Cash flow remains volatile with a negative FCF margin of 10.9% in 2026Q1, further complicated by an OCF/NI ratio of 0.63 that suggests earnings quality is currently insufficient to support operational self-sufficiency.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 |
|---|
| Cash from Operations | -8.79M | -46.34M | -61.32M | -57.76M | -33.08M | 24.71M | -22.99M | -369K | 18.86M | 25.51M | 12.31M | -2.19M | -7.11M | -13.3M | -20.45M |
| Operating CF Margin % | - | -9.13% | -15.99% | -18.35% | -11.7% | 8.4% | -10.22% | -0.16% | 10.41% | 16.02% | 10.76% | -3.05% | -15.59% | -63.52% | -842.12% |
| Operating CF Growth % | 1414.81% | 24.43% | -6.16% | -74.59% | -233.9% | 207.48% | -6129.81% | -101.96% | -26.05% | 107.23% | 662.57% | 69.21% | 46.58% | 34.95% | - |
| Net Income | -189.33M | -133.66M | -146.37M | -134.66M | -99.19M | -49.59M | -120.35M | 15.42M | -12.95M | -92K | 4.52M | -38.32M | -14.06M | -14.23M | -19.33M |
| Depreciation & Amortization | 40.59M | 38.09M | 39.92M | 37.98M | 35.95M | 34.42M | 34.61M | 9.86M | 6.26M | 5.48M | 4.72M | 4.27M | 4.23M | 1.16M | 638K |
| Stock-Based Compensation | 69.38M | 63.22M | 50.21M | 43.53M | 38.56M | 30.15M | 46.48M | 0 | 25.7M | 17.59M | 8.79M | 7.89M | 1.53M | 1.35M | 1.01M |
| Deferred Taxes | -6.48M | -6.49M | -216K | -120K | -54K | -1.03M | -12.18M | -66.31M | 1.51M | -925K | 575K | 27.05M | -5K | -165K | 0 |
| Other Non-Cash Items | 53.86M | 24.04M | 34.62M | 5.65M | 5.11M | 7.19M | 31.67M | 45.12M | 1.92M | 722K | -31K | 298K | -33K | 24K | -1.76M |
| Working Capital Changes | 23.19M | -31.55M | -39.47M | -10.13M | -13.45M | 3.58M | -3.22M | -4.47M | -3.58M | 2.73M | -6.26M | -3.38M | 1.23M | -1.44M | -1.14M |
| Change in Receivables | -53.16M | -53.02M | -21.97M | -3.84M | -3.14M | 1.7M | 2.24M | -6.63M | -2.25M | -2.18M | -6.79M | -2.16M | -2.51M | -2.34M | -456K |
| Change in Inventory | 5.14M | 2.65M | -18.79M | -4.83M | -15.47M | -7.7M | 1.96M | 4.08M | -2.3M | -4.16M | -2.94M | -1.85M | -413K | -938K | -686K |
| Change in Payables | 15.36M | 18.82M | 21K | 1.3M | 7.21M | 12.45M | -2.68M | 779K | 771K | 9.23M | 5.1M | 1.52M | 4.12M | 1.87M | 0 |
| Cash from Investing | -30.16M | -77.61M | 47.83M | 14.1M | 44.78M | -58.23M | -205.06M | 43.43M | -26.4M | -11.73M | -26.12M | -85.63M | -868K | -958K | 6.06M |
| Capital Expenditures | -9.69M | -7.67M | -6.3M | -20.25M | -30.27M | -47.78M | -6.93M | -4.72M | -10.31M | -6.31M | -6.28M | -877K | -868K | -852K | -533K |
| CapEx % of Revenue | 1.76% | 1.51% | 1.64% | 6.43% | 10.7% | 16.25% | 3.08% | 1.99% | 5.69% | 3.96% | 5.49% | 1.22% | 1.9% | 4.07% | 21.94% |
| Acquisitions | -12.44M | -12.44M | 38K | 0 | 151K | 3K | 0 | 49.65M | 1.24M | 11.7K | 0 | -15M | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | -21.77M | -22.16M | -3.15M | -3.17M | -1.01M | -2.08M | -1.82M | -1.61M | -1.24M | -11.7K | -19.84M | -15M | 0 | -106K | 6.59M |
| Cash from Financing | 25.7M | 11.89M | 91.54M | 15.04M | 6.25M | 39.26M | 262.54M | -9.64M | 21.58M | 4.67M | -1.64M | 107.11M | 3.5M | 19.26M | 10.54M |
| Debt Issued (Net) | 248K | 0 | 51.34M | -711K | -527K | -659K | 242.21M | -22.5M | 0 | 0 | -9.7M | -7.95M | 1.85M | 0 | 0 |
| Equity Issued (Net) | -7.04M | 0 | 46.76M | 19.03M | 9.21M | 30.94M | 24.22M | 18.45M | 0 | 0 | 0 | 0 | 0 | 19.09M | 0 |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -587K | 0 | 0 | 0 | 0 | -132K | 0 |
| Other Financing | 32.5M | 11.89M | -6.56M | -3.27M | -2.43M | 8.98M | -3.89M | -5.6M | 21.58M | 4.67M | 8.05M | 115.06M | 1.65M | 162K | 10.54M |
| Net Change in Cash | -10.9M | -111.26M | 76.16M | -26.06M | 18.82M | 4.11M | 34.17M | 32.61M | 14.09M | 18.01M | -15.08M | 19.27M | -4.42M | 5M | -3.85M |
| Free Cash Flow | -18.48M | -54.01M | -67.62M | -78.01M | -63.35M | -23.08M | -29.92M | -5.09M | 8.55M | 19.2M | 6.03M | -3.06M | -7.97M | -14.16M | -20.99M |
| FCF Margin % | -3.35% | -10.64% | -17.63% | -24.79% | -22.4% | -7.85% | -13.3% | -2.15% | 4.72% | 12.05% | 5.27% | -4.27% | -17.49% | -67.59% | -864.06% |
| FCF Growth % | 65.29% | 20.13% | 13.32% | -23.14% | -174.51% | 22.88% | -487.53% | -159.57% | -55.47% | 218.31% | 296.77% | 61.57% | 43.67% | 32.55% | - |
| FCF per Share | -0.32 | -0.94 | -1.28 | -1.61 | -1.34 | -0.50 | -0.67 | -0.12 | 0.24 | 0.56 | 0.17 | -0.18 | -0.32 | -0.57 | -10.57 |
| FCF Conversion (FCF/Net Income) | 0.10x | 0.25x | 0.42x | 0.43x | 0.33x | -0.50x | 0.19x | -0.02x | -1.46x | -277.26x | 2.72x | 0.06x | 0.59x | 1.05x | 1.06x |
| Interest Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 285K | 834K | 876K | 75K | 0 |
| Taxes Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 401K | 12K | 513K | 25K | 12K | 4K | 0 |
CMS reimbursement policy volatility
As reported in recent financial statements, the persistent gap between net income and operating cash flow, highlighted by an OCF/NI ratio of 0.63 in 2026Q1, suggests that reported losses are not being fully mitigated by non-cash adjustments or efficient working capital management during this growth phase.
The divergence between accounting losses and cash generation indicates that the company's operational model remains heavily reliant on external funding or equity-based compensation to sustain its current trajectory. Investors should monitor whether this conversion ratio improves as the iDose TR platform scales, as current figures suggest that earnings quality remains strained by high operating costs.
Based on quarterly filings, GKOS continues to experience significant FCF volatility, with a negative FCF margin of 10.9% in 2026Q1, reflecting the ongoing challenge of balancing aggressive R&D and commercial expansion against the company's inability to generate consistent self-sustaining cash flows from its core medical device operations.
The erratic nature of free cash flow, swinging from positive in 2025Q4 to negative in 2026Q1, suggests that the company's cash burn is highly sensitive to the timing of commercial investments and regulatory milestones. This trajectory warrants further investigation into whether the company can achieve a sustainable positive FCF inflection point without further dilutive financing.
According to historical data, working capital changes have been a primary driver of cash flow variability, notably the $45.9M inflow in 2025Q4 followed by a $23.2M outflow in 2025Q1, indicating that inventory and receivables management are currently volatile as the company transitions to a pharmaceutical-device hybrid model.
The significant swings in working capital suggest that the shift toward a buy-and-bill pharmaceutical model is introducing new complexities in cash collection and inventory stocking. Analysts should scrutinize whether these fluctuations represent temporary timing differences or a more permanent increase in the capital intensity required to support the iDose TR commercial launch.
Data from recent SEC filings reveals that stock-based compensation, which reached $19.1M in 2026Q1, consistently obscures the true extent of the company's cash burn by providing a non-cash expense that effectively subsidizes the operating budget while simultaneously diluting existing shareholders to preserve the company's $90M cash balance.
The reliance on equity-based compensation as a substitute for cash-funded operations suggests that the company's underlying business model is not yet self-funding. This practice warrants close monitoring, as it may mask the true cost of talent acquisition and retention necessary to maintain the company's competitive moat in the specialized ophthalmic surgical market.
Quick answers to the most common questions about buying GKOS stock.
Glaukos Corporation (GKOS) generated $-46.3M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Glaukos Corporation (GKOS) reported negative free cash flow of $54.0M in 2025, indicating capital requirements exceeded cash from operations.
Glaukos Corporation (GKOS) spent $7.7M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.