total assets	44,519,000	52,156,000
Money market funds | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 1
Assets
Total assets	44,519,000	52,156,000
U.S. government agency bonds | Fair Value, Measurements, Recurring
Assets
Total assets		25,650,000
U.S. government agency bonds | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets		25,650,000
U.S. treasury securities | Fair Value, Measurements, Recurring
Assets
Total assets	132,200,000	125,018,000
U.S. treasury securities | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	$ 132,200,000	125,018,000
Bank certificates of deposit
Assets
Number of certificates of deposit	1
Bank certificates of deposit | Fair Value, Measurements, Recurring
Assets
Cash equivalents	$ 9,281,000
Total assets	6,430,000	7,109,000
Bank certificates of deposit | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	6,430,000	7,109,000
Commercial paper. | Fair Value, Measurements, Recurring
Assets
Total assets		5,682,000
Commercial paper. | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets		5,682,000
Corporate notes | Fair Value, Measurements, Recurring
Assets
Total assets	19,032,000	21,140,000
Corporate notes | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	19,032,000	21,140,000
Asset-backed securities | Fair Value, Measurements, Recurring
Assets
Total assets	10,920,000	12,321,000
Asset-backed securities | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	10,920,000	12,321,000
Municipal bonds | Fair Value, Measurements, Recurring
Assets
Total assets	3,029,000	5,044,000
Municipal bonds | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	3,029,000	5,044,000
Investments held for deferred compensation plans | Fair Value, Measurements, Recurring
Assets
Total assets	14,816,000	11,589,000
Liabilities
Total liabilities	14,559,000	11,294,000
Investments held for deferred compensation plans | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 2
Assets
Total assets	14,816,000	11,589,000
Liabilities
Total liabilities	14,559,000	11,294,000
Contingent consideration | Fair Value, Measurements, Recurring
Liabilities
Total liabilities	1,500,000	$ 1,400,000
Contingent consideration | Fair Value, Measurements, Recurring | Fair Value, Inputs, Level 3
Liabilities
Total liabilities	$ 1,500,000

Fair Value Measurements - Trans

Fair Value Measurements - Transfers (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
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	$ 135,300	$ 444,000

Leases - Terms (Details)

Leases - Terms (Details)	9 Months Ended
	Sep. 30, 2024
Leases
Operating Lease Existence of Option to Extend	true
Minimum
Leases
Operating lease remaining lease term	1 year
Maximum
Leases
Operating lease remaining lease term	13 years
Optional lease extension term	10 years

Leases - Leases Details (Detail

Leases - Leases Details (Details)		1 Months Ended	9 Months Ended
	Nov. 14, 2020 ft² item property	Jul. 31, 2020 ft² item	Sep. 30, 2024 ft² item
Operating Leases
Number of most significant leases expiring on May 31, 2030			2
Maximum
Operating Leases
Optional lease extension term			10 years
Domestic Office Leases
Operating Leases
The number of adjacent facilities rented			2
Number of adjacent properties leased			2
Number of lease renewal periods		1
Optional lease extension term		5 years
Area of leased space | ft²		120,000
Foreign Subsidiaries Office Leases | Maximum
Operating Leases
Area of leased space | ft²			35,000
Aliso Facility
Operating Leases
Number of properties leased | property	1
Number of buildings leased	3
Number of lease renewal periods	2
Optional lease extension term	5 years
Area of leased space | ft²	160,000
Term of lease	13 years
Burlington Massachusetts Facility
Operating Leases
Number of lease renewal periods			1
Optional lease extension term			5 years
Area of leased space | ft²			60,000

Leases - Maturity (Details)

Leases - Maturity (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Operating Leases
Remainder of 2024	$ 1,018
2025	4,034
2026	4,034
2027	4,074
2028	4,152
2029	4,222
Thereafter	29,346
Total Operating lease payments	50,880
Less: imputed interest	18,681
Total Operating lease liabilities	32,199
Amount of operating leases with option to extend commitment	23,200
Finance Leases
Remainder of 2024	1,306
2025	5,340
2026	5,500
2027	5,665
2028	5,835
2029	6,010
Thereafter	90,060
Total Finance lease payments	119,716
Less: imputed interest	48,919
Total Finance lease liabilities	70,797
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	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Intangible Assets and Goodwill
Amortization of intangible assets			$ 18,729	$ 18,684
Finite Lived - Gross Amount	$ 271,490		271,490		$ 266,300
Finite Lived - Accumulated Amortization	(120,972)		(120,972)		(102,244)
Finite Lived - Net Amount	150,518		150,518		164,056
Total Gross Carrying Amount	390,390		390,390		385,200
Total Net Amount	269,418		269,418		282,956
Goodwill	66,134		66,134		66,134
In-Process Research and Development (IPR&D)
Intangible Assets and Goodwill
Indefinite Lived assets	$ 118,900		$ 118,900		118,900
Developed Technology
Intangible Assets and Goodwill
Weighted-Average Amortization Period	11 years 4 months 24 days		11 years 4 months 24 days
Finite Lived - Gross Amount	$ 252,200		$ 252,200		252,200
Finite Lived - Accumulated Amortization	(107,238)		(107,238)		(90,670)
Finite Lived - Net Amount	$ 144,962		$ 144,962		161,530
Customer Relationships
Intangible Assets and Goodwill
Weighted-Average Amortization Period	5 years		5 years
Finite Lived - Gross Amount	$ 14,100		$ 14,100		14,100
Finite Lived - Accumulated Amortization	(13,689)		(13,689)		(11,574)
Finite Lived - Net Amount	$ 411		$ 411		$ 2,526
License
Intangible Assets and Goodwill
Weighted-Average Amortization Period	4 years		4 years
Finite Lived - Gross Amount	$ 5,190		$ 5,190
Finite Lived - Accumulated Amortization	(45)		(45)
Finite Lived - Net Amount	5,145		5,145
Avedro | Cost of sales
Intangible Assets and Goodwill
Amortization of intangible assets	5,500	$ 5,500	16,600	16,600
Avedro | Selling, general and administrative
Intangible Assets and Goodwill
Amortization of intangible assets	$ 700	$ 700	$ 2,100	$ 2,100

Intangible Assets and Goodwil_3

Intangible Assets and Goodwill - Maturity (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Estimated amortization expense
Remainder of 2024	$ 5,970
2025	22,979
2026	23,736
2027	24,312
2028	21,896
Thereafter	51,625
Finite Lived - Net Amount	$ 150,518	$ 164,056

Revenue from Contracts with C_3

Revenue from Contracts with Customers - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Revenue from Contracts with Customers
Total net sales	$ 96,670	$ 78,048	$ 277,982	$ 232,346
United States
Revenue from Contracts with Customers
Total net sales	70,017	55,398	194,525	160,992
International
Revenue from Contracts with Customers
Total net sales	26,653	22,650	83,457	71,354
Glaucoma
Revenue from Contracts with Customers
Total net sales	76,032	58,340	219,133	176,468
Glaucoma | United States
Revenue from Contracts with Customers
Total net sales	51,565	38,060	143,297	112,765
Glaucoma | International
Revenue from Contracts with Customers
Total net sales	24,467	20,280	75,836	63,703
Corneal Health
Revenue from Contracts with Customers
Total net sales	20,638	19,708	58,849	55,878
Corneal Health | United States
Revenue from Contracts with Customers
Total net sales	18,452	17,338	51,228	48,227
Corneal Health | International
Revenue from Contracts with Customers
Total net sales	$ 2,186	$ 2,370	$ 7,621	$ 7,651

Revenue from Contracts with C_4

Revenue from Contracts with Customers - Other (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($)
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
Sales rebate beginning balance	$ 8,935
Current period provision	9,280
Payments and credits	(4,918)
Sales rebate ending balance	$ 13,297

Net Loss per Share - Dilutive S

Net Loss per Share - Dilutive Securities (Details) - shares shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Net Loss per Share
Anti-dilutive securities excluded from computation of earnings per share	4,356	8,374	4,289	8,376
Convertible senior notes
Net Loss per Share
Anti-dilutive securities excluded from computation of earnings per share	1,025	5,125	1,025	5,125
Stock options outstanding
Net Loss per Share
Anti-dilutive securities excluded from computation of earnings per share	2,349	2,492	2,294	2,574
Unvested restricted stock units
Net Loss per Share
Anti-dilutive securities excluded from computation of earnings per share	977	748	968	676
Employee stock purchase plan
Net Loss per Share
Anti-dilutive securities excluded from computation of earnings per share	5	9	2	1

Convertible Senior Notes - Gene

Convertible Senior Notes - General (Details) $ / shares in Units, $ in Thousands					9 Months Ended
	Dec. 16, 2024	Oct. 04, 2024 USD ($)	Jun. 28, 2024 USD ($) shares	Jun. 11, 2020 USD ($)	Sep. 30, 2024 USD ($) D $ / shares	Jun. 14, 2024 USD ($)	Dec. 31, 2023 USD ($)
Convertible Senior Notes
Denomination for conversion of debt		$ 1,000
2.75% Convertible Senior Notes due 2027
Convertible Senior Notes
Convertible Notes				$ 287,500	$ 57,500		$ 287,500
Interest rate (as a percent)				2.75%		2.75%
Net proceeds from the debt				$ 242,200
Amount of debt converted			$ 230,000		$ 230,000
Stock Issued During Period, Shares, Conversion of Convertible Securities | shares			4,253,423
Threshold consecutive trading days | D					30
Repurchase amount						$ 230,000
Premium percentage on conversion price					130%
Initial conversion price | $ / shares					$ 56.10
2.75% Convertible Senior Notes due 2027 | Subsequent Events
Convertible Senior Notes
Denomination for conversion of debt		1,000
Repurchase amount		$ 57,500
Conversion rate		17.8269
Number of additional shares issued in exchange for the original debt being converted in a noncash		0.3501
Convertible ratio		18.1770
Redemption price	100%
2.75% Convertible Senior Notes due 2027 | Minimum
Convertible Senior Notes
Threshold trading days | D					20

Convertible Senior Notes - Inte

Convertible Senior Notes - Interest expense (Details) - 2.75% Convertible Senior Notes due 2027 - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Convertible Senior Notes
Contractual interest expense	$ 395	$ 1,977	$ 4,590	$ 5,930
Amortization of debt issuance costs	67	343	662	1,030
Total interest expense	$ 462	$ 2,320	$ 5,252	$ 6,960
Interest rate at period end	3.20%		3.20%		3.20%

Convertible Senior Notes - Carr

Convertible Senior Notes - Carrying Amount (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023	Jun. 11, 2020
Convertible Senior Notes
Carrying amount of Convertible Notes	$ 56,759	$ 282,773
2.75% Convertible Senior Notes due 2027
Convertible Senior Notes
Convertible Notes	57,500	287,500	$ 287,500
Less: Unamortized debt issuance costs	(741)	(4,727)
Carrying amount of Convertible Notes	$ 56,759	$ 282,773

Convertible Senior Notes - Capp

Convertible Senior Notes - Capped Call Transactions (Details) - Capped Call Transactions $ / shares in Units, shares in Millions, $ in Millions		1 Months Ended
	Jun. 08, 2020 $ / instrument	Jun. 30, 2020 USD ($) $ / shares shares
Convertible Senior Notes
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
Convertible Senior Notes
Cap price (in dollars per share) | $ / instrument	86.30
Percentage of premium on share price	100%

Stock-Based Compensation - Allo

Stock-Based Compensation - Allocation of Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Allocation of stock-based compensation
Stock-based compensation expense	$ 14,420	$ 10,484	$ 36,898	$ 30,541
Cost of sales
Allocation of stock-based compensation
Stock-based compensation expense	863	591	2,427	1,579
Selling, general and administrative
Allocation of stock-based compensation
Stock-based compensation expense	9,670	6,802	23,957	19,868
Research and development
Allocation of stock-based compensation
Stock-based compensation expense	$ 3,887	$ 3,091	$ 10,514	$ 9,094

Stock-Based Compensation - Othe

Stock-Based Compensation - Other (Details) $ in Millions	9 Months Ended
	Sep. 30, 2024 USD ($)
Stock-based compensation
Unamortized stock-based compensation expense not yet recognized	$ 83.9
Restricted Stock Units (RSUs)
Stock-based compensation
Unamortized stock-based compensation expense not yet recognized	75.3
Stock options
Stock-based compensation
Unamortized stock-based compensation expense not yet recognized	8.6
Vesting based on time | Restricted Stock Units (RSUs)
Stock-based compensation
Unamortized stock-based compensation expense not yet recognized	$ 74.7
Options remaining vesting period	4 years
Weighted average period of recognition	2 years 8 months 12 days
Vesting based on time | Stock options
Stock-based compensation
Unamortized stock-based compensation expense not yet recognized	$ 8.3
Options remaining vesting period	4 years
Weighted average period of recognition	2 years 7 months 6 days
Vesting based on performance | Restricted Stock Units (RSUs)
Stock-based compensation
Unamortized stock-based compensation expense not yet recognized	$ 0.6
Weighted average period of recognition	1 year 8 months 12 days
Vesting based on performance | Restricted Stock Units (RSUs) | Maximum
Stock-based compensation
Options remaining vesting period	2 years
Vesting based on performance | Stock options
Stock-based compensation
Unamortized stock-based compensation expense not yet recognized	$ 0.3
Weighted average period of recognition	10 months 24 days
Vesting based on performance | Stock options | Maximum
Stock-based compensation
Options remaining vesting period	1 year

Income Taxes (Details)

Income Taxes (Details) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Income Taxes
Effective tax rate (as a percent)	(0.83%)		(0.79%)
Provision for income taxes	$ 177,000	$ 37,000	$ 885,000	$ 873,000
Unrecognized tax benefits	$ 35,300,000		$ 35,300,000		$ 32,800,000

Commitments and Contingencies -

Commitments and Contingencies - Other (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Commitments and Contingencies.
Restricted cash pledged for letter of credit	$ 4.7	$ 5.9
Adjustment rate of Letter of Credit (as a percent)	20%
Amount of Letter of Credit outstanding after adjustments	$ 2
Deferred compensation plan liability	14.6	11.3
Deferred Compensation Plan Assets	$ 14.8	$ 11.6

Business Segment Information (D

Business Segment Information (Details)	9 Months Ended
	Sep. 30, 2024 item
Business Segment Information
Number of business activities	1
Number of operating segments	1