You should read the following discussion and analysis of our financial condition
and results of operations together with "Selected Financial Data" and our
audited consolidated financial statements and related notes included in Items 6
and 8, respectively, of this Annual Report on Form 10-K. This discussion and
analysis and other parts of this Annual Report on Form 10-K contain
forward-looking statements that reflect our current plans, expectations,
estimates and beliefs that involve risks, uncertainties and assumptions, such as
statements regarding our plans, objectives, expectations, intentions and
projections. Our actual results and the timing of selected events may differ
materially from those discussed in these forward-looking statements. You should
carefully read Item 1A - "Risk Factors" included in this Annual Report on Form
10-K to gain an understanding of the important factors that could cause actual
results to differ materially from our forward-looking statements. Please also
see the section entitled "Special Note Regarding Forward-Looking Statements

and
Industry Data."

Overview

We are an ophthalmic medical technology and pharmaceutical company focused on
developing novel therapies for the treatment of glaucoma, corneal disorders, and
retinal disease. We developed Micro-Invasive Glaucoma Surgery (MIGS) to serve as
an alternative to the traditional glaucoma treatment paradigm and launched our
first MIGS device commercially in 2012. We have also developed a proprietary
bio-activated pharmaceutical therapy for the treatment of a corneal disorder,
keratoconus, that was approved by the U.S. Food and Drug Administration (FDA) in
2016 and we are developing a pipeline of surgical devices, sustained
pharmaceutical therapies, and implantable biosensors intended to treat glaucoma
progression, corneal disorders such as keratoconus, dry eye and refractive
vision correction, and retinal diseases such as neovascular age-related macular
degeneration and diabetic macular edema.

Impact of COVID-19 Pandemic and Current Economic Environment





In December 2019, a novel strain of coronavirus (COVID-19) emerged in Wuhan,
Hubei Province, China. The World Health Organization declared COVID-19 to be a
"pandemic," spreading across the globe and impacting worldwide economic
activity. In the U.S., certain federal, state and local governmental authorities
issued stay-at-home and other orders, proclamations and/or directives, including
restrictions on elective procedures and therapies, aimed at minimizing the
spread of COVID-19. Although some of these governmental restrictions have since
been lifted or scaled back, recent surges of COVID-19 have in some cases led,
and future surges could lead, to the reinstitution of stay-at-home or other
orders and may further result in restrictions being re-implemented in response
to efforts to reduce the spread of COVID-19. Even if stay-at-home or other
orders are removed, potential patients may elect to stay at home voluntarily.
The COVID-19 pandemic and subsequent economic slowdown has materially impacted
the global demand for our products, which are used in procedures and therapies
that are considered elective. This decrease in demand was most significantly
felt in the latter part of the quarter ended March 31, 2020 and the earlier part
of the quarter ended June 30, 2020. Beginning in May 2020, we began to see an
early recovery toward more normalized levels for cataract and keratoconus
procedures, a trend that continued through the quarter ended December 31, 2020.
The ultimate impact of the COVID-19 pandemic on our operations going forward is
unknown and will depend on future developments which are highly uncertain and
cannot be predicted with confidence, including the duration and severity of the
COVID-19 outbreak, the status of health and safety actions taken to contain its
spread, the severity and transmission rates of new variants of COVID-19, the
availability, distribution, and efficacy of vaccines for COVID-19, any
additional preventative and protective actions that governments, or we, may
take, any future surges of COVID-19 that may occur, the dynamics associated with
the rollout of the COVID-19 vaccines, and how quickly and to what extent
economic and operating conditions normalize within the markets in which we
operate. For additional information, see the section titled Risks Related to Our
Business within Item 1A. Risk Factors of this Annual Report on Form 10-K.



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We also continue to actively assess the impact of COVID-19 on our clinical
trials and other pipeline products. The closure of ophthalmic practices and
deferral of elective procedures beginning in the first quarter of 2020 in
response to COVID-19 disrupted new patient enrollment in our ongoing clinical
trials. This disruption has continued even as facilities have reopened as
doctors prioritize their standard procedures over clinical trial enrollment. In
particular, patient enrollment for our iDose clinical trials remains impacted,
which has delayed our estimated iDose approval timeline, where we now expect a
potential FDA approval of this product in 2023.

We have taken a number of steps aimed at minimizing the spread of COVID-19 and
protecting our employees, including shifting the majority of our workforce to
remote operations, which continues through the date hereof. We have maintained
streamlined manufacturing and assembly processes in order to consistently
provide product to our customers who depend on us. In addition to other health
and safety protocols that follow applicable guidance and regulations, employees
involved in such operation-critical processes have been organized into a number
of small shifts designed to minimize the time any one individual is required to
be onsite. Further, in an effort to identify, and avoid further infection from,
asymptomatic cases, we have offered periodic voluntary COVID-19 viral testing to
on-site employees.

We have also sought to preserve our cash position by instituting a number of
cost saving initiatives, including temporary reductions in discretionary
spending and capital expenditures. These actions were designed to preserve jobs
and core research and development programs. We also temporarily deferred a
significant portion of our planned 2020 capital expenditures, particularly those
related to facilities expansion and consolidation plans, although we have
started to reinstitute our plans to move forward with the planned capital
expenditures as state and local governments began to authorize re-openings.
Further, in June 2020, we issued an aggregate principal amount of $287.5 million
of 2.75% convertible notes due 2027 (the Convertible Notes), the net proceeds of
which will be used for working capital and general corporate purposes. As of
December 31, 2020, we had cash, cash equivalents, short-term investments, and
restricted cash of approximately $413.9 million, compared to $183.3 million as
of December 31, 2019.

On March 27, 2020, the United States enacted the Coronavirus Aid Relief, and
Economic Security Act (CARES Act), an emergency economic stimulus package that
includes spending and tax relief measures to strengthen the U.S. economy and
help fund a nationwide effort to curtail the effects of the COVID-19 pandemic.
Some of the more significant provisions which impact the Company include the
employee retention credit and payroll tax deferral. We do not expect recent IRS
guidance or the CARES Act to have a material impact on our results of operation.
For additional information, see the section titled Notes to Consolidated
Financial Statements, Note 11, Income Taxes.

Financial Overview



Our net sales were $225.0 million for the year ended December 31, 2020, which
was a decrease of $12.0 million from the year ended December 31, 2019. Net sales
for the years ended December 31, 2019 and December 31, 2018 were $237.0 million
and $181.3 million, respectively. We incurred net losses of $120.3 million for
the year ended December 31, 2020, achieved net income of $15.4 million for the
year ended December 31, 2019 and we incurred a net loss of $13.0 million for the
year ended December 31, 2018. The COVID-19 pandemic and measures intended to
reduce its spread had a material impact on our net sales for the year ended
December 31, 2020.

As of December 31, 2020, we had an accumulated deficit of $310.1 million.

Material Changes and Transactions

Convertible Senior Notes



In June 2020, we issued $287.5 million in aggregate principal amount of 2.75%
Convertible Senior Notes due in 2027 (Convertible Notes) pursuant to an
indenture, dated June 11, 2020, between us and Wells Fargo Bank, National
Association, as trustee, in a private offering to qualified institutional buyers
in accordance with Rule 144A under the Securities Act of 1933, as amended.
The Convertible Notes are senior unsecured obligations of ours and bear interest
at a rate of 2.75% per year, payable semi-annually in arrears on June
15 and December 15 of each year, beginning on December 15, 2020. The Convertible
Notes will mature on June 15, 2027, unless earlier converted, redeemed or

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repurchased in accordance with their terms. In connection with issuing the
Convertible Notes, we received $242.2 million in proceeds, after deducting fees
and offering expenses and paying the cost of certain capped call transactions.
These proceeds will be used for working capital and general corporate purposes.

For additional information, see Note 9, Convertible Senior Notes to the consolidated financial statements in Item 8 of this Annual Report on Form 10-K.

Acquisition of Avedro, Inc.



On November 21, 2019, we acquired Avedro, Inc. (Avedro), a hybrid ophthalmic
pharmaceutical and medical technology company focused on developing therapies
designed to treat corneal diseases and disorders and correct refractive
conditions, in a stock-for-stock transaction (Avedro Merger). Avedro developed
novel bio-activated drug formulations used in combination with proprietary
systems for the treatment of progressive keratoconus and corneal ectasia
following refractive surgery. The therapy is the first and only minimally
invasive anterior segment product offering approved by the FDA shown to halt the
progression of keratoconus.

Total consideration for the Avedro Merger was $437.8 million. The consideration
consisted of Glaukos common stock valued at $406.8 million issued to replace
Avedro common stock, Glaukos shares valued at $0.2 million to replace certain
vested Avedro warrants, and $30.8 million of value attributable to the
pre-combination services associated with replacement of all Avedro outstanding
and unexercised stock option awards and all unvested restricted stock units
(Replacement Awards). See Note 2, Note 4, Note 6 and Note 7 to the consolidated
financial statements in Item 8 of this Annual Report on Form 10-K for additional
information on our Avedro Merger.

Factors Affecting Our Performance



In addition to the disruption resulting from COVID-19 as discussed above, the
full effects of which at this time are difficult to predict, our operations to
date have been, and we believe our future growth will be, impacted by the
following:

the rate at which we expand our global sales and marketing infrastructure, and

? the speed at which we can continue increasing awareness of our products to

patients and physicians;

our industry is highly competitive and subject to rapid and profound

? technological, market and product-related changes. Our success depends, in

part, upon our ability to maintain a competitive position in the development of

new products for the treatment of chronic eye diseases;

publications of clinical results by us, our competitors and other third parties

? can have a significant influence on whether, and the degree to which, our


   products are used by physicians and the procedures and treatments those
   physicians choose to administer to their patients;

the physicians who use our products may not perform procedures during certain

? times of the year, due to seasonality patterns typical for certain of our

procedures, or when they are away from their practices for various reasons;

? the coverage and reimbursement rates by third-party payors for the procedures

using our products;

? our ability to successfully integrate the Avedro business into our operations

and expand our sales into the corneal health market; and

most of our sales outside of the U.S. are denominated in the local currency of

? the country in which we sell our products. As a result, our revenue from

international sales is impacted by fluctuations in foreign currency exchange


   rates.




Further, subject to our temporary costs saving initiatives and spending
deferrals due to COVID-19, we have made and expect to continue to make
significant investments in our global sales force, marketing programs, research
and development activities, clinical studies, and general and administrative
infrastructure. FDA-approved investigational device exemption (IDE) or
investigational new drug (IND) studies and new product development programs in
our industry are expensive. We have incurred a significant increase in
administrative costs since we began operating as a public company. Our operating
expenses have increased significantly following our acquisition of Avedro, and
we also expect to incur additional construction costs related to our new
facility in Aliso Viejo, California.

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We expect 2021 revenues and near-term performance to reflect competitive dynamics and the continuing disruption resulting from COVID-19, the full effects of which at this time are difficult to predict.

Although we have been profitable for certain periods in our operating history, there can be no assurance that we will be profitable or generate cash from operations in the future.

Components of Results of Operations

Net Sales


We currently operate in one reportable segment and net sales are generated
primarily from sales of iStent products and, following the Avedro Merger on
November 21, 2019, sales of Photrexa and other associated drug formulations, as
well as our proprietary bioactivation systems, to customers. Revenue is
recognized when control of the promised goods or services is transferred to the
customer in an amount that reflects the consideration to which we expect to be
entitled in exchange for those products or services.

We sell our products through a direct sales organization in the United States,
and outside the United States we sell our products primarily through direct
sales subsidiaries in sixteen countries and through independent distributors in
certain countries in which we do not have a direct presence or maintain a modest
commercial presence. The primary end-user customers for our products are surgery
centers, hospitals and physician private practices.

While net sales may increase as we expand our global sales and marketing
infrastructure and continue to increase awareness of our products by expanding
our sales base and increasing our marketing efforts, historically our net sales
within a fiscal year have been impacted seasonally, as demand for U.S.
ophthalmic procedures is typically softer in the first quarter and stronger in
the fourth quarter of a given year. However, we have not experienced the same
seasonality pattern in 2020 due to the COVID-19 pandemic, and its effect on our
commercial performance may continue into future reporting periods. Additionally,
for several years we had commercialized our products in the U.S. with few or no
direct competitors. Other products have now become available in the U.S. and
globally, or are in development by third parties, that have entered or could
enter the market and which may affect adoption of or demand for our products.
These other products could achieve greater commercial acceptance or demonstrate
better safety or effectiveness, clinical results, ease of use or lower costs
than our products, which could adversely impact our net sales.

Cost of Sales

Cost of sales reflects the aggregate costs to manufacture our products and includes raw material costs, labor costs, manufacturing overhead expenses and the effect of changes in the balance of reserves for excess and obsolete inventory.



We manufacture our iStent products at our current headquarters in San Clemente,
California using components manufactured by third parties. We manufacture our
KXL and Mosaic systems at our manufacturing facilities in Burlington,
Massachusetts, with some limited manufacturing operations in Dublin, Ireland,
and we contract with third-party manufacturers in the U.S. and Germany to
produce our Photrexa and other associated drug formulations.

Due to the relatively low production volumes of our iStent products and our KXL
and Mosaic systems compared to our potential capacity for those products, a
significant portion of our per unit costs is comprised of manufacturing overhead
expenses. These expenses include quality assurance, material procurement,
inventory control, facilities, equipment and operations supervision and
management.

Cost of sales includes a charge equal to a low single-digit percentage of
worldwide net sales of certain current and future products, including our iStent
products, with a required minimum annual payment of $0.5 million, which amount
became payable to the Regents of the University of California (the University)
in connection with our December 2014 agreement with the University (the UC
Agreement) related to a group of our U.S. patents (the Patent Rights). This
ongoing product payment obligation will change as patent coverage on certain
products being to lapse, and will terminate entirely terminate on the date the
last of the Patent Rights expires, which is currently expected to be in 2022.

Under the Protecting Americans from Tax Hikes Act of 2015 (PATH Act), the 2.3%
federal medical device excise tax on U.S. sales of medical devices manufactured
by us was suspended from January 1, 2016 to December 31,

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2017, and, pursuant to HR 195 passed on January 22, 2018, was further suspended
through December 31, 2019. The federal medical device excise tax was permanently
repealed in December 2019.

Beginning in the fourth quarter of 2019, cost of sales has included amortization
of the $252.2 million developed technology intangible asset recognized in
connection with the Avedro Merger. For the years ended December 31, 2020 and
December 31, 2019, the amortization expense was $22.1 million and $2.3 million,
respectively. Additionally, beginning in the fourth quarter of 2019, cost of
sales has included amortization of the fair market value inventory adjustment
recorded in connection with the Avedro Merger, which for the years ended
December 31, 2020 and December 31, 2019 was $24.7 million and $4.0 million,
respectively.

Our future gross profit as a percentage of net sales, or gross margin, will be
impacted by numerous factors including commencement of sales of products in our
pipeline, or any other future products, which may have higher product costs. Our
gross margin will also be affected by manufacturing inefficiencies that we may
experience as we attempt to manufacture our products on a larger scale,
manufacture new products and change our manufacturing capacity or output.
Additionally, our gross margin will continue to be affected by the
aforementioned expense related to the UC Agreement and the acquisition fair
market value inventory adjustment rollout related to the Avedro Merger. See Note
6, Business Combinations to the consolidated financial statements in Item 8 of
this Annual Report on Form 10-K for additional information on our Avedro Merger.
The current COVID-19 pandemic may impact our gross profit margins given the
potential impact to net sales in future periods.

Selling, General and Administrative



Our selling, general and administrative (SG&A) expenses primarily consist of
personnel-related expenses, including salaries, sales commissions, bonuses,
fringe benefits and stock-based compensation for our executive, financial,
marketing, sales, and administrative functions. Other significant SG&A expenses
include marketing programs; advertising; post-approval clinical studies;
conferences and congresses; travel expenses; costs associated with obtaining and
maintaining our patent portfolio; professional fees for accounting, auditing,
consulting and legal services; costs to implement our global enterprise systems;
and allocated overhead expenses.

The Avedro Merger has resulted in additional integration expenses, restructuring
expenses and personnel-related expenses during the year ended December 31, 2019
and additional personnel-related expenses, primarily stock-based compensation
during the year ended December 31, 2020. Additionally, SG&A will continue to be
impacted by the amortization of certain finite-lived intangible assets acquired
as a result of the Avedro Merger, along with Avedro's normal and recurring SG&A
expenses.

We expect SG&A expenses to continue to grow as a result of the Avedro Merger as
we increase our global sales and marketing infrastructure and general
administration infrastructure in the United States; however, as discussed above
under "Impact of COVID-19 Pandemic and Current Economic Environment," we have
sought to preserve our cash position by instituting a number of cost saving
initiatives, including temporary reductions in discretionary spending, including
variable expense associated with salesperson commissions and marketing, capital
expenditures, as well as a temporary salary reduction for many of our employees,
which as of the date hereof, have all been reinstated. We have started to
reinstitute our plans to move forward with the planned capital expenditures as
state and local governments begin to authorize re-openings. We also expect other
nonemployee-related costs, including sales and marketing program activities for
new products, outside services and accounting and general legal costs to
increase as our overall operations grow. The timing of these increased
expenditures and their magnitude are primarily dependent on the commercial
success and sales growth of our products, as well as on the timing of any new
product launches and other potential business and operational activities.

Research and Development



Our R&D activities primarily consist of new product development projects,
pre-clinical studies, IDE and IND studies, and other clinical trials. Our R&D
expenses primarily consist of personnel-related expenses, including salaries,
fringe benefits and stock-based compensation for our R&D employees; research
materials; supplies and services; and the costs of conducting clinical studies,
which include payments to investigational sites and investigators, clinical

research

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organizations, consultants, and other outside technical services and the costs
of materials, supplies and travel. We expense R&D costs as incurred. We expect
our R&D expenses to continue to increase as we initiate and advance our
development programs, including our expanding surgical, pharmaceutical and IOP
sensor development efforts and clinical trials across glaucoma, retinal disease
and corneal health. However as previously noted we have sought to preserve our
cash position by instituting a number of cost saving initiatives, including
temporary reductions in discretionary spending associated with earlier stage
development programs many of which we have begun to allocate funding beginning
in the third quarter and throughout the fourth quarter of 2020.

Completion dates and costs for our clinical development programs include seeking
regulatory approvals and our research programs vary significantly for each
current and future product candidate and are difficult to predict. As a result,
while we expect our R&D costs to continue to increase for the foreseeable
future, subject to our temporary COVID-19 costs saving initiatives, we cannot
estimate with any degree of certainty the costs we will incur in connection with
the development of our product candidates. We anticipate we will make
determinations as to which programs and product candidates to pursue and how
much funding to direct to each program and product candidate on an ongoing basis
in response to the scientific success of early research programs, results of
ongoing and future clinical trials, as well as ongoing assessments as to each
current or future product candidate's commercial potential and our likelihood of
obtaining necessary regulatory approvals. We are not currently able to fully
track expenses by product candidate.

In-Process Research and Development



Our in-process research and development (IPR&D) expenses relate to the
acquisition of DOSE Medical Corporation (DOSE) in which DOSE became a
wholly-owned subsidiary of the Company. DOSE is developing multiple
micro-invasive, sustained-released, bioerodible drug delivery platforms designed
to be used in the treatment of various retinal diseases, including age-related
macular degeneration and diabetic macular edema. Certain DOSE assets were in the
development-stage at the time of purchase and were determined to have no
alternative future use.

Non-Operating (Expense) Income, Net

Non-operating (expense) income, net primarily consists of interest expense associated with our finance lease for our Aliso Viejo, California facility and for our Convertible Notes, interest income derived from our short-term investments and unrealized gains and losses arising from exchange rate fluctuations on transactions denominated in a currency other than the U.S. dollar, primarily related to intercompany loans.

Income Taxes


Our tax benefit is comprised of U.S. federal and state income and franchise
taxes as well as foreign income taxes. Our current U.S. federal tax benefit
results from the carryback of NOLs and R&D tax credits permitted by the CARES
Act for the year ended December 31, 2020. Our current state tax provision
results from state minimum and franchise taxes for the year ended December 31,
2020. Our current foreign tax provision results from foreign income taxes
imposed on profitable operations in our foreign subsidiaries for the year ended
December 31, 2020. Our U.S. federal and state deferred tax benefit results from
the deferred tax liability recorded in connection with the Convertible Notes
which may be used as a source of future taxable income allowing us to record a
tax benefit for a portion of our operating losses generated for the year ended
December 31, 2020. Our net deferred tax liability of $10.5 million at December
31, 2020 represents the excess of our indefinite-lived deferred tax liabilities
over our indefinite-lived deferred tax assets, as well as deferred tax
liabilities recorded to additional paid-in capital within the consolidated
statement of stockholders' equity which were not available to offset our
deferred tax assets. We continue to provide a valuation allowance against our
other net deferred tax assets.



We record reserves for uncertain tax positions where we believe the ability to sustain the tax position does not reach the more likely than not threshold.





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Results of Operations

Comparison of Years Ended December 31, 2020 and December 31, 2019




                                                      Year ended
                                                    December 31,    % Increase
(in thousands)                                2020          2019    (decrease)
Statements of operations data:
Net sales                              $   224,959    $  236,984           (5) %
Cost of sales                               91,719        38,588           138 %
Gross profit                               133,240       198,396          (33) %
Operating expenses:

Selling, general and administrative        171,401       176,635           (3) %
Research and development                    85,392        68,308            25 %
In-process research and development              -         3,745           

NM
Total operating expenses                   256,793       248,688             3 %
Loss from operations                     (123,553)      (50,292)           146 %

Non-operating (loss) income, net           (8,761)           256           

NM
Income tax benefit                        (11,966)      (65,460)          (82) %
Net (loss) income                      $ (120,348)    $   15,424            NM


NM = Not Meaningful

Net Sales

Net sales for the years ended December 31, 2020 and December 31, 2019 were $225.0 million and $237.0 million, respectively, reflecting a decrease of $12.0 million or 5%.


Net sales of glaucoma products in the United States were $133.7 million and
$187.7 million for the years ended December 31, 2020 and December 31, 2019,
respectively, decreasing by approximately 28% primarily due to the disruption
resulting from COVID-19. We believe competition had also increased entering into
2020, the impact of which is difficult to assess given the COVID-19 disruption.
International sales of glaucoma products for the years ended December 31, 2020
and December 31, 2019 were $45.6 million and $43.3 million, respectively,
increasing by approximately 5%. The increase in net sales internationally was
due to sales expansion in certain of our existing international markets,
partially offset by the disruption resulting from COVID-19. Additionally, in the
second half of 2020, we launched our next generation iStent inject product, the
iStent inject W. Pricing of our glaucoma products in the United States and
internationally remained stable and did not provide a significant contribution
to the results in 2020. As such, changes in unit volumes were the primary driver
of the year over year change.



Net sales of corneal health products were $45.6 million and $6.0 million for the
years ended December 31, 2020 and December 31, 2019, respectively, as a result
of the full year operations of Avedro during the year ended December 31, 2020
that were not in our operating results for the majority of 2019. The $39.6
million increase in net sales generated from our corneal health products was
comprised of an increase of approximately $34.6 million in U.S. sales, including
an increase of $31.3 million of Photrexa net sales, using our direct sales
operations and an increase of approximately $5.0 million in net sales with
distributors being used in certain international locations where we do not have
a direct commercial presence. Sales of corneal health products in 2020 were
negatively impacted by disruption resulting from COVID-19.



Cost of Sales



Cost of sales for the years ended December 31, 2020 and December 31, 2019 were
$91.7 million and $38.6 million, respectively, reflecting an increase of
approximately $53.1 million or 138%. The increase was primarily comprised of
approximately $24.7 million, net related to the acquisition fair market value
inventory adjustment rollout, and $22.1 million related to amortization of
certain finite-lived intangible assets acquired, both of which are related to
the Avedro Merger. Our gross margin was approximately 59% for the year ended
December 31, 2020 compared to

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approximately 84% for the year ended December 31, 2019. The decreased gross margin resulted primarily from the impact of the aforementioned accounting adjustments related to the Avedro Merger and, to a lesser extent, changes in product mix, most notably the inclusion of modestly lower margin products related to the Avedro Merger and international market sales.

Selling, General and Administrative Expenses

SG&A expenses for the years ended December 31, 2020 and December 31, 2019 were $171.4 million and $176.6 million, respectively, reflecting a decrease of $5.2 million or 3%.



We incurred approximately $98.2 million of commercial personnel and
discretionary spending in the year ending December 31, 2020 related primarily to
existing sales infrastructure in glaucoma, training samples and marketing
associated with our global launch of iStent Inject W and expansion of our sales
infrastructure and commercial activities in Corneal Health. We also incurred
approximately $73.2 million of general and administrative personnel and
discretionary spending associated with our ongoing administrative functions,
previously disclosed patent litigation and global enterprise systems
implementation, and amortization of our right-of-use asset related to our
long-term lease in Aliso Viejo, California.

Our results for the year ending December 31, 2020 include approximately $24.6
million in additional SG&A expenses as a result of the full year operations of
Avedro that were not in our operating results for the majority of 2019. These
expenses were primarily comprised of commercial personnel and discretionary
spending of $16.7 million and general and administrative personnel and
discretionary spending of $7.9 million.

The above increase in expenses associated with the full year operations of
Avedro was offset by reductions in SG&A expenses for the year ended December 31,
2020 primarily consisting of a decrease of approximately $9.4 million in
professional services and software systems costs related to our global
enterprise systems implementation, decreases of $6.3 million and $3.2 million in
transaction expenses and restructuring expenses, respectively, related to our
acquisition of Avedro and a decrease of approximately $3.1 million related to
our previously disclosed patent litigation. The remaining decrease in expenses
of approximately $7.8 million primarily relates to decreased sales and marketing
expenses and broader SG&A cost savings related to the COVID-19 pandemic.

Research and Development Expenses

R&D expenses for the years ended December 31, 2020 and December 31, 2019 were $85.4 million and $68.3 million, respectively, reflecting an increase of $17.1 million or 25%.



Our R&D expenses for the year ended December 31, 2020 primarily relate to
compensation and related employee expenses and project spending associated with
our emerging pipeline of product candidates, including the clinical and
development costs associated with iDose TR, iStent Infinite, the continued
development of a pharmaceutical therapeutic system for the treatment of
keratoconus without the removal of the epithelium (often referred to as iLink
epi-on), as well as earlier stage micro-surgical, pharmaceutical, and biosensor
projects that span across glaucoma, dry eye, presbyopia, and common retina
conditions such as neovascular age-related macular degeneration, diabetic
macular edema, and retinal vein occlusion.

Our results for the year ending December 31, 2020 include approximately $19.1
million in additional R&D expenses that were not in our operating results for
the majority of 2019. These expenses were primarily comprised of $8.3 million of
compensation and related employee expenses and approximately $10.8 million in
other core R&D and clinical expenses spent on the continued development of iLink
epi-on and other earlier stage technology and therapeutic investments.

The above increase in expenses as a result of the full year operations of Avedro
was primarily offset by reductions of R&D spending related to the COVID-19
pandemic of approximately $1.3 million primarily related to decreased personnel
and discretionary spending on our earlier stage programs.

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In-Process Research and Development



There were no IPR&D expenses for the year ended December 31, 2020. IPR&D
expenses for the year ended December 31, 2019 were $3.7 million, comprised of
$2.2 million related to the purchase of certain DOSE assets and $1.5 million
related to the upfront payment for our exclusive global licensing agreement with
Intratus.

Non-Operating (Expense) Income, Net



We had non-operating expense, net of $8.8 million and $0.3 million of
non-operating income, net for the years ended December 31, 2020 and December 31,
2019, respectively. The increase in non-operating expense, net primarily relates
to interest expense recognized related to the Convertible and recognition of
unrealized foreign currency losses due to higher intercompany loan balances
denominated in, and impacted by, changes in foreign currency exchange rates.

Income Tax (Benefit) Provision



Our effective tax rate for the year ended 2020 was not meaningful due to the
large deferred tax benefit recorded in connection with the Convertible Notes
relative to the amount of our net loss before taxes. For the year ended December
31, 2020 we recorded a (benefit) for income taxes of $(12.0) million which was
primarily the result of the deferred tax liability recorded in conjunction with
the Convertible Notes as a source of taxable income to benefit the current year
losses, partially offset by current U.S. state and foreign income taxes. For the
year ended December 31, 2019 we recorded a (benefit) for income taxes of $(65.5)
million that was primarily comprised of the U.S. federal and state deferred tax
benefit recorded in connection with the Avedro Merger relative to the amount of
net loss before taxes, partially offset by current U.S. state and foreign income
taxes.

Comparison of Years ended December 31, 2019 and December 31, 2018




                                                     Year ended
                                                   December 31,    % Increase
(in thousands)                               2019          2018    (decrease)
Statements of operations data:
Net sales                              $  236,984    $  181,278            31 %
Cost of sales                              38,588        25,075            54 %
Gross profit                              198,396       156,203            27 %
Operating expenses:

Selling, general and administrative       176,635       119,529            48 %
Research and development                   68,308        49,676            38 %
In-process research and development         3,745             -           

NM
Total operating expenses                  248,688       169,205            47 %
Loss from operations                     (50,292)      (13,002)            NM %
Non-operating income, net                     256           634          (60) %

Income tax (benefit) provision           (65,460)           583           

NM
Net income (loss)                      $   15,424    $ (12,951)            NM


NM = Not Meaningful

Net Sales

Net sales for the years ended December 31, 2019 and December 31, 2018 were $237.0 million and $181.3 million, respectively, reflecting an increase of $55.7 million or 31%.



The increase in net sales from our glaucoma products resulted primarily from
expansion of U.S. sales of our iStent inject, the withdrawal from the market of
a competitive MIGS device in late August 2018, and direct sales operations in
our existing international markets. Net sales of glaucoma products in the United
States were $187.7 million and $151.7 million for the years ended December 31,
2019 and December 31, 2018, respectively, increasing by 24%. International sales
for the years ended December 31, 2019 and December 31, 2018 were $43.3 million
and $29.6 million,

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respectively, increasing by 46%. Net sales at our subsidiaries in Australia,
Germany, Japan, France and the United Kingdom accounted for the majority of the
increase internationally.

The remaining $6.0 million increase in net sales was generated from our corneal health products as a result of our Avedro Merger on November 21, 2019.

Pricing for our products was not a significant contributing factor to the increase in net sales for the year ended December 31, 2019.

Cost of Sales



Cost of sales for the years ended December 31, 2019 and December 31, 2018 were
$38.6 million and $25.1 million, respectively, reflecting an increase of
approximately $13.5 million or 54%. The increase was driven by growing worldwide
volume, with approximately $4.0 million related to the acquisition fair market
value inventory adjustment rollout and $2.3 million related to amortization of
certain finite-lived intangible assets acquired, both of which are related to
the Avedro Merger; offset by a one-time federal medical device excise tax refund
benefit of approximately $0.5 million. Our gross margin was approximately 84%
for the year ended December 31, 2019 compared to approximately 86% for the year
ended December 31, 2018.

Selling, General and Administrative Expenses

SG&A expenses for the years ended December 31, 2019 and December 31, 2018 were $176.6 million and $119.5 million, respectively, reflecting an increase of $57.1 million or 48%.


The acquisition of Avedro represented an increase in SG&A expenses of $19.1
million that were not in our 2018 results. These expenses were primarily
comprised of $7.6 million due to stock-based compensation resulting from
post-combination services associated with the Replacement Awards, $7.1 million
related to legal, financial advisory and other transaction costs associated with
the acquisition, and amortization of finite-lived intangible assets acquired of
approximately $0.3 million. In connection with the Avedro acquisition, we
implemented a restructuring plan in December 2019 that includes an estimated
headcount reduction of 40 employees and a reallocation of responsibilities
primarily within the SG&A functions. As of December 31, 2019 we have accrued
$4.1 million of restructuring plan costs, and we expect to incur a total of
approximately $5.6 million in restructuring charges upon completion of the plan,
which we expect to be completed in 2021.

We incurred $3.5 million in normal and recurring Avedro SG&A expenses from acquisition date through December 31, 2019 that were not in our 2018 results.


Additionally, the increase in SG&A expenses for the year ended December 31, 2019
primarily consisted of approximately $5.7 million related to our
previously-disclosed patent litigation, approximately $10.1 million in
professional services and software systems costs related to our global
enterprise systems implementation, and $8.3 million in additional compensation
and related employee expenses was associated with our growing number of domestic
and international employees.

The remaining increase in SG&A expenses was primarily comprised of expenses incurred for training samples related to our U.S. launch of iStent inject, amortization of our right-of-use asset related to our long-term lease in Aliso Viejo, California and non-employee related expenses incurred by our foreign subsidiaries.

Research and Development Expenses



R&D expenses for the years ended December 31, 2019 and December 31, 2018 were
$68.3 million and $49.7 million, respectively, reflecting an increase of
$18.6 million or 38%. The increase in R&D expenses was primarily the result of
approximately $4.8 million in additional compensation and related employee
expenses as well as an overall increase of approximately $12.3 million in other
core R&D and clinical expenses, including expenses associated with our iDose
Travoprost Phase III clinical trials. The acquisition of Avedro also represented
an increase of approximately $1.5 million in R&D expenses that were not in

our
2018 results.

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In-Process Research and Development



IPR&D expenses for the year ended December 31, 2019 were $3.7 million, comprised
of $2.2 million related to the purchase of certain DOSE assets and $1.5 million
related to the upfront payment for our exclusive global licensing agreement with
Intratus. There were no IPR&D expenses for the year ended December 31, 2018.

Non-Operating Income, Net



We had non-operating income, net of $0.3 million and $0.6 million for the years
ended December 31, 2019 and December 31, 2018, respectively. These amounts
primarily relate to interest expense associated with the financing lease for our
Aliso Viejo, California facility and recognition of unrealized foreign currency
losses due to higher intercompany loan balances denominated in, and impacted by,
changes in foreign currency exchange rates offset by increases in interest
income related to our short-term investments.

Income Tax (Benefit) Provision



Our effective tax rate for the year ended 2019 was not meaningful due to the
large deferred tax benefit recorded in connection with the Avedro Merger
relative to the amount of our net loss before taxes. For the year ended December
31, 2019 we recorded a (benefit) for income taxes of $(65.5) million which was
primarily comprised of the U.S. federal and state deferred tax benefit related
to the Avedro Merger. For the year ended December 31, 2018 we recorded a
provision for income taxes of $0.6 million that was primarily comprised of
current U.S. state and foreign income taxes.

Liquidity and Capital Resources



For the year ended December 31, 2020, we incurred a net loss of $120.3 million
and used cash from operations of $23.0 million. As of December 31, 2020, we had
an accumulated deficit of approximately $310.1 million. We fund our operations
from cash generated from commercial operations and proceeds from exercises of
stock options, in addition to utilizing funds from the June 2020 issuance of the
Convertible Notes. We have made and expect to continue to make significant
investments in our global sales force, marketing programs, research and
development activities, clinical studies and general and administrative
infrastructure. FDA-approved IDE and IND studies and new product development
programs in our industry are expensive. However, due to the COVID-19 economic
slowdown, as disclosed above under "Impact of COVID-19 Pandemic and Current
Economic Environment", we have also sought to preserve our cash position by
instituting a number of cost saving initiatives, including substantial
reductions in discretionary spending and capital expenditures, as well as a
temporary salary reduction for many of our employees, which were reinstated in
the fourth quarter of 2020.

We have incurred a significant increase in administrative costs since we began
operating as a public company. Our operating expenses have increased
significantly following our acquisition of Avedro, and we also expect to incur
additional construction costs related to our new facility in Aliso Viejo,
California.

Our Convertible Notes may be converted at the option of the holders at the times
and under the circumstances and at the conversion rate described in Note 9,
Convertible Senior Notes. As of December 31, 2020, none of the conditions
allowing holders of the Convertible Notes to convert had been met. If our
trading price remains above 130% of the conversion price for at least 20 trading
days during the 30 consecutive trading-day period ending on, and including,
March 31, 2021, holders of the Convertible Notes would have the right to convert
their Convertible Notes during the calendar quarter beginning April 1, 2021.
Upon conversion, we will pay or deliver, as the case may be, cash, shares of our
common stock or a combination of cash and shares of our common stock, at our
election, in the manner and subject to the terms and conditions provided in the
Indenture. Our current intent is to settle the principal amount of the
Convertible Notes in cash upon conversion, with any remaining conversion value
being delivered in shares of our common stock.

We plan to fund our operations, capital funding and other liquidity needs using
existing cash and investments and, to the extent available, cash generated from
commercial operations. Our existing cash and investments includes the remaining
net proceeds from the Convertible Notes issued in June 2020 (after payment

for
the related capped call

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transactions), which we are using for working capital and general corporate
purposes. Although we have been profitable for certain periods in our operating
history, there can be no assurance that we will be profitable or generate cash
from operations. We may seek to obtain additional financing in the future
through other debt or equity financings. There can be no assurance that we will
be able to obtain additional financing on terms acceptable to us, or at all. We
believe that our available cash, cash equivalents, investment balances and
interest we earn on these balances and any cash generated from commercial
operations will be sufficient to fund our operations and satisfy our liquidity
requirements for at least the next 12 months from the date our consolidated
financial statements for the year ended December 31, 2020 are made publicly
available.

The following table summarizes our cash and cash equivalents, short-term investments and selected working capital data as of December 31, 2020 and December 31, 2019 (in thousands):




                              December 31,      December 31,
                                  2020              2019
Cash and cash equivalents    $       96,596    $       62,430
Short-term investments              307,772           111,553
Accounts receivable, net             36,059            38,417
Inventory, net                       15,809            42,578
Accounts payable                      4,371             5,781
Accrued liabilities                  45,331            51,919
Working capital (1)                 419,740           205,178



(1) Working capital consists of total current assets less total current


    liabilities


Cash Flows

Our historical cash outflows have primarily been associated with cash used for
operating activities such as the expansion of our sales, marketing and R&D
activities; purchase of and growth in inventory and other working capital needs;
the acquisition of intellectual property; and expenditures related to equipment
and improvements used to increase our manufacturing capacity, to improve our
manufacturing efficiency and for overall facility expansion.

The following table is a condensed summary of our cash flows for the periods
indicated:


                                                                                   Year ended
                                                                                December 31,
(in thousands)                                                2020         2019          2018

Net cash (used in) provided by:
Operating activities                                   $  (22,988)    $   (369)    $   18,864
Investing activities                                     (205,060)       43,426      (26,400)
Financing activities                                       262,542      (9,645)        21,576
Exchange rate changes                                         (88)        (252)            48
Net increase in cash, cash equivalents and
restricted cash                                        $    34,406    $  

33,160 $ 14,088

At December 31, 2020, our cash and cash equivalents were held for working capital purposes. We do not enter into investments for trading or speculative purposes. Our policy is to invest any cash in excess of our immediate requirements in investments designed to preserve the principal balance and provide liquidity.

Operating Activities



In the year ended December 31, 2020 and December 31, 2019, our operating
activities used $23.0 million and $0.4 million of net cash, respectively. In the
year ended December 31, 2018 our operating activities generated $18.9 million of
net cash.

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For the year ended December 31, 2020, included in net cash used in operating
activities reflected our net loss of $120.3 million, adjusted for non-cash items
of $100.6 million, primarily consisting of stock-based compensation expense of
$46.5 million, depreciation and amortization of $29.4 million, amortization of
the inventory fair value adjustment as a result of the Avedro Merger of $24.7
million, amortization of lease right-of-use assets of $5.2 million, the fair
value of cash-settled stock options of $3.2 million and a deferred income tax
benefit of $12.2 million. This was offset by changes in operating assets and
liabilities of $3.2 million, which resulted from decreases in accounts
receivable, inventory, and other assets partially offset by decreases in
accounts payable and accrued liabilities and increases in prepaid expenses and
other assets.

For the year ended December 31, 2019, included in net cash used in operating
activities reflected our net income of $15.4 million, adjusted for non-cash
items of $7.3 million, primarily consisting of stock-based compensation expense
of $36.3 million, depreciation and amortization of $6.3 million, amortization of
the inventory fair value adjustment as a result of the Avedro Merger of $4.0
million, amortization of lease right-of-use assets of $3.6 million, the fair
value of cash-settled stock options of $3.1 million and a deferred income tax
benefit of $66.3 million. This was offset by changes in operating assets and
liabilities of $8.5 million, which resulted from increases in accounts
receivable, prepaid expenses and other current assets and other assets totaling
$9.3 million, offset by increases in accounts payable and accrued liabilities
and inventory of $0.8 million.

For the year ended December 31, 2018, included in net cash provided by operating
activities reflected our net loss of $13.0 million, adjusted for non-cash items
of $35.4 million, primarily consisting of stock-based compensation expense of
$25.7 million and depreciation and amortization of $6.3 million. This was
partially offset by changes in operating assets and liabilities of $3.6 million,
which resulted from increases in accounts receivable, inventory and prepaid
expenses and other current assets totaling $6.3 million, offset by increases in
accounts payable and accrued liabilities and other assets of $2.7 million.

Investing Activities


In the year ended December 31, 2020 net cash from investing activities used
approximately $205.1 million. In the year ended December 31, 2019, net cash from
investing activities generated $43.4 million, and in the year ended December 31,
2018, we used approximately $26.4 million.

In the year ended December 31, 2020, we used approximately $301.0 million for
purchases of short-term investments, received proceeds from sales and maturities
of short-term investments of $104.7 million and used approximately $1.8 million
related to investments in company-owned life insurance.

In the year ended December 31, 2019, we used approximately $80.4 million for
purchases of short-term investments, received proceeds from sales and maturities
of short-term investments of $80.5 million and used approximately $1.6 million
related to investments in company-owned life insurance. Additionally, the Avedro
Merger resulted in an increase in cash from investing activities of $49.7
million.

In the year ended December 31, 2018, we used approximately $93.7 million for
purchases of short-term investments, received proceeds from sales and maturities
of short-term investments of $78.9 million and used approximately $1.2 million
related to investments in company-owned life insurance.

Cash used for purchases of property and equipment was approximately $6.9 million, $4.7 million and $10.3 million for the years ended December 31, 2020, December 31, 2019 and December 31, 2018, respectively.



Subject to our near-term deferral of certain capital expenditures due to the
COVID-19 pandemic, we expect to increase our investment in property and
equipment in the future as we expand our manufacturing capacity for current and
new products, improve our manufacturing efficiency and for overall facility
expansion, as discussed above.

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Financing Activities

In the year ended December 31, 2020 and December 31, 2018 our financing
activities provided $262.5 million and $21.6 million of net cash, respectively,
whereas in the year ended December 31, 2019, our financing activities used $9.6
million of net cash.

In the year ended December 31, 2020, we received net cash proceeds of
approximately $287.5 million related to our Convertible Notes, used $9.6 million
for transaction costs related to the Convertible Notes and used $35.7 million on
payment of the capped call transaction related to the Convertible Notes. We
received net cash proceeds of approximately $24.2 million from the exercises of
stock options and purchases of our common stock by employees pursuant to our
Employee Stock Purchase Plan and used $3.9 million for payment of employee taxes
related to restricted stock unit vestings.

In the year ended December 31, 2019, we used approximately $22.5 million for
payment of debt assumed related to the Avedro Merger, we received net cash
proceeds of approximately $18.5 million from the exercises of stock options and
purchases of our common stock by employees pursuant to our Employee Stock
Purchase Plan and used $5.6 million for payment of employee taxes related to
restricted stock unit vestings.

In the year ended December 31, 2018, we received net cash proceeds of
approximately $22.2 million from the exercises of stock options and purchases of
our common stock by employees pursuant to our Employee Stock Purchase Plan and
used $0.6 million for payment of employee taxes related to restricted stock

unit
vestings.

Contractual Obligations

The following table summarizes our known contractual obligations as of December 31, 2020 and the effect those obligations are expected to have on our liquidity and cash flows in future periods.




                                                                                             Payments due by period
Contractual obligations                                   Less than                                       More than
(in thousands)                                 Total         1 year      1 - 3 years      3 - 5 years       5 years
Operating and finance lease obligations    $ 161,571    $     2,788    $       7,394    $      15,372    $  136,017
Firm purchase commitments (i)                 20,292         20,097              128               67             -
Total contractual obligations              $ 181,863    $    22,885    $   

   7,522    $      15,439    $  136,017

(i) Of the above disclosed amounts, we had $2.5 million and $1.7 million in

commitments for our implementation of global enterprise systems and capital

expenditures, respectively, as of December 31, 2020.

Off-balance Sheet Arrangements



We do not have any off-balance sheet arrangements as defined in the rules and
regulations of the Securities and Exchange Commission. We do not have any
relationships with unconsolidated entities or financial partnerships, such as
entities often referred to as structured finance or special purpose entities,
which would have been established for the purpose of facilitating off-balance
sheet arrangements or for any other contractually narrow or limited purpose.
However, from time to time we enter into certain types of contracts that
contingently require us to indemnify parties against third-party claims
including in connection with certain real estate leases, and supply purchase
agreements, and with directors and officers. The terms of such obligations vary
by contract and in most instances a maximum dollar amount is not explicitly
stated therein. Generally, amounts under these contracts cannot by reasonably
estimated until a specific claim is asserted, thus no liabilities have been
recorded for these obligations on our balance sheets for any of the periods

presented.

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Critical Accounting Policies and Significant Estimates


Management's discussion and analysis of our financial condition and results of
operations are based on our consolidated financial statements, which have been
prepared in accordance with U.S. generally accepted accounting principles
(GAAP). The preparation of these consolidated financial statements requires us
to make estimates and judgments that affect the reported amounts of assets and
liabilities and related disclosure of contingent assets and liabilities, revenue
and expenses at the date of the consolidated financial statements. Generally, we
base our estimates on historical experience and on various other assumptions in
accordance with GAAP that we believe to be reasonable under the circumstances.
Actual results may differ materially from these estimates under different
assumptions or conditions and such differences could be material to our
financial position and results of operations.

While our significant accounting policies are more fully described in the Notes
to our consolidated financial statements appearing elsewhere in this Annual
Report on Form 10-K, we believe the following accounting policies to be most
critical for fully understanding and evaluating our financial condition and
results of operations.

Revenue Recognition

We derive our revenue from sales of our products in the United States and internationally. Customers are primarily comprised of ambulatory surgery centers, hospitals and physician private practices, with distributors being used in certain international locations where we do not have a direct commercial presence.


We concluded that one performance obligation exists for the majority of our
contracts with customers which is to deliver products in accordance with our
normal delivery times. Revenue is recognized when this performance obligation is
satisfied, which is the point in time when we consider control of a product to
have transferred to the customer. Revenue recognized reflects the consideration
to which we expect to be entitled in exchange for those products or services. We
have determined the transaction price to be the invoice price, net of
adjustments, which includes estimates of variable consideration for certain
product returns.



We offer volume-based rebate agreements to certain customers and, in these
instances, we provide a rebate (in the form of a credit memo) at the contract's
conclusion, if earned by the customer. In such cases, the transaction price is
allocated between our delivery of product and the issuance of a rebate at the
contract's conclusion for the customer to utilize on prospective purchases. The
performance obligation to issue a customer's rebate, if earned, is transferred
over time and our method of measuring progress is the output method, whereby the
progress is measured by the estimated rebate earned to date over the total
rebate estimated to be earned over the contract period. The provision for
volume-based rebates is estimated based on customers' contracted rebate programs
and the customers' projected sales levels. We periodically monitor our customer
rebate programs to ensure the rebate allowance is fairly stated. Our rebate
allowance is included in accrued liabilities in the consolidated balance sheets
and estimated rebates accrued were not material during the periods presented.



Additionally, we have a performance obligation related to certain customers'
right to a future discount on single dose pharmaceutical purchases in the U.S.,
and that performance obligation is expected to be recognized when the customer
elects to utilize the discount, which is generally within one year.
Additionally, we have a performance obligation related to extended warranty
agreements with customers related to our KXL systems.



Customers are not granted specific rights of return; however, we may permit
returns of certain products from customers if such product is returned in a
timely manner and in good condition. We generally provide a warranty on our
products for one year from the date of shipment, and offer an extended warranty
for our KXL systems. Any product found to be defective or out of specification
will be replaced or serviced at no charge during the warranty period. Estimated
allowances for sales returns and warranty replacements are recorded at the time
of sale of the product and are estimated based upon the historical patterns of
product returns matched against sales, and an evaluation of specific factors
that may increase the risk of product returns. Product returns and warranty
replacements to date have been consistent with amounts reserved or accrued and
have not been significant. If actual results in the future vary from our
estimates, we will adjust these estimates which would affect net product revenue
and earnings in the period such variances become known.

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Clinical Trial Expense Accruals



As part of our R&D expenses, we accrue at each balance sheet date the estimated
costs of clinical study activities performed by third-party clinical sites with
whom we have agreements providing for fees based upon the quantities of subjects
enrolled and clinical evaluation visits that occur over the life of the study.
The estimates are determined based upon a review of the agreements and data
collected by internal and external clinical personnel as to the status of
enrollment and subject visits, and are based upon the facts and circumstances
known to us at each financial reporting date. If the actual timing of
performance of activities varies from the assumptions used in the estimates, we
adjust the accruals accordingly. There have been no material adjustments to our
prior period accrued estimates for clinical trial activities through December
31, 2020. If we underestimate or overestimate the activity or fees associated
with a study or service at a given point in time, adjustments to R&D expenses
may be necessary in future periods. Subsequent changes in estimates may result
in a material change in our accruals. Material nonrefundable advance payments
for goods and services, including fees for process development or manufacturing
and distribution of clinical supplies that will be used in future research and
development activities, are deferred and recognized as expense in the period
that the related goods are consumed or services are performed.

Intangible Assets

Intangible assets primarily consist of developed technology, customer relationships, and IPR&D assets related to the Avedro Merger, as well as the buyout of a royalty payment obligation.


Intangible assets with finite-lives include developed technology, customer
relationships and the buyout of a royalty payment obligation, which are
amortized on a straight-line basis over their estimated useful lives, which
range from five to eleven years. We review finite-lived intangible assets for
impairment whenever events or changes in circumstances indicate that the
carrying amount of the assets or asset group may not be recoverable. When such
an event occurs, management determines whether there has been impairment by
comparing the anticipated undiscounted future net cash flows to the related
asset group's carrying value.

Indefinite-lived intangible assets are comprised of IPR&D assets associated with
other applications of Avedro's corneal remodeling platform, which will not be
amortized until technological feasibility is met, but will be assessed for
impairment annually.

Please see Note 7, Intangible Assets and Goodwill to the consolidated financial statements in Item 8 of this Annual Report on Form 10-K for additional information on our intangible assets.

Goodwill

Goodwill represents the excess of the purchase price of an acquired business
over the fair value of the identifiable assets acquired and liabilities assumed.
Goodwill is not amortized, but is tested for impairment annually in the fourth
quarter, or more frequently if events or circumstances indicate the carrying
value may no longer be recoverable and that an impairment loss may have
occurred. The Company operates as one segment, which is considered to be the
sole reporting unit, and therefore goodwill is tested for impairment at the
consolidated level. Please see Note 6, Business Combinations and Note 7,
Intangible Assets and Goodwill to the consolidated financial statements in Item
8 of this Annual Report on Form 10-K for additional information on our goodwill.

Inventory Valuation


Except for inventory acquired in connection with the Avedro Merger, further
described in Note 6, Business Combinations to the consolidated financial
statements in Item 8 of this Annual Report on Form 10-K, we value inventory at
the lower of cost and net realizable value. Cost is determined by the first-in,
first-out method. This policy requires us to make estimates regarding the market
value of our inventory, including an assessment of excess or obsolete inventory.
We evaluate inventory for excess quantities and obsolescence based on an
estimate of the future demand for

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our product within a specified time horizon, and record an allowance to reduce
the carrying value of inventory as determined necessary. The estimates we use
for demand are also used for near-term capacity planning and inventory
purchasing and are consistent with our revenue forecasts. If our actual demand
is less than our forecast demand, we may be required to take additional excess
inventory charges, which would decrease gross margin and adversely impact net
operating results in the future.

Stock-Based Compensation Expense


Stock-based compensation expense for stock options is measured at the date of
grant, based on the estimated fair value of the award using the Black-Scholes
option pricing model.

Stock-based compensation expense for restricted stock units is also measured at the date of grant, based on the closing price of our common stock.



For awards subject to time-based vesting conditions, we recognize stock-based
compensation expense over the requisite service period on a straight-line basis,
net of estimated forfeitures.

The estimation of the fair value of each stock-based option grant or issuance on
the date of grant involves numerous assumptions by management. Although we
calculate the fair value under the Black-Scholes option pricing model, which is
a standard option pricing model, this model still requires the use of numerous
assumptions, including, among others, the expected life (turnover), volatility
of the underlying equity security, a risk free interest rate and expected
dividends. Because we have a limited operating history as a public company,
there is a lack of company-specific historical and implied volatility data, and
therefore we have estimated stock price volatility based upon an index of the
historical volatilities of a group of comparable publicly-traded medical device
peer companies. We will continue to apply this process until a sufficient amount
of historical information regarding the volatility of our own stock price
becomes available. We have estimated the expected term of our stock options
using the "simplified" method, whereby the expected life equals the average of
the vesting term and the original contractual term of the option. The use of
different values by management in connection with these assumptions in the
Black-Scholes option pricing model could produce substantially different
results.

Convertible Senior Notes


We evaluate embedded conversion features within convertible debt under ASC 815,
Derivatives and Hedging to determine whether the embedded conversion features
should be bifurcated from the host instrument and accounted for as a derivative
at fair value with changes in fair value recorded in earnings. If the conversion
feature does not require derivative treatment under ASC 815, the instrument is
evaluated under ASC 470-20, Debt with Conversion and Other Options.



The carrying amount of the liability component is calculated by measuring the
fair value of a similar debt instrument that does not have an associated
convertible feature. The carrying amount of the equity component representing
the conversion option is determined by deducting the fair value of the liability
component from the par value of the convertible notes. The equity component is
not re-measured as long as it continues to meet the conditions for equity
classification. The excess of the principal amount of the liability component
over its carrying amount (i.e., debt discount) will be amortized to interest
expense over the term of the convertible notes.



We may record debt issuance costs and/or debt discounts in connection with
raising funds through the issuance of convertible debt. These costs may be paid
in the form of cash or equity (such as warrants). These costs are allocated
between debt and equity, with the portion allocated to debt amortized to
interest expense. If a conversion of the underlying debt occurs, a proportionate
share of the unamortized amounts is immediately expensed.

Recent Accounting Pronouncements



For a description of recent accounting pronouncements, see Note 2 of the notes
to our consolidated financial statements included in Part II, Item 8 of this
Annual Report on Form 10-K.

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