Alimera Sciences (ALIM) 10-Q 15 May 23 2023 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2023	May 09, 2023
Document and Entity Information [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Current Fiscal Year End Date	--12-31
Document Period End Date	Mar. 31, 2023
Document Fiscal Year Focus	2023
Document Transition Report	false
Entity File Number	001-34703
Entity Registrant Name	Alimera Sciences, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	20-0028718
Entity Address, Address Line One	6310 Town Square
Entity Address, Address Line Two	Suite 400
Entity Address, City or Town	Alpharetta
Entity Address, State or Province	GA
Entity Address, Postal Zip Code	30005
City Area Code	678
Local Phone Number	990-5740
Title of 12(b) Security	Common Stock, $0.01 par value per share
Trading Symbol	ALIM
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Smaller Reporting Company	true
Emerging Growth Company	false
Entity Shell Company	false
Entity common stock, shares outstanding (in shares)		7,404,826
Entity Central Index Key	0001267602
Amendment Flag	false
Document Fiscal Period Focus	Q1

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
CURRENT ASSETS:
Cash and cash equivalents	$ 13,086	$ 5,274
Restricted cash	31	30
Accounts receivable, net	18,433	19,612
Prepaid expenses and other current assets	2,910	2,892
Inventory	1,215	1,605
Total current assets	35,675	29,413
NON-CURRENT ASSETS:
Property and equipment, net	2,419	2,525
Right of use assets, net	1,338	1,395
Intangible asset, net	8,479	8,957
Deferred tax asset	131	129
Warrant asset	197	183
TOTAL ASSETS	48,239	42,602
CURRENT LIABILITIES:
Accounts payable	9,669	10,088
Accrued expenses	4,241	3,998
Notes payable		25,313
Finance lease obligations	263	333
Total current liabilities	14,173	39,732
NON-CURRENT LIABILITIES:
Notes payable, net of discount	44,152	18,683
Common Warrants	3,788
Other non-current liabilities	5,042	4,995
COMMITMENTS AND CONTINGENCIES
STOCKHOLDERS’ DEFICIT:
Common stock, $.01 par value — 150,000,000 shares authorized, 7,391,594 shares issued and outstanding at March 31, 2023 and 6,995,513 shares issued and outstanding at December 31, 2022	74	70
Additional paid-in capital	378,146	378,238
Accumulated deficit	(402,081)	(415,388)
Accumulated other comprehensive loss	(2,783)	(2,955)
TOTAL STOCKHOLDERS’ DEFICIT	(18,916)	(20,808)
TOTAL LIABILITIES AND STOCKHOLDERS’ DEFICIT	48,239	42,602
Series A Preferred Stock [Member]
STOCKHOLDERS’ DEFICIT:
Preferred stock, $.01 par value — 10,000,000 shares authorized at March 31, 2023 and December 31, 2022:		$ 19,227
Series B Preferred Stock [Member]
STOCKHOLDERS’ DEFICIT:
Preferred stock, $.01 par value — 10,000,000 shares authorized at March 31, 2023 and December 31, 2022:	$ 7,728

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Preferred stock, par value (usd per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	10,000,000	10,000,000
Common stock, par value (usd per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	150,000,000	150,000,000
Common stock, shares issued (in shares)	7,391,594	6,995,513
Common stock, shares outstanding (in shares)	7,391,594	6,995,513
Series A Preferred Stock [Member]
Preferred stock, shares authorized (in shares)	0	1,300,000
Preferred stock, shares issued (in shares)	0	600,000
Preferred stock, shares outstanding (in shares)	0	600,000
Preferred stock, liquidation preference		$ 24,000
Series B Preferred Stock [Member]
Preferred stock, shares authorized (in shares)	27,000	0
Preferred stock, shares issued (in shares)	12,000	0
Preferred stock, shares outstanding (in shares)	12,000	0
Preferred stock, liquidation preference	$ 12,000

Condensed Consolidated Statemen

Condensed Consolidated Statements Of Operations - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Condensed Consolidated Statements Of Operations [Abstract]
PRODUCT REVENUE, NET	$ 13,546	$ 11,898
COST OF GOODS SOLD, EXCLUDING DEPRECIATION AND AMORTIZATION	(2,028)	(1,680)
GROSS PROFIT	11,518	10,218
RESEARCH, DEVELOPMENT AND MEDICAL AFFAIRS EXPENSES	4,164	3,583
GENERAL AND ADMINISTRATIVE EXPENSES	4,171	3,240
SALES AND MARKETING EXPENSES	5,804	6,853
DEPRECIATION AND AMORTIZATION	681	689
OPERATING EXPENSES	14,820	14,365
LOSS FROM OPERATIONS	(3,302)	(4,147)
INTEREST EXPENSE AND OTHER	(1,667)	(1,364)
UNREALIZED FOREIGN CURRENCY (LOSS) GAIN, NET	(13)	108
CHANGE IN FAIR VALUE OF WARRANT ASSET	14	(552)
NET LOSS	(4,968)	(5,955)
PREFERRED STOCK DIVIDENDS	(14)
NET LOSS APPLICABLE TO COMMON STOCKHOLDERS	$ (4,982)	$ (5,955)
NET LOSS PER SHARE — Basic	$ (0.71)	$ (0.85)
NET LOSS PER SHARE — Diluted	$ (0.71)	$ (0.85)
WEIGHTED AVERAGE SHARES OUTSTANDING — Basic	7,032,231	6,990,737
WEIGHTED AVERAGE SHARES OUTSTANDING — Diluted	7,032,231	6,990,737

Condensed Consolidated Statem_2

Condensed Consolidated Statements Of Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Condensed Consolidated Statements Of Comprehensive Loss [Abstract]
NET LOSS	$ (4,968)	$ (5,955)
OTHER COMPREHENSIVE INCOME (LOSS)
Foreign currency translation adjustments	172	(356)
TOTAL OTHER COMPREHENSIVE INCOME (LOSS)	172	(356)
COMPREHENSIVE LOSS	$ (4,796)	$ (6,311)

Condensed Consolidated Statem_3

Condensed Consolidated Statements Of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
CASH FLOWS FROM OPERATING ACTIVITIES:
Net loss	$ (4,968)	$ (5,955)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	681	689
Unrealized foreign currency transaction gain, net	13	(108)
Amortization of debt discount and deferred financing costs	282	271
Stock-based compensation expense	226	312
Change in fair value of warrant asset	(14)	552
Changes in assets and liabilities:
Accounts receivable	1,301	184
Prepaid expenses and other current assets	70	265
Inventory	397	203
Accounts payable	(434)	(1,992)
Accrued expenses and other current liabilities	215	(541)
Other long-term liabilities	22	(93)
Net cash used in operating activities	(2,209)	(6,213)
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchases of property and equipment	(9)	(149)
Net cash provided by used in investing activities	(9)	(149)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of Preferred stock - Series B	12,000
Series B Convertible Preferred Stock issuance costs	(498)
Issuance of debt	2,500
Payment of debt costs	(2,625)
Payment of finance lease obligations	(127)	(62)
Repurchase of Series A Preferred Stock	(938)
Repurchase of common stock	(314)
Net cash provided by (used in) financing activities	9,998	(62)
EFFECT OF EXCHANGE RATES ON CASH AND CASH EQUIVALENTS AND RESTRICTED CASH	33	(141)
NET CHANGE IN CASH AND CASH EQUIVALENTS AND RESTRICTED CASH	7,813	(6,565)
CASH AND CASH EQUIVALENTS AND RESTRICTED CASH — Beginning of period	5,304	16,544
CASH AND CASH EQUIVALENTS AND RESTRICTED CASH — End of period	13,117	9,979
SUPPLEMENTAL DISCLOSURES:
Cash paid for interest	1,354	1,061
Cash paid for income taxes		18
Supplemental schedule of noncash investing and financing activities:
Note payable end of term payment accrued but unpaid	$ 2,375	$ 2,250

Condensed Consolidated Statem_4

Condensed Consolidated Statements Of Changes In Stockholders' Deficit - USD ($) $ in Thousands	Common Stock [Member] Common Class A [Member]	Common Stock [Member]	Preferred Stock [Member] Series A Preferred Stock [Member]	Preferred Stock [Member] Series B Preferred Stock [Member]	Additional Paid-In Capital [Member] Common Class A [Member]	Additional Paid-In Capital [Member]	Accumulated Deficit [Member] Series A Preferred Stock [Member]	Accumulated Deficit [Member]	Accumulated Other Comprehensive Loss [Member]	Common Class A [Member]	Series A Preferred Stock [Member]	Total
Beginning balance (in shares) at Dec. 31, 2021		6,935,154	600,000
Beginning balance at Dec. 31, 2021		$ 69	$ 19,227			$ 377,229		$ (397,281)	$ (1,849)			$ (2,605)
Issuance of common stock, net of issuance costs (in shares)		57,500
Issuance of common stock, net of issuance costs		$ 1										1
Stock-based compensation expense						312						312
Net loss								(5,955)				(5,955)
Foreign currency translation adjustments									(356)			(356)
Ending balance (in shares) at Mar. 31, 2022		6,992,654	600,000
Ending balance at Mar. 31, 2022		$ 70	$ 19,227			377,541		(403,236)	(2,205)			(8,603)
Beginning balance (in shares) at Dec. 31, 2022		6,995,513	600,000
Beginning balance at Dec. 31, 2022		$ 70	$ 19,227			378,238		(415,388)	(2,955)			(20,808)
Issuance of common stock, net of issuance costs (in shares)		597,000
Issuance of common stock, net of issuance costs		$ 6				(6)
Repurchase of stock (in shares)	(200,919)		(600,000)
Repurchase of stock	$ (2)		$ (19,227)		$ (312)		$ 18,289			$ (314)	$ (938)
Issuance of Preferred stock - Series B (in shares)				12,000
Issuance of Preferred stock - Series B				$ 7,714								7,714
Preferred stock dividends				$ 14				(14)
Stock-based compensation expense						226						226
Net loss								(4,968)				(4,968)
Foreign currency translation adjustments									172			172
Ending balance (in shares) at Mar. 31, 2023		7,391,594		12,000
Ending balance at Mar. 31, 2023		$ 74		$ 7,728		$ 378,146		$ (402,081)	$ (2,783)			$ (18,916)

Nature Of Operations

Nature Of Operations	3 Months Ended
	Mar. 31, 2023
Nature Of Operations [Abstract]
Nature Of Operations	1. NATURE OF OPERATIONS Alimera Sciences, Inc., together with its wholly owned subsidiaries (the Company), is a pharmaceutical company that specializes in the commercialization and development of ophthalmic pharmaceuticals. The Company was formed on June 4, 2003 under the laws of the State of Delaware. The Company presently focuses on diseases affecting the retina, because the Company believes these diseases are not well treated with current therapies and affect millions of people globally. The Company’s only product is ILUVIEN ® (fluocinolone acetonide intravitreal implant) 0.19 mg, which has received marketing authorization and reimbursement in 24 countries for the treatment of diabetic macular edema (DME). In the U.S. and certain other countries outside Europe, ILUVIEN is indicated for the treatment of DME in patients who have been previously treated with a course of corticosteroids and did not have a clinically significant rise in intraocular pressure. In 17 countries in Europe, ILUVIEN is indicated for the treatment of vision impairment associated with chronic DME considered insufficiently responsive to available therapies. In addition, ILUVIEN has received marketing authorization in 17 European countries and reimbursement in ten countries for the prevention of relapse in recurrent non-infectious uveitis affecting the posterior segment (NIU-PS). The Company markets ILUVIEN directly in the U.S., Germany, the U.K., Portugal and Ireland . In addition, the Company has entered into various agreements under which distributors are providing or will provide regulatory, reimbursement and sales and marketing support for ILUVIEN in Austria, Belgium, the Czech Republic, Denmark, Finland, France, Italy, Luxembourg, the Netherlands, Norway, Spain, Sweden, Switzerland, Australia, New Zealand and several countries in the Middle East. In addition, the Company has granted an exclusive license to Ocumension Therapeutics for the development and commercialization of the Company’s 0.19mg fluocinolone acetonide intravitreal injection in China, East Asia and the Western Pacific. As of March 31, 2023, the Company has recognized sales of ILUVIEN to its international distributors in the Middle East, China, Austria, Belgium, Czech Republic, France, Italy, Luxembourg, Spain, the Netherlands, and the Nordic Region. Effects of the COVID-19 Pandemic The public health crisis caused by the COVID-19 pandemic and the measures being taken by governments, businesses, and the public at large to limit the COVID-19 pandemic’s spread have had, and the Company expects will continue to have to some degree, certain negative effects on, and present certain risks to, the Company’s business. These limitations and other effects of the COVID-19 pandemic have had an adverse impact on the Company’s revenues beginning late in the first quarter of 2020, and this adverse impact has continued to a lesser degree through the date of this report in some of the Company’s key markets in Europe that have now begun to recover. As the COVID-19 pandemic continued, the Company’s liquidity and financial condition were adversely affected as well. These COVID-19 pandemic-related factors may continue to adversely affect the Company’s revenue, liquidity and financial condition, and the extent and duration of that effect is uncertain, particularly if SARS-CoV-2 variants emerge that may increase the transmissibility of the coronavirus or be more deadly, or both. This uncertainty could in the future affect certain estimates the Company uses to prepare its quarterly financial results, including impairment of intangible assets, the income tax provision and realizability of certain receivables and the prospective compliance with the Company’s covenants in its loan agreement. In response to the COVID-19 pandemic, the Company has implemented measures to mitigate the impact of the pandemic on its financial position and operations. The Company is continuing to monitor the effects of the SARS-CoV-2 variants and to increase its engagement with its customers to mitigate any loss of revenue in the affected markets.

Basis Of Presentation

Basis Of Presentation	3 Months Ended
	Mar. 31, 2023
Basis Of Presentation [Abstract]
Basis Of Presentation	2. BASIS OF PRESENTATION The Company has prepared the accompanying unaudited interim condensed consolidated financial statements and notes thereto (Interim Financial Statements) in accordance with accounting principles generally accepted in the U.S. (U.S. GAAP) for interim financial information and with the instructions to Form 10-Q and Article 8-03 of Regulation S-X of the Securities and Exchange Commission (SEC). Accordingly, these Interim Financial Statements do not include all of the information and disclosures required by U.S. GAAP for complete financial statements. In the opinion of the Company’s management, the accompanying Interim Financial Statements reflect all adjustments, which include normal recurring adjustments, necessary to present fairly the Company’s interim financial information. The accompanying Interim Financial Statements and related notes should be read in conjunction with the Company’s audited financial statements for the year ended December 31, 2022, and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2022, which was filed with the SEC on March 31, 2023 (the 2022 Form 10-K). The financial results for any interim period are not necessarily indicative of the expected financial results for the full year.

Summary Of Significant Accounti

Summary Of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2023
Summary Of Significant Accounting Policies [Abstract]
Summary Of Significant Accounting Policies	3. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES The Company’s accounting policies followed for quarterly financial reporting are the same as those disclosed in the Notes to Financial Statements included in the 2022 Form 10-K. Adoption of New Accounting Standard In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (ASC 326): Measurement of Credit Losses on Financial Instruments . This ASU replaces the current incurred loss impairment methodology for financial assets measured at amortized cost with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information, including forecasted information, to develop credit loss estimates. The standard became effective for the Company on January 1, 2023. The adoption of this ASU did not have a material impact on its financial statements. In October 2021, the FASB issued ASU 2021-08, Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. The amendments in this ASU require that an acquirer recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with ASC Topic 606, Revenue from Contracts with Customers (ASC 606). The amendments in this ASU are effective for fiscal years beginning after December 15, 2022, with early adoption permitted. The adoption of this ASU did not have a material impact on the Company’s financial statements. Accounting Standards Issued but Not Yet Effective In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (ASC 848) - Facilitation of the Effects of Reference Rate Reform on Financial Reporting. This standard provides optional expedients and exceptions for applying GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The standard was available until December 31, 2022. In December 2022, the FASB issued ASU No. 2022-06 which extended the period of time preparers can utilize the reference rate reform relief guidance in Topic 848. The guidance ensures the relief in Topic 848 covers the period of time during which a significant number of modifications may take place and the ASU defers the sunset date of Topic 848 from December 31, 2022 to December 31, 2024. The Company does not anticipate the adoption of this ASU will have a material impact on its financial statements.

Revenue Recognition

Revenue Recognition	3 Months Ended
	Mar. 31, 2023
Revenue Recognition [Abstract]
Revenue Recognition	4. REVENUE RECOGNITION Overview The Company recognizes revenue when a customer obtains control of the related good or service. The amount recognized reflects the consideration the entity expects to receive in exchange for those goods or services. To determine revenue recognition for arrangements that an entity determines are within the scope of ASC 606 Revenue from Contracts with Customers, the Company performs the following steps as outlined in the guidance: (1) identify the contract with the customer, (2) identify the performance obligations within the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract, and (5) recognize revenue when the entity satisfies a performance obligation. At the inception of a contract, the contract is evaluated to determine if it falls within the scope of ASC 606, followed by the Company’s assessment of the goods or services promised within each contract, assessment of whether the promised good or service is distinct and determination of the performance obligations. The Company then recognizes revenue based on the transaction price that is allocated to the respective performance obligation when the performance obligation is satisfied. If the contract contains a single performance obligation, the entire transaction price is allocated to the single performance obligation. Contracts that contain multiple performance obligations require an allocation of the transaction price based on the estimated relative standalone selling prices of the promised products or services underlying each performance obligation. The Company determines standalone selling prices based on the price at which the performance obligation is sold separately. If the standalone selling price is not observable through past transactions, the Company estimates the standalone selling price taking into account available information such as market conditions related to the performance obligations. Net Product Sales The Company sells its products to major pharmaceutical distributors, pharmacies, hospitals and wholesalers (collectively, its Customers). In addition to distribution agreements with Customers, the Company enters into arrangements with healthcare providers and payors that provide for government-mandated and/or privately-negotiated rebates, chargebacks, and discounts with respect to the purchase of the Company’s products. The Company recognizes revenues from product sales at a point in time when the Customer obtains control, typically upon delivery. The Company accrues for fulfillment costs when the related revenue is recognized. Taxes collected from Customers relating to product sales and remitted to governmental authorities are excluded from revenues. Estimates of Variable Consideration Revenues from product sales are recorded at the net sales price (transaction price), which includes estimates of variable consideration for reserves related to statutory rebates to State Medicaid and other government agencies; commercial rebates and fees to Managed Care Organizations (MCOs), Group Purchasing Organizations (GPOs), distributors, and specialty pharmacies; product returns; sales discounts (including trade discounts); distributor costs; wholesaler chargebacks; and allowances for patient assistance programs relating to the Company’s sales of its products. These reserves are based on estimates of the amounts earned or to be claimed on the related sales. Management’s estimates take into consideration historical experience, current contractual and statutory requirements, specific known market events and trends, industry data, and Customer buying and payment patterns. Overall, these reserves reflect the Company’s best estimates of the amount of consideration to which it is entitled based on the terms of the contract. The amount of variable consideration included in the net sales price is limited to the amount that is probable not to result in a significant reversal in the amount of the cumulative revenue recognized in a future period. If actual results vary, the Company may adjust these estimates, which could have an effect on earnings in the period of adjustment. With respect to the Company’s international contracts with third-party distributors, certain contracts have elements of variable consideration, and management reviews those contracts on a regular basis and makes estimates of revenue based on historical ordering patterns and known market events and data. The amount of variable consideration included in net sales in each period could vary depending on the terms of these contracts and the probability of reversal in future periods. Consideration Payable to Customers Distribution service fees are payments issued to distributors for compliance with various contractually-defined inventory management practices or services provided to support patient access to a product. Distribution service fees reserves are based on the terms of each individual contract and are classified within accrued expenses and are recorded as a reduction of revenue. Product Returns The Company’s policies provide for product returns in the following circumstances: (a) expiration of shelf life on certain products; (b) product damaged while in the Customer’s possession; and (c) following product recalls. Generally, returns for expired product are accepted three months before and up to one year after the expiration date of the related product, and the related product is destroyed after it is returned. The Company may, at its option, either refund the sales price paid by the Customer by issuing a credit or exchanging the returned product for replacement inventory. The Company typically does not provide cash refunds. The Company estimates the proportion of recorded revenue that will result in a return by considering relevant factors, including historical returns experience, the estimated level of inventory in the distribution channel, the shelf life of products and product recalls, if any. The estimation process for product returns involves, in each case, several interrelating assumptions, which vary for each Customer. The Company estimates the amount of its product sales that may be returned by its Customers and records this estimate as a reduction of revenue from product sales in the period the related revenue is recognized, and because this returned product cannot be resold, there is no corresponding asset for product returns. Through the date of this report, product returns have been minimal. License Revenue The Company enters into agreements in which it licenses certain rights to its products to partner companies that act as distributors. The terms of these agreements may include payment to the Company of one or more of the following: non-refundable up-front license fees, milestone payments if specified objectives are achieved, and/or royalties on product sales. The Company recognizes revenue from upfront payments at a point in time, typically upon fulfilling the delivery of the associated intellectual property to the customer. Contracts that contain multiple performance obligations require an allocation of the transaction price based on the estimated relative standalone selling prices of the promised products or services underlying each performance obligation. The Company determines standalone selling prices based on the price at which the performance obligation is sold separately. If the standalone selling price is not observable through past transactions, the Company estimates the standalone selling price taking into account available information such as market conditions related to the performance obligations. The Company will recognize sales-based milestone payments as revenue upon the achievement of the cumulative sales amount specified in the contract in accordance with ASC 606. For those milestone payments which are contingent on the occurrence of particular future events, the Company determines that these need to be considered for inclusion in the calculation of total consideration from the contract as a component of variable consideration using the expected value method. As such, the Company assesses each milestone to determine the probability of and substance behind achieving each milestone. Given the inherent uncertainty associated with these future events, the Company will not recognize revenue from such milestones until there is a high probability of occurrence, which typically occurs near or upon achievement of the event. Customer Payment Obligations The Company receives payments from its Customers based on billing schedules established in each contract, which vary across the Company’s locations, but generally range between 30 to 120 days. Occasionally, the Company offers extended payment terms or payment term discounts to certain Customers. Amounts are recorded as accounts receivable when the Company's right to consideration is unconditional. The Company does not assess whether a contract has a significant financing component if the expectation is that the Customer will pay for the product or services within one year or less of receiving those products or services.

Leases

Leases	3 Months Ended
	Mar. 31, 2023
Leases [Abstract]
Leases	5. LEASES The Company evaluates all of its contracts to determine whether it is or contains a lease at inception. The Company reviews its contracts for options to extend, terminate or purchase any right of use assets and accounts for these, as applicable, at inception of the contract. Upon adoption of ASC 842 , the Company elected the transition package of three practical expedients permitted within the standard. In accordance with the package of practical expedients, the Company did not reassess initial direct costs, lease classification or whether its contracts contain or are leases. The Company made an accounting policy election not to recognize right of use assets and liabilities for leases with a term of 12 months or less, or those that do not meet the Company’s capitalization threshold, unless the leases include options to renew or purchase the underlying asset that are reasonably certain to be exercised. Lease costs associated with those leases are recognized as incurred. The Company has also chosen the practical expedient that allows it to combine lease and non-lease components as a single lease component. Lease renewal options are not recognized as part of the lease liability until the Company determines it is reasonably certain it will exercise any applicable renewal options. The Company has determined it is not reasonably certain it will exercise any applicable renewal options. The Company has not recorded any liability for renewal options in these Interim Financial Statements. The useful lives of leased assets as well as leasehold improvements, if any, are limited by the expected lease term. Operating Leases The Company’s operating lease activities primarily consist of leases for office space in the U.S., the U.K., Ireland, Portugal and Germany. Most of these leases include options to renew, with renewal terms generally ranging from one to eight years . The exercise of lease renewal options is at the Company’s sole discretion. Certain of the Company’s operating lease agreements include variable lease costs that are based on common area maintenance and property taxes. The Company expenses these payments as incurred. The Company’s operating lease agreements do not contain any material residual value guarantees or material restrictive covenants. Supplemental balance sheet information as of March 31, 2023 and December 31, 2022 for the Company’s operating leases is as follows: March 31, December 31, 2023 2022 (In thousands) NON-CURRENT ASSETS: Right of use assets, net $ 1,338 $ 1,395 Total lease assets $ 1,338 $ 1,395 CURRENT LIABILITIES: Accrued expenses $ 701 $ 768 NON-CURRENT LIABILITIES: Other non-current liabilities 2,154 2,267 Total lease liabilities $ 2,855 $ 3,035 The Company’s operating lease cost for the three months ended March 31, 2023 was $ 149,000 , and is included in general and administrative expenses in its condensed consolidated statement of operations. The Company’s operating lease cost for the three months ended March 31, 2022 was $ 138,000 and is included in general and administrative expenses in its condensed consolidated statement of operations. As of March 31, 2023, a schedule of maturity of lease liabilities under all of the Company’s operating leases is as follows: Years Ending December 31 (In thousands) 2023 (remaining) $ 528 2024 676 2025 474 2026 488 2027 503 Thereafter 1,052 Total 3,721 Less amount representing interest ( 866 ) Present value of minimum lease payments 2,855 Less current portion (as a portion of accrued expenses) ( 701 ) Non-current portion (as a portion of other non-current liabilities) $ 2,154 Cash paid for operating leases was $ 175,000 during the three months ended March 31, 2023. No right-of-use assets were obtained in connection with operating leases for the three months ended March 31, 2023. Cash paid for operating leases was $ 68,000 during the three months ended March 31, 2022. No right-of-use assets were obtained in connection with operating leases for the three months ended March 31, 2022. As of March 31, 2023, the weighted average remaining lease terms of the Company’s operating leases was 6.2 years. The weighted average discount rate used to determine the lease liabilities was 9.5 %. Finance Leases The Company’s finance lease activities primarily consist of leases for office equipment and automobiles. Property and equipment leases are capitalized at the lesser of fair market value or the present value of the minimum lease payments at the inception of the leases using the Company’s incremental borrowing rate. The Company’s finance lease agreements do not contain any material residual value guarantees or material restrictive covenants. Supplemental balance sheet information as of March 31, 2023 and December 31, 2022 for the Company’s finance leases is as follows: March 31, December 31, 2023 2022 (In thousands) NON-CURRENT ASSETS: Property and equipment, net $ 374 $ 366 Total lease assets $ 374 $ 366 CURRENT LIABILITIES: Finance lease obligations $ 263 $ 333 NON-CURRENT LIABILITIES: Other non-current liabilities 160 131 Total lease liabilities $ 423 $ 464 Depreciation expense associated with property and equipment under finance leases was approximately $ 52,000 and $ 94,000 for the three months ended March 31, 2023 and 2022, respectively. Interest expense associated with finance leases was $ 10,000 for each of the three months ended March 31, 2023 and 2022. As of March 31, 2023, a schedule of maturity of lease liabilities under finance leases, together with the present value of minimum lease payments, is as follows: Years Ending December 31 (In thousands) 2023 (remaining) $ 273 2024 144 2025 87 2026 4 Total 508 Less amount representing interest ( 85 ) Present value of minimum lease payments 423 Less current portion ( 263 ) Non-current portion $ 160 Cash paid for finance leases was $ 127,000 during the three months ended March 31, 2023. The Company acquired $ 90,000 of property and equipment in exchange for finance leases during the three months ended March 31, 2023. Cash paid for finance leases was $ 98,000 during the three months ended March 31, 2022. No property or equipment was obtained in exchange for finance leases during the three months ended March 31, 2022. As of March 31, 2023, the weighted average remaining lease terms of the Company’s finance leases was 0.3 years. The weighted average discount rate used to determine the finance lease liabilities was 9.5 %.

Going Concern

Going Concern	3 Months Ended
	Mar. 31, 2023
Going Concern [Abstract]
Going Concern	6. GOING CONCERN The accompanying Interim Financial Statements have been prepared on a going concern basis, which contemplates the realization of assets and the satisfaction of liabilities in the normal course of business. The Interim Financial Statements do not include any adjustments that might result from the outcome of this uncertainty. The Company has incurred recurring losses, negative cash flow from operations and has accumulated a deficit of $ 402,081,000 from the Company’s inception through March 31, 2023. As of March 31, 2023, the Company had approximately $ 13,086,000 in cash and cash equivalents. The Company’s ability to achieve profitability and positive cash flow depends on its ability to increase revenue and contain its expenses. Further, the Company must maintain compliance with the debt covenants of its Loan and Security Agreement dated December 31, 2019 with SLR and certain other lenders (as amended, the 2019 Loan Agreement). (See Note 10) In management’s opinion, the uncertainty regarding future revenues raises substantial doubt about the Company’s ability to continue as a going concern without access to additional debt and/or equity financing, over the course of the next twelve months. Additionally, if the Company were unable to comply with the Revenue Covenant (as defined in Note 10) at any time over the course of the next year, the lenders have the right to accelerate the maturity of the loan which would raise substantial doubt about the Company’s ability to continue as a going concern without access to alternative debt and/or equity financing, over the course of the next twelve months. To meet the Company’s anticipated future working capital needs, in March 2023, the Company consummated an equity financing and amended the 2019 Loan Agreement (See Note 10). However, the Company may need to raise additional debt and/or equity financing. While the Company has historically been able to raise additional capital through issuance of equity and/or debt financing and has implemented a plan to control its expenses to satisfy its obligations due within one year from the date of issuance of these financial statements, the Company cannot guarantee that it will be able to maintain debt compliance, raise additional debt or equity, contain expenses, or increase revenue. Accordingly, there is substantial doubt about the Company’s ability to continue as a going concern within one year after these financial statements are issued.

Inventory

Inventory	3 Months Ended
	Mar. 31, 2023
Inventory [Abstract]
Inventory	7. INVENTORY Inventory consisted of the following: March 31, December 31, 2023 2022 (In thousands) Component parts (1) $ 236 $ 152 Work-in-process (2) 546 560 Finished goods 433 893 Total Inventory $ 1,215 $ 1,605 (1) Component parts inventory consists of manufactured components of the ILUVIEN applicator. (2) Work-in-process consists of completed units of ILUVIEN that are undergoing, but have not completed, quality assurance testing as required by U.S. or EEA regulatory authorities.

Intangible Asset

Intangible Asset	3 Months Ended
	Mar. 31, 2023
Intangible Asset [Abstract]
Intangible Asset	8. INTANGIBLE ASSET As a result of the U.S. Food and Drug Administration’s (FDA) approval of ILUVIEN in September 2014, the Company was required to pay in October 2014 a milestone payment of $ 25,000,000 (the EyePoint Milestone Payment) to EyePoint Pharmaceuticals US, Inc. (EyePoint), formerly known as pSivida US, Inc. (see Note 9). The gross carrying amount of the intangible asset is $ 25,000,000 , which is being amortized over approximately 13 years from the payment date. The amortization expense related to the intangible asset was approximately $ 478,000 for the three months ended March 31, 2023 and 2022, respectively. The net book value of the intangible asset was $ 8,479,000 and $ 8,957,000 as of March 31, 2023 and December 31, 2022, respectively. The estimated remaining amortization as of March 31, 2023 is as follows (in thousands): Years Ending December 31 (In thousands) 2023 (remaining) $ 1,462 2024 1,946 2025 1,940 2026 1,940 2027 1,191 Total $ 8,479

License Agreements

License Agreements	3 Months Ended
	Mar. 31, 2023
License Agreements [Abstract]
License Agreements	9. LICENSE AGREEMENTS EyePoint Agreement In February 2005, the Company entered into an agreement with EyePoint (formerly known as pSivida US, Inc.) for the use of fluocinolone acetonide (FAc) in EyePoint’s proprietary insert technology. This agreement was subsequently amended a number of times (as amended, the EyePoint Agreement). The EyePoint Agreement provides the Company with a worldwide exclusive license to utilize certain underlying technology used in the development and commercialization of ILUVIEN. In July 2017, the Company amended and restated its EyePoint license agreement, which was made effective July 1, 2017 (the New Collaboration Agreement). Under the New Collaboration Agreement, the Company has the right to the technology underlying ILUVIEN for the treatment of (a) human eye diseases, including uveitis, in Europe, the Middle East, and Africa, and (b) human eye diseases other than uveitis worldwide. The New Collaboration Agreement converted the Company’s previous profit share obligation to a royalty payable on global net revenues of ILUVIEN. Following the signing of the New Collaboration Agreement, the Company retained a right to recover up to $ 15,000,000 of commercialization costs that were incurred prior to profitability of ILUVIEN and to offset a portion of future payments owed to EyePoint with these accumulated commercialization costs, referred to as the Future Offset. Due to the uncertainty of future net profits, the Company has fully reserved the Future Offset in the accompanying Interim Financial Statements. In March 2019, pursuant to the New Collaboration Agreement, the Company forgave $ 5,000,000 of the Future Offset in connection with the approval of ILUVIEN for NIU-PS in the U.K. As of March 31, 2023, the balance of the Future Offset was approximately $ 6,879,000 , which is fully reserved. During the three months ended March 31, 2023 and 2022, the Company’s net royalty expense payable to EyePoint was 5.2 %, which was reduced from 6 % due to the recoverable balance of the Future Offset. The Company will be required to pay an additional 2 % royalty on future global net revenues and other related consideration in excess of $ 75,000,000 in any year. During the three months ended March 31, 2023, the Company recognized approximately $ 703,000 of royalty expense, which is included in cost of goods sold, excluding depreciation and amortization. As of March 31, 2023, approximately $ 703,000 of this royalty expense was included in the Company’s accounts payable. During the three months ended March 31, 2022, the Company recognized approximately $ 617,000 of royalty expense which is included in cost of goods sold, excluding depreciation and amortization. Ocumension License Agreement On April 14, 2021, the Company entered into an exclusive license agreement (the License Agreement) with Ocumension (Hong Kong) Limited (Ocumension HK), a wholly owned subsidiary of Ocumension Therapeutics, for the development and commercialization under Ocumension HK’s own brand name(s), either directly or through its affiliates or approved third-party sublicensees, of the Company’s 0.19 mg fluocinolone acetonide intravitreal implant in applicator (the Product; currently marketed in the United States, Europe, and the Middle East as ILUVIEN®) for the treatment and prevention of eye diseases in humans, other than uveitis, in a specified territory. The Territory is defined as the People’s Republic of China, including Hong Kong SAR and Macau SAR, region of Taiwan, South Korea, Brunei, Cambodia, East Timor, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam. The Company received a nonrefundable upfront payment of $ 10,000,000 from Ocumension HK and may in the future receive additional sales-based milestone payments totaling up to $ 89,000,000 upon the achievement by Ocumension HK of certain specified sales milestones during the term of the License Agreement. The Company’s receipt of future milestone payments depends upon whether Ocumension HK is able to successfully complete product development and commercialization in the Territory, which requires, among other things, obtaining necessary regulatory approvals and appropriate reimbursement pricing in the various countries and jurisdictions in the Territory, a process that may take several years. In 2021 the Company recognized $ 11,048,000 in license revenue from the Ocumension transaction (including the value of a warrant subscription agreement, which Alimera received as consideration, for Alimera to purchase 1,000,000 shares of Ocumension Therapeutics during a period of four years ), in accordance with ASC 606, Revenue from Contracts with Customers, with the remaining approximate $ 300,000 in consideration classified as deferred revenue that will be recognized over the remaining term of the license agreement once Ocumension begins to sell products. The term of the License will continue (a) until the 10th anniversary of the latest first commercial sale of the Product in any country or jurisdiction in the Territory or (b) for as long as Ocumension HK is commercializing the Product in any part of the Territory, whichever is later. The term is subject to the Company’s right to partially terminate the Agreement beginning on the 10th anniversary of the effective date with respect to any country or jurisdiction in the Territory in which Ocumension has not achieved at the time of termination first commercial sale and is not continuing to commercialize the Product. Ocumension will purchase Product from the Company at a fixed transfer price without royalty obligation on future sale (other than milestone payments as described above). Ocumension HK is responsible for all costs of development and commercialization in the Territory . When the Company entered into the license agreement, it also entered into a share purchase agreement and a warrant subscription agreement, which are discussed in Note 16.

Loan Agreements

Loan Agreements	3 Months Ended
	Mar. 31, 2023
Loan Agreements [Abstract]
Loan Agreements	10. LOAN AGREEMENTS Loan Agreements with SLR Investment Corp. (formerly named Solar Capital Ltd.) On January 5, 2018, the Company entered into a $ 40,000,000 loan and security agreement with Solar Capital Ltd., as Collateral Agent, and the parties signatory thereto from time to time as Lenders, including Solar Capital Ltd. in its capacity as a Lender (the 2018 Loan Agreement). On December 31, 2019, the Company refinanced the 2018 Loan Agreement by entering into a $ 45,000,000 loan and security agreement (the 2019 Loan Agreement) with SLR Investment Corp. (SLR, f/k/a Solar Capital Ltd.), as Agent, and the parties signing the Loan Agreement from time to time as Lenders, including SLR in its capacity as a Lender (collectively, the Lenders). The Company amended the 2019 Loan Agreement on March 24, 2023 (the Fifth Amendment) and entered into a related exit fee agreement with the Lenders. (See Note 21) Pursuant to the Fifth Amendment, the Lenders agreed to, among other things, (i) an additional tranche of $ 2,500,000 to increase the Company’s existing term loan facility to $ 47,500,000 , subject to certain closing conditions, and (ii) extend a $ 15,000,000 additional term loan available to be funded at the Lender’s sole discretion. Interest on the 2019 Loan Agreement prior to the Fifth Amendment was payable at an annual rate the greater of (i) one-month LIBOR or (ii) 1.78 %, plus 7.65 % per annum. Interest on the 2019 Loan Agreement following the Fifth Amendment is payable at an annual rate equal to 5.15 % plus the greater of (i) 4.60 % and (ii) one-month SOFR, which will reset monthly. As of March 31, 2023, the interest rate on the 2019 Loan Agreement was approximately 9.75 %. The 2019 Loan Agreement provides for interest only payments until April 30, 2025, which may be extended an additional 12 months if the Company meets certain financial targets by March 31, 2025, followed by monthly payments of principal and interest through the loan maturity date of April 30, 2028. 2018 Exit Fee Agreement Notwithstanding the repayment of the outstanding loan under the 2018 Loan Agreement, the Company remains obligated to pay additional fees under the Exit Fee Agreement (2018 Exit Fee Agreement) dated as of January 5, 2018 by and among the Company, SLR, as Agent, and the Lenders. The 2018 Exit Fee Agreement survived the termination of the 2018 Loan Agreement upon the repayment of the outstanding loan under the 2018 Loan Agreement and has a term of 10 years. The Company is obligated to pay up to, but no more than, $ 2,000,000 in fees under the 2018 Exit Fee Agreement. Specifically, the Company is obligated to pay an exit fee of $ 2,000,000 on a “change in control” (as defined in the 2018 Exit Fee Agreement). To the extent that the Company has not already paid the $ 2,000,000 fee, the Company is also obligated to pay a fee of $ 1,000,000 on achieving each of the following milestones:  first, if the Company achieves revenues of $ 80,000,000 or more from the sale of its ILUVIEN product in the ordinary course of business to third party customers, measured on a trailing 12 -month basis during the term of the agreement, tested at the end of each month; and  second, if the Company achieves revenues of $ 100,000,000 or more from the sale of its ILUVIEN product in the ordinary course of business to third party customers, measured in the same manner. 2019 Exit Fee Agreement The Company is also obligated to pay additional fees under the Exit Fee Agreement dated as of December 31, 2019 by and among the Company, SLR as Agent, and the Lenders (2019 Exit Fee Agreement). The 2019 Exit Fee Agreement will survive the termination of the 2019 Loan Agreement and has a term of 10 years. The Company will be obligated to pay a $ 675,000 exit fee upon the occurrence of an exit event, which generally means a change in control, as defined in the 2019 Exit Fee Agreement. 2023 Exit Fee Agreement On March 24, 2023, the Company entered into the Fifth Amendment Exit Fee Agreement (the New Exit Fee Agreement), which will survive the termination of the Amended Loan Agreement and has a term of 10 years. The Company will be obligated to pay an exit fee of 1.5 % of the original principal amount funded under the Amended Loan Agreement upon the occurrence of an exit event, which generally means a change in control, as defined in the New Exit Fee Agreement. If the Company has not already paid the exit fee under the New Exit Fee Agreement, the Company is also obligated to pay an equivalent fee upon achieving revenues of $ 82,500,000 or more from the sale of ILUVIEN in the ordinary course of business to third party customers, measured on a trailing 12-month basis during the term of the New Exit Fee Agreement, tested at the end of each month. The Company’s existing exit fee agreements remain in effect. The fees payable pursuant to the Company’s existing exit fee agreements and the New Exit Fee Agreement will not exceed $ 3,387,500 in total. Third Amendment to 2019 Loan Agreement On February 22, 2022, the Company entered into a Third Amendment to the 2019 Loan Agreement (the Third Amendment), which, among other things: (a) specified the minimum revenue amount, calculated on a trailing six-month basis and tested at the end of each calendar quarter in 2022, that the Company must achieve for each such period (the Revenue Covenant); (b) consented to the Company maintaining a lower minimum revenue amount under the Revenue Covenant for the trailing six-month period ended December 31, 2021 than previously required under the Loan Agreement (and waived any event of default that may have occurred or may be deemed to have occurred as a result of the Company’s lower revenue amount for that period); and (c) required that the Revenue Covenant be tested at March 31, 2023 and at the last day of each quarter thereafter, with the minimum revenue amount equal to a percentage of the Company’s projected revenues in accordance with an annual plan submitted by the Company to the Collateral Agent by January 15 of such year, such plan to be thereafter approved by the Company’s board of directors and the Collateral Agent in its sole discretion no later than February 28 of such year. Fourth Amendment to 2019 Loan Agreement On December 7, 2022, the Company entered into a Fourth Amendment to the 2019 Loan Agreement (the Fourth Amendment), which, among other things: (a) extends the amortization date from January 1, 2023 to April 1, 2023, provided that such date may be further extended to July 1, 2023 upon the Company’s request and in consultation with the Lenders, in each of the Lenders’ sole discretion; (b) specifies the minimum revenue amount, calculated on a trailing six-month basis and tested at the end of each calendar quarter in 2023, that the Company must achieve for each such period (the Revenue Covenant); and (c) requires that the Revenue Covenant be tested at March 31, 2023 and at the last day of each quarter thereafter, with the minimum revenue amount equal to a percentage of Alimera’s projected revenues in accordance with an annual plan submitted by the Company to the Collateral Agent by January 15th of such year, such plan to be thereafter approved by Alimera’s board of directors and the Collateral Agent in its sole discretion no later than February 28 of such year. Fifth Amendment to 2019 Loan Agreement On March 24, 2023, the Company entered into a Fifth Amendment to the 2019 Loan Agreement (the Fifth Amendment and the 2019 Loan Agreement as so amended, the Amended Loan Agreement), under which the Lenders agreed to, among other things: (a) a n additional tranche of $ 2,500,000 to increase the Company’s existing term loan facility to $ 47,500,000 , subject to certain closing conditions (the New Term Loan) ; (b) extend a $ 15,000,000 additional term loan available to be funded at the Lender’s sole discretion; (c) annual interest rate equal to 5.15 % plus the greater of (i) 4.60 %, and (ii) one-month SOFR, which will reset monthly, on the New Term Loan; (d) extend the maturity date to April 30, 2028 and the interest-only period to April 30, 2025, which may be extended an additional 12 months if the Company meets certain financial targets by March 31, 2025; and (e) specify the minimum revenue amount, calculated on a trailing six-month basis beginning with the six month period ended March 31, 2023, and tested at the end of each calendar quarter, that the Company must achieve for each such period (the Revenue Covenant. The Company expects to comply with the Revenue Covenant at the next reportable date, which is June 30, 2023, and the remainder of the Revenue Covenants through one year after these financial statements are issued. Modification of Debt In accordance with the guidance in ASC 470-50, Debt , the Company entered into and accounted for the Third Amendment, Fourth Amendment, and Fifth Amendment as modifications and expensed, as they were incurred, legal costs associated with third parties as costs of the modifications. The Company capitalized $ 113,000 of costs in connection with the Fourth Amendment. The Company did not capitalize any costs associated with the Third Amendment. The Company capitalized $ 2,625,000 of costs in connection with the Fifth Amendment. Fair Value of Debt The weighted average interest rates of the Company’s notes payable approximate the rate at which the Company could obtain alternative financing. Therefore, the carrying amount of the notes approximated their fair value at March 31, 2023 and December 31, 2022.

Loss Per Share (EPS)

Loss Per Share (EPS)	3 Months Ended
	Mar. 31, 2023
Loss Per Share (EPS) [Abstract]
Loss Per Share (EPS)	11. LOSS PER SHARE (EPS) The Company follows ASC 260, Earnings Per Share (ASC 260), which requires the reporting of both basic and diluted earnings per share. Because the Company’s preferred stockholders participate in dividends equally with common stockholders (if the Company were to declare and pay dividends), the Company uses the two-class method to calculate EPS. However, the Company’s preferred stockholders are not contractually obligated to share in losses. Basic EPS is computed by dividing net income or loss available to stockholders by the weighted average number of shares outstanding for the period. Diluted EPS is calculated in accordance with ASC 260 by adjusting weighted average shares outstanding for the dilutive effect of common stock options and warrants the Company has issued. In periods where a net loss is recorded, no effect is given to potentially dilutive securities, since the effect would be anti-dilutive. Common stock equivalent securities that would potentially dilute basic EPS in the future, but were not included in the computation of diluted EPS because they were either not classified as participating or would have been anti-dilutive, were as follows: March 31, 2023 2022 Series A convertible preferred stock — 601,504 Series B convertible preferred stock 5,714,286 — Common stock warrants 5,714,286 — Stock options 1,216,953 1,315,161 Total 12,645,525 1,916,665

Preferred Stock

Preferred Stock	3 Months Ended
	Mar. 31, 2023
Preferred Stock [Abstract]
Preferred Stock	12. PREFERRED STOCK Securities Purchase Agreement On March 24, 2023, the Company entered into a Securities Purchase Agreement (the Purchase Agreement) with certain investors for the sale of up to 27,000 shares of the Company’s newly designated Series B Convertible Preferred Stock, par value $ 0.01 per share (the Series B Preferred Stock) and warrants (the Warrants) to purchase up to 5,714,286 shares of the Company’s common stock, for an aggregate purchase price of up to $ 27,000,000 in two tranches. On March 24, 2023 (the Tranche 1 Closing Date), the Company issued and sold an aggregate of 12,000 shares of Series B Preferred Stock at a per-share purchase price of $ 1,000 (the Stated Value) and the Warrants for aggregate gross proceeds of $ 12,000,000 (the Tranche 1 Closing). The proceeds from the Tranche 1 Closing will be used to fund development and commercialization of the Company’s existing and potential future pipeline drugs, maintenance of the Company’s credit facility and corporate purposes substantially related to the commercialization of the Company’s existing and pipeline drugs, as well as the Repurchase (as defined below). At the closing of the second tranche (the Tranche 2 Closing), the Company will issue and sell an aggregate of 15,000 shares of Series B Preferred at a per-share purchase price equal to the Stated Value for aggregate gross proceeds of $ 15,000,000 . The number of shares to be issued at the Tranche 2 Closing is subject to increase by mutual agreement of the Company and investors. The Tranche 2 Closing will only occur upon the mutual agreement of the Company and the holders of a majority of the outstanding Series B Preferred Stock (the Preferred Majority); provided that the closing shall occur no later than December 31, 2023, if at all. The proceeds from the Tranche 2 Closing, if any, will be used to fund potential in-licenses or acquisitions of new technologies, products or businesses in ophthalmology, subject to applicable Nasdaq listing rules. The initial conversion price of the shares of Series B Preferred Stock issued at the Tranche 1 Closing is $ 2.10 (the Tranche 1 Conversion Price). The shares of Series B Preferred Stock issued at the Tranche 2 Closing, if any, will have an initial conversion price equal to the 30 -day preceding volume-weighted average price of the common stock on Nasdaq, but in any event (i) no less than eighty percent ( 80 %) of the Tranche 1 Conversion Price per share nor (ii) greater than two-times the Tranche 1 Conversion Price per share. In each case, the conversion price of the Series B Preferred Stock is subject to certain customary adjustments, including a weighted average anti-dilution adjustment. Unless and until stockholder approval to issue the common stock underlying the Series B Preferred Stock is obtained, the Series B Preferred Stock will not be convertible into common stock to the extent that such conversion would cause (i) the aggregate number of shares of common stock that would be issued pursuant to the Purchase Agreement and the transactions contemplated thereby to exceed 1,401,901 ( 19.99 % of the voting power or number of shares of common stock, issued and outstanding immediately prior to the execution of the Purchase Agreement), which number will be reduced, on a share-for-share basis, by the number of shares of common stock issued or issuable pursuant to any transactions that may be aggregated with the transactions contemplated by the Purchase Agreement under applicable Nasdaq rules (the Exchange Cap); or (ii) the aggregate number of shares of common stock that would be issued pursuant to such conversion, when aggregated with any shares of common stock then beneficially owned by the holder (or group of holders required to be aggregated) of such shares, would result in (a) a “change of control” under applicable Nasdaq listing rules (the Change of Control Cap) or (b) such holder or a “person” or “group” to beneficially own in excess of 9.99 % of the common stock outstanding immediately after giving effect to the issuance of shares of common stock issuable upon such conversion (the Ownership Limitation). The Series B Preferred Stock will be entitled to receive dividends and other distributions pro rata with the common stock. In addition, prior to conversion, dividends will accrue on the Series B Preferred Stock at an annual rate of 6 % of the Stated Value, accruing daily. The Series B Preferred Stock is not redeemable. At March 31, 2023, the Series B Preferred Stock had $ 14,000 of cumulative dividends in arrears ($ 1.17 per share). The Warrants have an exercise price equal to the Tranche 1 Conversion Price (as adjusted pursuant to the Certificate of Designation of the Series B Preferred Stock through the date of Stockholder Approval) and expire seven years from the date of the Tranche 1 Closing. The Warrants are exercisable upon the earlier of (a) a change of control and (b) March 24, 2024; provided that prior to Stockholder Approval, exercise of the Warrants is subject to the Ownership Limitation, the Change of Control Cap and the Exchange Cap. If the Company consummates the Tranche 2 Closing or a qualified financing transaction of at least $ 15,000,000 prior to December 31, 2023, the number of shares underlying the Warrants will automatically be reduced to an aggregate of 1,000,000 shares of common stock. Series A Convertible Preferred Stock In October 2012, the Company closed its preferred stock financing in which it sold units consisting of 1,000,000 shares of Series A Convertible Preferred Stock (Series A Preferred Stock) and warrants (which expired on October 1, 2017) to purchase 300,000 shares of Series A Preferred Stock for gross proceeds of $ 40,000,000 , prior to the payment of approximately $ 560,000 of related issuance costs. The powers, preferences and rights of the Series A Preferred Stock are set forth in the certificate of designation for the Series A Preferred Stock filed by the Company with the Delaware Secretary of State as part of the Company’s certificate of incorporation. As of December 31, 2022, there were 600,000 shares of Series A Convertible Preferred Stock issued and outstanding. As a condition to entering into the Purchase Agreement, the Company repurchased 200,919 shares of common stock and 600,000 shares of its Series A Preferred Stock held by the holders thereof (the Repurchase), for an aggregate purchase price of approximately $ 1,252,000 . The holders of the Series A Preferred Stock were entitled to a liquidation preference before the holders of common stock would be entitled to receive any consideration in the event of the Company’s liquidation. As of December 31, 2022, the Series A Preferred Stock aggregate liquidation preference was $ 24,000,000 . As a result of the Repurchase, no shares of the Series A Preferred Stock remain outstanding and the liquidation preference is no longer in effect. Following the Repurchase, the Company filed a certificate of elimination of the Series A Preferred Stock with the Secretary of State of the State of Delaware.

Equity Incentive Plans

Equity Incentive Plans	3 Months Ended
	Mar. 31, 2023
Equity Incentive Plans [Abstract]
Stock Incentive Plans	13. EQUITY INCENTIVE PLANS Under the Company’s 2019 Omnibus Incentive Plan (the 2019 Plan), the Compensation Committee of the Board is authorized to grant equity-based incentive awards that include stock options, restricted stock units and shares of restricted stock to officers, directors, employees and contractors. Equity-based awards are also outstanding under the Company’s 2010 Equity Incentive Plan, although no new awards can be granted under that plan. The Company also has an employee stock purchase plan. Stock Options During the three months ended March 31, 2023 and 2022, the Company recorded compensation expense related to stock options of approximately $ 167,000 and $ 258,000 , respectively. As of March 31, 2023, the total unrecognized compensation cost related to non-vested stock options granted was $ 1,028,000 and is expected to be recognized over a weighted average period of 2.46 years. The following table presents a summary of stock option activity for the three months ended March 31, 2023 and 2022: Three Months Ended March 31, 2023 2022 Weighted Weighted Average Average Exercise Exercise Options Price ($) Options Price ($) Options outstanding at beginning of period 1,175,339 19.03 1,075,795 23.35 Grants 100,402 2.73 283,550 4.84 Forfeitures and expirations ( 58,788 ) 11.85 ( 44,184 ) 22.36 Options outstanding at period end 1,216,953 18.03 1,315,161 19.39 Options exercisable at period end 867,650 23.38 810,201 27.92 Weighted average per share fair value of options granted during the period $ 1.88 $ 3.32 The following table provides additional information related to outstanding stock options as of March 31, 2023: Weighted Weighted Average Average Remaining Aggregate Exercise Contractual Intrinsic Shares Price ($) Term Value ($) (In thousands) Outstanding 1,216,953 18.03 5.79 years 1 Exercisable 867,650 23.38 4.61 years — Outstanding, vested and expected to vest 1,184,035 18.39 5.70 years 1 The following table provides additional information related to outstanding stock options as of December 31, 2022: Weighted Weighted Average Average Remaining Aggregate Exercise Contractual Intrinsic Shares Price ($) Term Value ($) (In thousands) Outstanding 1,175,339 19.03 5.68 — Exercisable 878,115 23.62 4.72 — Outstanding, vested and expected to vest 1,139,482 19.46 5.58 — As of March 31, 2023, 54,918 shares remain available for grant under the 2019 Plan. Restricted Stock and Restricted Stock Units (RSUs) The following table presents a summary of restricted stock and RSU activity for the three months ended March 31, 2023 and 2022: Three Months Ended March 31, 2023 2022 Weighted Weighted Average Average Grant Date Grant Date Shares Fair Value ($) Shares Fair Value ($) Restricted stock and RSUs outstanding at beginning of period 73,594 4.98 46,250 5.65 Grants 632,050 1.39 57,500 4.96 Vested units ( 20,468 ) 4.98 ( 9,687 ) 5.01 Forfeitures — — — — Restricted stock and RSUs outstanding at period end 685,176 1.67 94,063 5.29 Employee stock-based compensation expense related to restricted stock and RSUs recognized in accordance with ASC 718, Compensation - Stock Compensation (ASC 718) was $ 47,000 and $ 46,000 for the three months ended March 31, 2023 and 2022, respectively. As of March 31, 2023, the total unrecognized compensation cost related to restricted stock and RSUs was $ 887,000 and is expected to be recognized over a weighted average period of 3.62 years. Employee Stock Purchase Plan During the three months ended March 31, 2023 and 2022, the Company recorded compensation expense related to its employee stock purchase plan of approximately $ 11,000 , and $ 8,000 , respectively.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2023
Income Taxes [Abstract]
Income Taxes	14. INCOME TAXES In accordance with ASC 740, Income Taxes, the Company recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities at the enacted tax rates in effect for the year in which the differences are expected to reverse. The Company records a valuation allowance against its net deferred tax asset to reduce the net carrying value to an amount that is more likely than not to be realized. At the end of each interim period, the Company makes its best estimate of the effective tax rate expected to be applicable for the full fiscal year. This estimate reflects, among other items, the Company’s best estimate of operating results and foreign currency exchange rates. The Company also applies the provisions for income taxes related to, among other things, accounting for uncertain tax positions and disclosure requirements. There has been no change to the Company’s policy that recognizes potential interest and penalties related to uncertain tax positions. The Company conducts business globally and, as a result, files income tax returns in the U.S. federal jurisdiction and various state and foreign jurisdictions. In the normal course of business, the Company is subject to examination by taxing authorities throughout the world. For the three months ended March 31, 2023, the Company has not recorded income tax expense or benefit. No tax benefit is expected to be realized for the losses in the United States and the United Kingdom due to the ongoing losses and valuation allowances in these jurisdictions. Tax expense or benefit for income and losses in other jurisdictions (Ireland, Germany, and Portugal) are immaterial for the quarter. At December 31, 2022, the Company had U.S. federal NOL carry-forwards of approximately $ 147,200,000 and state NOL carry-forwards of approximately $ 107,700,000 available to reduce future taxable income, subject to limitation based upon the results of the Company’s analyses under Internal Revenue Code Sections 382 and 383. The Company’s U.S. federal NOL carry-forwards remain fully reserved as of March 31, 2023. If not utilized, the federal NOL carry-forwards will expire at various dates between 2029 and 2037, the Company’s federal NOL created in 2018 and onward will carry forward indefinitely and the state NOL carry-forwards will expire at various dates between 2023 and 2042. NOL carry-forwards may be subject to annual limitations under Internal Revenue Code Sections 382 and 383 in the event that certain changes in ownership of the Company were to occur. The Company has not yet completed a formal evaluation of the impact of the issuance of the Company’s Series B Preferred Stock on March 24, 2023 on the Company’s NOL carry-forwards and whether certain changes in ownership have occurred that would limit the Company’s ability to utilize a portion of its NOL carry-forwards. As of December 31, 2022, the Company’s U.K. subsidiary is in a net deferred tax asset position primarily due to the step up in tax basis for intangible assets created by the transfer of intellectual property from the Netherlands to the U.K. Based upon the expected pattern of reversal of deferred taxes, it is not more likely than not that these deferred tax assets will be realized. As such, a full valuation allowance is placed against the net deferred tax assets of the U.K. subsidiary. The Company’s Irish subsidiary has a deferred tax asset for net operating loss carryforwards. The Company expects this net operating loss carryforward to be fully realizable in the future based upon the Company’s control of the transfer pricing arrangements. A valuation allowance is not recorded on the deferred tax assets of the Ireland subsidiary. Deferred tax considerations for all other foreign entities are immaterial to the financial statements. Effective January 1, 2022, for U.S. tax purposes research and development costs, including software development costs, are required to be capitalized and will be deductible over five years for costs incurred domestically and over fifteen years for costs incurred in a foreign country. Additionally, the first year of amortization requires that amortization begin with the midpoint of the taxable year. As of December 31, 2022, the Company recorded a deferred tax asset of approximately $ 969,000 related to capitalized research and development costs. This deferred tax asset is fully reserved with a valuation allowance. On August 16, 2022, the president signed the Inflation Reduction Act ( IRA ) into law. The IRA enacted a 15% corporate minimum tax effective in 2024, a 1% tax on share repurchases after December 31, 2022, and created and extended certain tax-related energy incentives. The Company does not currently expect the tax-related provisions of the IRA to have a material effect on its financial results. The Company anticipates that its foreign subsidiaries will be profitable and have earnings in the future. Once the foreign subsidiaries have earnings, the Company intends to indefinitely reinvest in its foreign subsidiaries all undistributed earnings and original investments in such subsidiaries. As a result, the Company does not expect to record deferred tax liabilities in the future related to excesses of book over tax basis in the stock of its foreign subsidiaries in accordance with ASC 740-30-25. Tax years from 2018 to 2020 remain subject to examination in California, Georgia, Kentucky, Tennessee, Texas and on the federal level, with the exception of the assessment of NOL carry-forwards available for utilization, which can be examined for all years since 2009. The statute of limitations on these years will close when the NOLs expire or when the statute closes on the years in which the NOLs are utilized.

Segment Information

Segment Information	3 Months Ended
	Mar. 31, 2023
Segment Information [Abstract]
Segment Information	15. SEGMENT INFORMATION During the three months ended March 31, 2023 and 2022, two customers within the U.S. segment that are large pharmaceutical distributors accounted for 56 % and 58 % of the Company’s consolidated product revenues, respectively. These same two customers within the U.S. segment accounted for approximately 63 % and 71 % of the Company’s consolidated accounts receivable at March 31, 2023 and at December 31, 2022, respectively. The Chief Executive Officer (CEO), who is the chief operating decision maker, has determined that the Company’s operations are now managed as three operating segments: U.S., International and Operating Cost. The Company determined that each of these operating segments represented a reportable segment. In monitoring performance, aligning strategies and allocating resources, the chief operating decision maker manages and evaluates the Company’s U.S., International and Operating Cost segments based on segment income or loss from operations adjusted for certain non-cash items, such as stock-based compensation expense and depreciation and amortization. Therefore, the Company classifies within Other (a) the non-cash expenses included in research, development and medical affairs expenses; general and administrative expenses; and sales and marketing expenses; and (b) depreciation and amortization. The Company’s U.S. and International segments represent the sales and marketing, general and administrative and research and development activities dedicated to the respective geographies. The Operating Cost segment primarily represents the general and administrative and research and development activities not specifically associated with the U.S. or International segments and includes expenses such as executive management; information technology administration and support; legal; compliance; clinical studies; and business development. Each of the Company’s U.S., International and Operating Cost segments is separately managed and is evaluated primarily upon segment income or loss from operations. Other is presented to reconcile to the Company’s consolidated totals. The Company does not report balance sheet information by segment because the chief operating decision maker does not review that information. The Company allocates certain operating expenses among its reporting segments based on activity-based costing methods. These activity-based costing methods require the Company to make estimates that affect the amount of each expense category that is attributed to each segment. Changes in these estimates will directly affect the amount of expense allocated to each segment and therefore the operating profit of each reporting segment. The following tables present a summary of the Company’s reporting segments for the three months ended March 31, 2023 and 2022: Three Months Ended March 31, 2023 U.S. International Operating Cost Other Consolidated (In thousands) REVENUE: PRODUCT REVENUE, NET $ 7,582 $ 5,964 $ — $ — $ 13,546 COST OF GOODS SOLD, EXCLUDING DEPRECIATION AND AMORTIZATION ( 905 ) ( 1,123 ) — — ( 2,028 ) GROSS PROFIT 6,677 4,841 — — 11,518 RESEARCH, DEVELOPMENT AND MEDICAL AFFAIRS EXPENSES 1,162 756 2,224 22 4,164 GENERAL AND ADMINISTRATIVE EXPENSES 1,184 716 2,116 155 4,171 SALES AND MARKETING EXPENSES 4,274 1,415 66 49 5,804 DEPRECIATION AND AMORTIZATION — — — 681 681 OPERATING EXPENSES 6,620 2,887 4,406 907 14,820 SEGMENT INCOME (LOSS) FROM OPERATIONS 57 1,954 ( 4,406 ) ( 907 ) ( 3,302 ) OTHER INCOME AND EXPENSES, NET — — — ( 1,666 ) ( 1,666 ) NET LOSS BEFORE TAXES $ ( 4,968 ) Three Months Ended March 31, 2022 U.S. International Operating Cost Other Consolidated (In thousands) REVENUE: PRODUCT REVENUE, NET $ 6,919 $ 4,979 $ — $ — $ 11,898 COST OF GOODS SOLD, EXCLUDING DEPRECIATION AND AMORTIZATION ( 815 ) ( 865 ) — — ( 1,680 ) GROSS PROFIT 6,104 4,114 — — 10,218 RESEARCH, DEVELOPMENT AND MEDICAL AFFAIRS EXPENSES 1,170 916 1,461 36 3,583 GENERAL AND ADMINISTRATIVE EXPENSES 317 422 2,283 218 3,240 SALES AND MARKETING EXPENSES 4,674 2,004 117 58 6,853 DEPRECIATION AND AMORTIZATION — — — 689 689 OPERATING EXPENSES 6,161 3,342 3,861 1,001 14,365 SEGMENT INCOME (LOSS) FROM OPERATIONS ( 57 ) 772 ( 3,861 ) ( 1,001 ) ( 4,147 ) OTHER INCOME AND EXPENSES, NET — — — ( 1,808 ) ( 1,808 ) NET LOSS BEFORE TAXES $ ( 5,955 )

Other Agreements With Ocumensio

Other Agreements With Ocumension	3 Months Ended
	Mar. 31, 2023
Other Agreements With Ocumension [Abstract]
Other Agreements With Ocumension	16. OTHER AGREEMENTS WITH OCUMENSION Share Purchase Agreement On April 14, 2021, the Company entered into a Share Purchase Agreement with Ocumension Therapeutics, pursuant to which the Company offered and sold to Ocumension 1,144,945 shares of common stock (the “Shares”), at a purchase price of $ 8.734044 per Share. The number of Shares sold was equal to 19.9 % of the number of shares of common stock outstanding immediately before the closing. The aggregate gross proceeds from the sale of the Shares were $ 10,000,000 . The Company has used the net proceeds from the sale of the Shares to continue to commercialize ILUVIEN® and for general corporate purposes, which may include working capital, capital expenditures, other clinical trial expenditures, acquisitions of new technologies, products or businesses in ophthalmology, and investments. Pursuant to the Share Purchase Agreement and subject to certain limited exceptions, Ocumension is prohibited from selling, transferring, or otherwise disposing of the Shares for a year following the closing date. Ocumension is entitled to certain purchase rights if the Company elects to offer or sell new securities in either a private or public offering. Warrant Subscription Agreement On April 14, 2021, the Company entered into the warrant agreement with Ocumension Therapeutics pursuant to which Ocumension agreed to issue to the Company 1,000,000 non-transferable warrants granting the Company the right for a period of four years to subscribe to up to an aggregate of 1,000,000 shares of Ocumension stock at the subscription price of HK$ 23.88 per warrant share (or US$ 3.07 per warrant share as converted to U.S. Dollars at the exchange rate on April 9, 2021 of 0.12853 U.S. Dollars per HK$), subject to adjustment. (The converted rate is for illustrative purposes only; if the Company exercises the warrants, it will pay the subscription price of HK$ 23.88 per warrant share in HK$.) The warrants were issued on August 13, 2021, pursuant to the terms of the warrant agreement. The warrants are not and will not be listed on any stock exchange.

Fair Value

Fair Value	3 Months Ended
	Mar. 31, 2023
Fair Value [Abstract]
Fair Value	17. FAIR VALUE The Company applies ASC 820, Fair Value Measurements, in determining the fair value of certain assets and liabilities. Under this standard, fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (i.e., the “exit price”) in an orderly transaction between market participants at the measurement date. In determining fair value, the Company uses various valuation approaches. The hierarchy of those valuation approaches is broken down into three levels based on the reliability of inputs as follows: Level 1 inputs are quoted prices in active markets for identical assets or liabilities that the reporting entity has the ability to access at the measurement date. An active market for the asset or liability is a market in which transactions for the asset or liability occur with sufficient frequency and volume to provide pricing information on an ongoing basis. The valuation under this approach does not entail a significant degree of judgment. Level 2 inputs are inputs other than quoted prices included within Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs include: quoted prices for similar assets or liabilities in active markets, inputs other than quoted prices that are observable for the asset or liability, (e.g., interest rates and yield curves observable at commonly quoted intervals or current market) and contractual prices for the underlying financial instrument, as well as other relevant economic measures. Level 3 inputs are unobservable inputs for the asset or liability. Unobservable inputs shall be used to measure fair value to the extent that observable inputs are not available, thereby allowing for situations in which there is little, if any, market activity for the asset or liability at the measurement date. The following fair value table presents information about the Company’s assets and liabilities measured at fair value on a recurring basis: March 31, 2023 Level 1 Level 2 Level 3 Total (In thousands) Assets: Warrant asset (1) $ — $ 197 $ — $ 197 Assets measured at fair value $ — $ 197 $ — $ 197 Liabilities: Common stock warrant liability (1) $ — $ 3,788 $ — $ 3,788 Liabilities measured at fair value $ — $ 3,788 $ — $ 3,788 December 31, 2022 Level 1 Level 2 Level 3 Total (In thousands) Assets: Warrant asset (1) $ — $ 183 $ — $ 183 Assets measured at fair value $ — $ 183 $ — $ 183 Liabilities: Common stock warrant liability (1) $ — $ — $ — $ — Liabilities measured at fair value $ — $ — $ — $ — (1) The Company uses the Black-Scholes pricing model and assumptions that consider, among other variables, the fair value of the underlying stock, risk-free interest rate, volatility, expected life and dividend rates in estimating fair value for the warrants considered to be derivative instruments. Changes in this value each reporting period are reported in the condensed consolidated statement of operations .

Summary Of Significant Accoun_2

Summary Of Significant Accounting Policies (Policy)	3 Months Ended
	Mar. 31, 2023
Summary Of Significant Accounting Policies [Abstract]
Adoption Of New Accounting Standard And Accounting Standards Issued But Not Yet Effective	Adoption of New Accounting Standard In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments - Credit Losses (ASC 326): Measurement of Credit Losses on Financial Instruments . This ASU replaces the current incurred loss impairment methodology for financial assets measured at amortized cost with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information, including forecasted information, to develop credit loss estimates. The standard became effective for the Company on January 1, 2023. The adoption of this ASU did not have a material impact on its financial statements. In October 2021, the FASB issued ASU 2021-08, Business Combinations (Topic 805): Accounting for Contract Assets and Contract Liabilities from Contracts with Customers. The amendments in this ASU require that an acquirer recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with ASC Topic 606, Revenue from Contracts with Customers (ASC 606). The amendments in this ASU are effective for fiscal years beginning after December 15, 2022, with early adoption permitted. The adoption of this ASU did not have a material impact on the Company’s financial statements. Accounting Standards Issued but Not Yet Effective In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (ASC 848) - Facilitation of the Effects of Reference Rate Reform on Financial Reporting. This standard provides optional expedients and exceptions for applying GAAP to contracts, hedging relationships, and other transactions affected by reference rate reform if certain criteria are met. The standard was available until December 31, 2022. In December 2022, the FASB issued ASU No. 2022-06 which extended the period of time preparers can utilize the reference rate reform relief guidance in Topic 848. The guidance ensures the relief in Topic 848 covers the period of time during which a significant number of modifications may take place and the ASU defers the sunset date of Topic 848 from December 31, 2022 to December 31, 2024. The Company does not anticipate the adoption of this ASU will have a material impact on its financial statements.

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2023
Leases [Abstract]
Summary of Operating Leases Supplemental Balance Sheet Information	March 31, December 31, 2023 2022 (In thousands) NON-CURRENT ASSETS: Right of use assets, net $ 1,338 $ 1,395 Total lease assets $ 1,338 $ 1,395 CURRENT LIABILITIES: Accrued expenses $ 701 $ 768 NON-CURRENT LIABILITIES: Other non-current liabilities 2,154 2,267 Total lease liabilities $ 2,855 $ 3,035
Schedule of Future Minimum Operating Lease Payments	Years Ending December 31 (In thousands) 2023 (remaining) $ 528 2024 676 2025 474 2026 488 2027 503 Thereafter 1,052 Total 3,721 Less amount representing interest ( 866 ) Present value of minimum lease payments 2,855 Less current portion (as a portion of accrued expenses) ( 701 ) Non-current portion (as a portion of other non-current liabilities) $ 2,154
Summary of Finance Leases Supplemental Balance Sheet Information	March 31, December 31, 2023 2022 (In thousands) NON-CURRENT ASSETS: Property and equipment, net $ 374 $ 366 Total lease assets $ 374 $ 366 CURRENT LIABILITIES: Finance lease obligations $ 263 $ 333 NON-CURRENT LIABILITIES: Other non-current liabilities 160 131 Total lease liabilities $ 423 $ 464
Schedule of Future Minimum Finance Lease Payments	Years Ending December 31 (In thousands) 2023 (remaining) $ 273 2024 144 2025 87 2026 4 Total 508 Less amount representing interest ( 85 ) Present value of minimum lease payments 423 Less current portion ( 263 ) Non-current portion $ 160

Inventory (Tables)

Inventory (Tables)	3 Months Ended
	Mar. 31, 2023
Inventory [Abstract]
Schedule of Inventory	March 31, December 31, 2023 2022 (In thousands) Component parts (1) $ 236 $ 152 Work-in-process (2) 546 560 Finished goods 433 893 Total Inventory $ 1,215 $ 1,605 (1) Component parts inventory consists of manufactured components of the ILUVIEN applicator. (2) Work-in-process consists of completed units of ILUVIEN that are undergoing, but have not completed, quality assurance testing as required by U.S. or EEA regulatory authorities.

Intangible Asset (Tables)

Intangible Asset (Tables)	3 Months Ended
	Mar. 31, 2023
Intangible Asset [Abstract]
Future Amortization	Years Ending December 31 (In thousands) 2023 (remaining) $ 1,462 2024 1,946 2025 1,940 2026 1,940 2027 1,191 Total $ 8,479

Loss Per Share (EPS) (Tables)

Loss Per Share (EPS) (Tables)	3 Months Ended
	Mar. 31, 2023
Loss Per Share (EPS) [Abstract]
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	March 31, 2023 2022 Series A convertible preferred stock — 601,504 Series B convertible preferred stock 5,714,286 — Common stock warrants 5,714,286 — Stock options 1,216,953 1,315,161 Total 12,645,525 1,916,665

Equity Incentive Plans (Tables)

Equity Incentive Plans (Tables)	3 Months Ended
	Mar. 31, 2023
Equity Incentive Plans [Abstract]
Summary of Stock Option Transactions	The following table presents a summary of stock option activity for the three months ended March 31, 2023 and 2022: Three Months Ended March 31, 2023 2022 Weighted Weighted Average Average Exercise Exercise Options Price ($) Options Price ($) Options outstanding at beginning of period 1,175,339 19.03 1,075,795 23.35 Grants 100,402 2.73 283,550 4.84 Forfeitures and expirations ( 58,788 ) 11.85 ( 44,184 ) 22.36 Options outstanding at period end 1,216,953 18.03 1,315,161 19.39 Options exercisable at period end 867,650 23.38 810,201 27.92 Weighted average per share fair value of options granted during the period $ 1.88 $ 3.32
Summary of Additional Stock Option Transactions	The following table provides additional information related to outstanding stock options as of March 31, 2023: Weighted Weighted Average Average Remaining Aggregate Exercise Contractual Intrinsic Shares Price ($) Term Value ($) (In thousands) Outstanding 1,216,953 18.03 5.79 years 1 Exercisable 867,650 23.38 4.61 years — Outstanding, vested and expected to vest 1,184,035 18.39 5.70 years 1 The following table provides additional information related to outstanding stock options as of December 31, 2022: Weighted Weighted Average Average Remaining Aggregate Exercise Contractual Intrinsic Shares Price ($) Term Value ($) (In thousands) Outstanding 1,175,339 19.03 5.68 — Exercisable 878,115 23.62 4.72 — Outstanding, vested and expected to vest 1,139,482 19.46 5.58 —
Summary of Restricted Stock Transactions	The following table presents a summary of restricted stock and RSU activity for the three months ended March 31, 2023 and 2022: Three Months Ended March 31, 2023 2022 Weighted Weighted Average Average Grant Date Grant Date Shares Fair Value ($) Shares Fair Value ($) Restricted stock and RSUs outstanding at beginning of period 73,594 4.98 46,250 5.65 Grants 632,050 1.39 57,500 4.96 Vested units ( 20,468 ) 4.98 ( 9,687 ) 5.01 Forfeitures — — — — Restricted stock and RSUs outstanding at period end 685,176 1.67 94,063 5.29

Segment Information (Tables)

Segment Information (Tables)	3 Months Ended
	Mar. 31, 2023
Segment Information [Abstract]
Summary of Operations by Segment	Three Months Ended March 31, 2023 U.S. International Operating Cost Other Consolidated (In thousands) REVENUE: PRODUCT REVENUE, NET $ 7,582 $ 5,964 $ — $ — $ 13,546 COST OF GOODS SOLD, EXCLUDING DEPRECIATION AND AMORTIZATION ( 905 ) ( 1,123 ) — — ( 2,028 ) GROSS PROFIT 6,677 4,841 — — 11,518 RESEARCH, DEVELOPMENT AND MEDICAL AFFAIRS EXPENSES 1,162 756 2,224 22 4,164 GENERAL AND ADMINISTRATIVE EXPENSES 1,184 716 2,116 155 4,171 SALES AND MARKETING EXPENSES 4,274 1,415 66 49 5,804 DEPRECIATION AND AMORTIZATION — — — 681 681 OPERATING EXPENSES 6,620 2,887 4,406 907 14,820 SEGMENT INCOME (LOSS) FROM OPERATIONS 57 1,954 ( 4,406 ) ( 907 ) ( 3,302 ) OTHER INCOME AND EXPENSES, NET — — — ( 1,666 ) ( 1,666 ) NET LOSS BEFORE TAXES $ ( 4,968 ) Three Months Ended March 31, 2022 U.S. International Operating Cost Other Consolidated (In thousands) REVENUE: PRODUCT REVENUE, NET $ 6,919 $ 4,979 $ — $ — $ 11,898 COST OF GOODS SOLD, EXCLUDING DEPRECIATION AND AMORTIZATION ( 815 ) ( 865 ) — — ( 1,680 ) GROSS PROFIT 6,104 4,114 — — 10,218 RESEARCH, DEVELOPMENT AND MEDICAL AFFAIRS EXPENSES 1,170 916 1,461 36 3,583 GENERAL AND ADMINISTRATIVE EXPENSES 317 422 2,283 218 3,240 SALES AND MARKETING EXPENSES 4,674 2,004 117 58 6,853 DEPRECIATION AND AMORTIZATION — — — 689 689 OPERATING EXPENSES 6,161 3,342 3,861 1,001 14,365 SEGMENT INCOME (LOSS) FROM OPERATIONS ( 57 ) 772 ( 3,861 ) ( 1,001 ) ( 4,147 ) OTHER INCOME AND EXPENSES, NET — — — ( 1,808 ) ( 1,808 ) NET LOSS BEFORE TAXES $ ( 5,955 )

Fair Value (Tables)

Fair Value (Tables)	3 Months Ended
	Mar. 31, 2023
Fair Value [Abstract]
Fair Value Of Assets And Liabilities	March 31, 2023 Level 1 Level 2 Level 3 Total (In thousands) Assets: Warrant asset (1) $ — $ 197 $ — $ 197 Assets measured at fair value $ — $ 197 $ — $ 197 Liabilities: Common stock warrant liability (1) $ — $ 3,788 $ — $ 3,788 Liabilities measured at fair value $ — $ 3,788 $ — $ 3,788 December 31, 2022 Level 1 Level 2 Level 3 Total (In thousands) Assets: Warrant asset (1) $ — $ 183 $ — $ 183 Assets measured at fair value $ — $ 183 $ — $ 183 Liabilities: Common stock warrant liability (1) $ — $ — $ — $ — Liabilities measured at fair value $ — $ — $ — $ — (1) The Company uses the Black-Scholes pricing model and assumptions that consider, among other variables, the fair value of the underlying stock, risk-free interest rate, volatility, expected life and dividend rates in estimating fair value for the warrants considered to be derivative instruments. Changes in this value each reporting period are reported in the condensed consolidated statement of operations

Nature Of Operations (Narrative

Nature Of Operations (Narrative) (Details) - ILUVIEN [Member]	Mar. 31, 2023 country
Nature Of Operations [Line Items]
Number of countries in which product has received marketing authorization and reimbursement for the treatment of diabetic macular edema	24
Number of countries in which product is indicated for the treatment of vision impairment associated with chronic DME considered insufficiently responsive to available therapies	17
Number of countries authorized for marketing	17
Number of countries with reimbursement approval	10

Revenue Recognition (Narrative)

Revenue Recognition (Narrative) (Details)	3 Months Ended
	Mar. 31, 2023
Period before expiration date returns are accepted	3 months
Period after expiration date returns are accepted	1 year
Minimum [Member]
Customer payment obligation, period	30 years
Maximum [Member]
Customer payment obligation, period	120 years

Leases (Narrative) (Details)

Leases (Narrative) (Details) - USD ($)	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Lessee, Lease, Description [Line Items]
Operating lease cost	$ 149,000	$ 138,000
Cash paid for leases	175,000	68,000
Property and equipment acquired under operating leases	$ 0	0
Weighted average remaining lease term	6 years 2 months 12 days
Weighted average discount rate, leases	9.50%
Depreciation expense property and equipment under finance leases	$ 52,000	94,000
Finance lease interest expense	10,000	10,000
Cash paid for finance leases	127,000	98,000
Property and equipment acquired under finance leases	$ 90,000	$ 0
Finance lease, weighted average remaining term	3 months 18 days
Finance lease, weighted average discount rate	9.50%
Minimum [Member]
Lessee, Lease, Description [Line Items]
Lease renewal term	1 year
Maximum [Member]
Lessee, Lease, Description [Line Items]
Lease renewal term	8 years

Leases (Summary of Operating Le

Leases (Summary of Operating Leases Supplemental Balance Sheet Information) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
NON-CURRENT ASSETS:
Total lease assets	$ 1,338	$ 1,395
CURRENT LIABILITIES:
Accrued expenses	701	$ 768
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]		Accrued Liabilities, Current
NON-CURRENT LIABILITIES:
Other non-current liabilities	2,154	$ 2,267
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]		Other Liabilities, Noncurrent
Total lease liabilities	$ 2,855	$ 3,035

Leases (Schedule of Future Mini

Leases (Schedule of Future Minimum Operating Lease Payments) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Leases [Abstract]
2023 (remaining)	$ 528
2024	676
2025	474
2026	488
2027	503
Thereafter	1,052
Total	3,721
Less amount representing interest	(866)
Total lease liabilities	2,855	$ 3,035
Less current portion (as a portion of accrued expenses)	(701)	$ (768)
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]		Accrued Liabilities, Current
Non-current portion (as a portion of other non-current liabilities)	$ 2,154	$ 2,267
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]		Other Liabilities, Noncurrent

Leases (Summary of Finance Leas

Leases (Summary of Finance Leases Supplemental Balance Sheet Information) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
NON-CURRENT ASSETS:
Total lease assets	$ 374	$ 366
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Property, Plant and Equipment, Net
CURRENT LIABILITIES:
Finance lease obligations	$ 263	333
NON-CURRENT LIABILITIES:
Other non-current liabilities	$ 160	131
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other Liabilities, Noncurrent
Total lease liabilities	$ 423	$ 464

Leases (Schedule of Future Mi_2

Leases (Schedule of Future Minimum Finance Lease Payments) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Total lease liabilities	$ 423	$ 464
Less current portion	(263)	(333)
Non-current portion	$ 160	$ 131
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other Liabilities, Noncurrent
Property, Plant and Equipment [Member]
2023 (remaining)	$ 273
2024	144
2025	87
2026	4
Total	508
Less amount representing interest	(85)
Total lease liabilities	423
Less current portion	(263)
Non-current portion	$ 160

Going Concern (Narrative) (Deta

Going Concern (Narrative) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Accumulated deficit	$ 402,081	$ 415,388
Cash and cash equivalents	$ 13,086	$ 5,274

Inventory (Schedule of Inventor

Inventory (Schedule of Inventory) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Inventory
Component parts	$ 236	$ 152
Work-in-process	546	560
Finished goods	433	893
Total inventory	$ 1,215	$ 1,605

Intangible Asset (Narrative) (D

Intangible Asset (Narrative) (Details) - USD ($)		3 Months Ended
	Oct. 31, 2014	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Gross intangible assets		$ 25,000,000
Useful life (in years)		13 years
Amortization of intangible assets		$ 478,000	$ 478,000
Net intangible assets		8,479,000		$ 8,957,000
License Agreement [Member]
Finite-Lived Intangible Assets [Line Items]
Net intangible assets		$ 8,479,000		$ 8,957,000
Eyepoint License Agreement [Member]
Finite-Lived Intangible Assets [Line Items]
Milestone payment after the first product approved by the FDA	$ 25,000,000

Intangible Asset (Future Amorti

Intangible Asset (Future Amortization) (Details) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets, Amortization Expense, Maturity Schedule [Abstract]
2023 (remaining)	$ 1,462
2024	1,946
2025	1,940
2026	1,940
2027	1,191
Total	$ 8,479	$ 8,957

License Agreements (Narrative)

License Agreements (Narrative) (Details) - USD ($) $ in Thousands	1 Months Ended	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2023	Mar. 31, 2022	Aug. 01, 2017
Collaborative Arrangement, Co-promotion [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement, royalty payable on net revenue, percentage		5.20%	5.20%
Collaborative arrangement, increase in royalty payable on net revenue (as a percentage)		6%	6%
Collaborative arrangement, royalty payable on net revenue over threshold, percentage		2%
Collaborative arrangement, royalty payable on net revenue, revenue threshold		$ 75,000
Royalty expense		703	$ 617
Accrued royalty expense		703
Eyepoint License Agreement [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement, forgiveness of future offset, additional amount	$ 5,000
Eyepoint License Agreement [Member] | Maximum [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Recoverable amount to offset future royalty payments		6,879		$ 15,000
Ocumension [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Payment from related party		10,000
Revenue from related party		$ 11,048
License agreement, shares purchased		1,000,000
License agreement, share purchase duration		4 years
Deferred revenue related party		$ 300
Ocumension [Member] | Milestone One [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Payment from related party		$ 89,000

Loan Agreements (SLR Investment

Loan Agreements (SLR Investment Corp.) (Narrative) (Details) - SLR Investment Corp. (formerly named Solar Capital Ltd.) [Member] - USD ($)		3 Months Ended	12 Months Ended
	Mar. 24, 2023	Mar. 31, 2023	Dec. 31, 2019	Jan. 05, 2018
Loan Agreement 2018 [Member]
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity				$ 40,000,000
Loan Agreement 2019 [Member]
Debt Instrument [Line Items]
Increase in borrowing capacity	$ 2,500,000
Line of credit facility, maximum borrowing capacity	$ 47,500,000		$ 45,000,000
Debt instrument, interest rate, stated percentage		5.15%
Interest rate effective percentage		9.75%
Loan Agreement 2019 [Member] | Amendment 3 [Member]
Debt Instrument [Line Items]
Loan amendment, minimum revenue amount trailing period		6 months
Loan Agreement 2019 [Member] | Amendment 4 [Member]
Debt Instrument [Line Items]
Loan amendment, minimum revenue amount trailing period		6 months
Loan Agreement 2019 [Member] | Amendment 5 [Member]
Debt Instrument [Line Items]
Option to extend term	12 months
Loan amendment, minimum revenue amount trailing period	6 months
Loan Agreement 2019 [Member] | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		4.60%
SLR Loan [Member]
Debt Instrument [Line Items]
Debt instrument, interest rate, stated percentage			7.65%
SLR Loan [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate			1.78%
Term Loan [Member]
Debt Instrument [Line Items]
Debt instrument, face amount	$ 15,000,000
Term Loan [Member] | Amendment 5 [Member]
Debt Instrument [Line Items]
Debt instrument, face amount	$ 15,000,000
Debt instrument, interest rate, stated percentage	5.15%
Term Loan [Member] | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate [Member] | Amendment 5 [Member]
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	4.60%
2018 Exit Fee Agreement [Member]
Debt Instrument [Line Items]
Debt instrument, exit fee agreement, term		10 years
Debt instrument, exit fee		$ 2,000,000
2018 Exit Fee Agreement [Member] | Achievement of Milestone [Member]
Debt Instrument [Line Items]
Debt instrument, exit fee		1,000,000
2018 Exit Fee Agreement [Member] | Milestone 1 [Member]
Debt Instrument [Line Items]
Milestone revenue requirement		$ 80,000,000
Milestone period requirement		12 months
2018 Exit Fee Agreement [Member] | Milestone 2 [Member]
Debt Instrument [Line Items]
Milestone revenue requirement		$ 100,000,000
2019 Exit Fee Agreement [Member]
Debt Instrument [Line Items]
Debt instrument, exit fee agreement, term		10 years
Debt instrument, exit fee		$ 2,000,000
2019 Exit Fee Agreement [Member] | Milestone 2 [Member]
Debt Instrument [Line Items]
Debt instrument, exit fee		$ 675,000
2019 Exit Fee Agreement [Member] | Amendment 5 [Member]
Debt Instrument [Line Items]
Increase in borrowing capacity	$ 2,500,000
Line of credit facility, maximum borrowing capacity	$ 47,500,000
2023 Exit Fee Agreement [Member]
Debt Instrument [Line Items]
Debt instrument, exit fee agreement, term	10 years
Exit fee, percentage of original principal amount funded	1.50%
Milestone revenue requirement	$ 82,500,000
Maximum [Member] | 2023 Exit Fee Agreement [Member]
Debt Instrument [Line Items]
Debt instrument, exit fee	$ 3,387,500

Loan Agreements (Modification o

Loan Agreements (Modification of Debt) (Narrative) (Details) - Loan Agreement 2019 [Member] - SLR Investment Corp. (formerly named Solar Capital Ltd.) [Member] $ in Thousands	Mar. 31, 2023 USD ($)
Amendment 4 [Member]
Debt Instrument [Line Items]
Deferred financing costs	$ 113
Amendment 5 [Member]
Debt Instrument [Line Items]
Deferred financing costs	$ 2,625

Loss Per Share (EPS) (Schedule

Loss Per Share (EPS) (Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share) (Details) - shares	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	12,645,525	1,916,665
Series A Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)		601,504
Series B Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	5,714,286
Common Stock Warrants [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	5,714,286
Stock Options [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	1,216,953	1,315,161

Preferred Stock (Narrative) (De

Preferred Stock (Narrative) (Details) - USD ($) $ / shares in Units, $ in Thousands		1 Months Ended	3 Months Ended
	Mar. 24, 2023	Oct. 31, 2012	Mar. 31, 2023	Dec. 31, 2022
Conversion of Stock [Line Items]
Preferred stock, par value (usd per share)			$ 0.01	$ 0.01
Class of warrant or right, number of securities called by warrants or rights (in shares)		300,000
Stock issuance costs incurred		$ 560	$ 498
Proceeds from issuance of preferred stock			$ 12,000
Shares repurchased	$ 1,252
Tranche One [Member]
Conversion of Stock [Line Items]
Proceeds from issuance of preferred stock	12,000
Tranche Two [Member]
Conversion of Stock [Line Items]
Proceeds from issuance of preferred stock	15,000
Minimum qualified financing transaction amount required	$ 15,000
Series A Preferred Stock [Member]
Conversion of Stock [Line Items]
Issuance of stock (in shares)		1,000,000
Preferred stock, shares outstanding (in shares)			0	600,000
Preferred stock, shares issued (in shares)			0	600,000
Proceeds from issuance of preferred stock		$ 40,000
Shares repurchased (in shares)	600,000
Shares repurchased			$ 938
Preferred stock, liquidation preference				$ 24,000
Series B Preferred Stock [Member]
Conversion of Stock [Line Items]
Preferred stock, shares outstanding (in shares)			12,000	0
Preferred stock, shares issued (in shares)			12,000	0
Preferred stock dividend rate percentage	6%
Preferred stock dividends in arrears			$ 14
Preferred stock dividends in arrears, per share			$ 1.17
Preferred stock, liquidation preference			$ 12,000
Series B Preferred Stock [Member] | Securities Purchase Agreement [Member]
Conversion of Stock [Line Items]
Preferred stock, par value (usd per share)	$ 0.01
Series B Preferred Stock [Member] | Tranche One [Member]
Conversion of Stock [Line Items]
Issuance of stock (in shares)	12,000
Share Price	$ 1,000
Preferred stock conversion price (usd per share)	$ 2.10
Class of Warrant or Right, Expiration Period	7 years
Series B Preferred Stock [Member] | Tranche Two [Member]
Conversion of Stock [Line Items]
Issuance of stock (in shares)	15,000
Conversion price equal to preceding volume-weighted average price of the common stock on Nasdaq, period (in days)	30 days
Conversion price minimum percentage of tranche one conversion price	80%
Common Stock [Member]
Conversion of Stock [Line Items]
Shares repurchased (in shares)	200,919
Common Stock [Member] | Tranche Two [Member]
Conversion of Stock [Line Items]
Minimum qualified financing transaction amount required	$ 1,000
Minimum [Member] | Common Stock [Member] | Before Conversion [Member]
Conversion of Stock [Line Items]
Ownership interest of holders after conversion of preferred stock (percent)	19.99%
Minimum [Member] | Common Stock [Member] | After Conversion [Member]
Conversion of Stock [Line Items]
Ownership interest of holders after conversion of preferred stock (percent)	9.99%
Maximum [Member] | Securities Purchase Agreement [Member]
Conversion of Stock [Line Items]
Proceeds from issuance of preferred stock	$ 27,000
Maximum [Member] | Series B Preferred Stock [Member] | Securities Purchase Agreement [Member]
Conversion of Stock [Line Items]
Issuance of stock (in shares)	27,000
Maximum [Member] | Common Stock [Member] | Securities Purchase Agreement [Member]
Conversion of Stock [Line Items]
Class of warrant or right, number of securities called by warrants or rights (in shares)	5,714,286
Shares issued in conversion of preferred stock (in shares)	1,401,901

Equity Incentive Plans (Narrati

Equity Incentive Plans (Narrative) (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 226	$ 312
Weighted average contractual term	4 years 7 months 9 days		4 years 8 months 19 days
2019 Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for grant (in shares)	54,918
Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 167	258
Share-based compensation not yet recognized	$ 1,028
Weighted average contractual term	2 years 5 months 15 days
New Awards [Member] | Equity Incentive Plan 2010 [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for grant (in shares)	0
Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 47	46
Weighted average contractual term	3 years 7 months 13 days
Unrecognized share based compensation expense	$ 887
Employee Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation expense	$ 11	$ 8

Equity Incentive Plans (Summary

Equity Incentive Plans (Summary of Stock Option Transactions) (Details) - $ / shares	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Options
Options outstanding at beginning of period	1,175,339	1,075,795
Grants	100,402	283,550
Forfeitures and expirations	(58,788)	(44,184)
Options outstanding at period end	1,216,953	1,315,161
Options exercisable at period end	867,650	810,201	878,115
Weighted average per share fair value of options granted during the period	$ 1.88	$ 3.32
Weighted Average Exercise Price ($)
Options outstanding at beginning of period	19.03	23.35
Grants	2.73	4.84
Forfeitures and expirations	11.85	22.36
Options outstanding at period end	18.03	19.39
Options exercisable at period end	$ 23.38	$ 27.92	$ 23.62

Equity Incentive Plans (Summa_2

Equity Incentive Plans (Summary of Additional Stock Option Transactions) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022	Dec. 31, 2021
Outstanding Stock Options
Outstanding, shares (in shares)	1,216,953	1,175,339	1,315,161	1,075,795
Outstanding, weighted average exercise price (usd per share)	$ 18.03	$ 19.03	$ 19.39	$ 23.35
Outstanding, weighted average remaining contractual term	5 years 9 months 14 days	5 years 8 months 4 days
Outstanding, aggregate intrinsic value	$ 1
Exercisable Stock Options
Exercisable, shares (in shares)	867,650	878,115	810,201
Exercisable, weighted average exercise price (usd per share)	$ 23.38	$ 23.62	$ 27.92
Exercisable, weighted average remaining contractual term	4 years 7 months 9 days	4 years 8 months 19 days
Exercisable and expected to vest
Outstanding, vested and expected to vest, shares (in shares)	1,184,035	1,139,482
Outstanding, vested and expected to vest, weighted average exercise price (usd per share)	$ 18.39	$ 19.46
Outstanding, vested and expected to vest, weighted average remaining contractual term	5 years 8 months 12 days	5 years 6 months 29 days
Outstanding, vested and expected to vest, aggregate intrinsic value	$ 1

Equity Incentive Plans (Summa_3

Equity Incentive Plans (Summary of Restricted Stock Transactions) (Details) - Restricted Stock and Restricted Stock Units [Member] - $ / shares	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Restricted Stock & RSUs
Beginning of period (in shares)	73,594	46,250
Grants (in shares)	632,050	57,500
Vested units (in shares)	(20,468)	(9,687)
Forfeitures (in shares)
End of period (in shares)	685,176	94,063
Weighted Average Grant Date Fair Value ($)
Beginning of period (usd per share)	$ 4.98	$ 5.65
Grants (usd per share)	1.39	4.96
Vested units (usd per share)	4.98	5.01
Forfeitures (usd per share)
End of period (usd per share)	$ 1.67	$ 5.29

Income Taxes (Narrative) (Detai

Income Taxes (Narrative) (Details) $ in Thousands	Dec. 31, 2022 USD ($)
Operating Loss Carryforwards [Line Items]
Deferred tax asset, research and development costs	$ 969
Federal [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carry-forwards	147,200
State [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carry-forwards	$ 107,700

Segment Information (Narrative)

Segment Information (Narrative) (Details)	3 Months Ended		12 Months Ended
	Mar. 31, 2023 segment customer	Mar. 31, 2022 customer segment	Dec. 31, 2022
Segment Reporting Information [Line Items]
Number of operating segments	3
Customer Concentration Risk [Member] | Revenues [Member]
Segment Reporting Information [Line Items]
Number of customers | customer	2	2
Customer Concentration Risk [Member] | Accounts Receivable [Member]
Segment Reporting Information [Line Items]
Number of customers	2	2
Large Pharmaceutical Distributors [Member] | Customer Concentration Risk [Member] | Revenues [Member]
Segment Reporting Information [Line Items]
Concentration risk percentage	56%	58%
Large Pharmaceutical Distributors [Member] | Customer Concentration Risk [Member] | Accounts Receivable [Member]
Segment Reporting Information [Line Items]
Concentration risk percentage	63%		71%

Segment Information (Summary of

Segment Information (Summary of Operations by Segment) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting Information [Line Items]
PRODUCT REVENUE, NET	$ 13,546	$ 11,898
COST OF GOODS SOLD, EXCLUDING DEPRECIATION AND AMORTIZATION	(2,028)	(1,680)
GROSS PROFIT	11,518	10,218
RESEARCH, DEVELOPMENT AND MEDICAL AFFAIRS EXPENSES	4,164	3,583
GENERAL AND ADMINISTRATIVE EXPENSES	4,171	3,240
SALES AND MARKETING EXPENSES	5,804	6,853
DEPRECIATION AND AMORTIZATION	681	689
OPERATING EXPENSES	14,820	14,365
LOSS FROM OPERATIONS	(3,302)	(4,147)
OTHER INCOME AND EXPENSES, NET	(1,666)	(1,808)
NET LOSS BEFORE INCOME TAXES	(4,968)	(5,955)
U.S. [Member]
Segment Reporting Information [Line Items]
PRODUCT REVENUE, NET	7,582	6,919
COST OF GOODS SOLD, EXCLUDING DEPRECIATION AND AMORTIZATION	(905)	(815)
GROSS PROFIT	6,677	6,104
RESEARCH, DEVELOPMENT AND MEDICAL AFFAIRS EXPENSES	1,162	1,170
GENERAL AND ADMINISTRATIVE EXPENSES	1,184	317
SALES AND MARKETING EXPENSES	4,274	4,674
OPERATING EXPENSES	6,620	6,161
LOSS FROM OPERATIONS	57	(57)
International [Member]
Segment Reporting Information [Line Items]
PRODUCT REVENUE, NET	5,964	4,979
COST OF GOODS SOLD, EXCLUDING DEPRECIATION AND AMORTIZATION	(1,123)	(865)
GROSS PROFIT	4,841	4,114
RESEARCH, DEVELOPMENT AND MEDICAL AFFAIRS EXPENSES	756	916
GENERAL AND ADMINISTRATIVE EXPENSES	716	422
SALES AND MARKETING EXPENSES	1,415	2,004
OPERATING EXPENSES	2,887	3,342
LOSS FROM OPERATIONS	1,954	772
Operating Cost [Member]
Segment Reporting Information [Line Items]
RESEARCH, DEVELOPMENT AND MEDICAL AFFAIRS EXPENSES	2,224	1,461
GENERAL AND ADMINISTRATIVE EXPENSES	2,116	2,283
SALES AND MARKETING EXPENSES	66	117
OPERATING EXPENSES	4,406	3,861
LOSS FROM OPERATIONS	(4,406)	(3,861)
Other Segments [Member]
Segment Reporting Information [Line Items]
RESEARCH, DEVELOPMENT AND MEDICAL AFFAIRS EXPENSES	22	36
GENERAL AND ADMINISTRATIVE EXPENSES	155	218
SALES AND MARKETING EXPENSES	49	58
DEPRECIATION AND AMORTIZATION	681	689
OPERATING EXPENSES	907	1,001
LOSS FROM OPERATIONS	(907)	(1,001)
OTHER INCOME AND EXPENSES, NET	$ (1,666)	$ (1,808)

Other Agreements With Ocumens_2

Other Agreements With Ocumension (Narrative) (Details) $ / shares in Units, $ in Thousands	Apr. 14, 2021 USD ($) $ / shares shares	Apr. 14, 2021 $ / shares shares	Apr. 09, 2021	Oct. 31, 2012 shares
Related Party Transaction [Line Items]
Class of warrant or right, number of securities called by warrants or rights (in shares)				300,000
Ocumension [Member]
Related Party Transaction [Line Items]
Partnership agreement, shares sold	1,144,945
Partnership agreement, price per share | $ / shares	$ 8.734044
Partnership agreement, percentage of shares outstanding before closing	19.90%
Partnership agreement, consideration received | $	$ 10,000
Partnership agreement, warrant or rights period	4 years
Shares called by warrants	1,000,000	1,000,000
Exchange rate			0.12853
Class of warrant or right, exercise price of warrants or rights (per share) | (per share)	$ 3.07	$ 23.88

Fair Value (Fair Value Of Asset

Fair Value (Fair Value Of Assets And Liabilities) (Details) - Fair Value, Recurring [Member] - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant asset	$ 197	$ 183
Assets measured at fair value	197	183
Common stock warrant liability	3,788
Liabilities measured at fair value	3,788
Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Warrant asset	197	183
Assets measured at fair value	197	$ 183
Common stock warrant liability	3,788
Liabilities measured at fair value	$ 3,788