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Income Taxes - Provision, Reconciliation and Deferred Taxes (Details) - USD ($)
 3 Months Ended 12 Months Ended
Nov. 21, 2019
Dec. 31, 2019
Sep. 30, 2019
Jun. 30, 2019
Mar. 31, 2019
Dec. 31, 2018
Sep. 30, 2018
Jun. 30, 2018
Mar. 31, 2018
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
United States and foreign loss before income taxes:                        
United States                   $ (50,339,000) $ (14,776,000) $ 12,543,000
Foreign                   303,000 2,408,000 (12,542,000)
(Loss) income before taxes                   (50,036,000) (12,368,000) 1,000
Current:                        
Federal                   237,000   235,000
State                   122,000 274,000 93,000
Foreign                   487,000 309,000  
Total current income tax provision                   846,000 583,000 328,000
Deferred:                        
Federal                   (58,368,000)   (235,000)
State                   (7,938,000)    
Total deferred income tax provision                   (66,306,000)   (235,000)
Income tax (benefit) provision   $ (65,841,000) $ 187,000 $ 72,000 $ 122,000 $ 530,000 $ 37,000 $ 11,000 $ 5,000 (65,460,000) 583,000 93,000
Reconciliations of the U.S. federal statutory tax rate to the combined effective tax rate                        
Statutory rate of tax benefit                   (10,508,000) (2,597,000)  
State income taxes, net of federal benefit                   (2,418,000) (1,518,000) (17,000)
Permanent and other items                   4,371,000 1,349,000 279,000
Stock-based compensation                   (5,006,000) (6,007,000) (5,478,000)
Research credits                   (3,594,000) (2,556,000) (2,215,000)
Uncertain tax positions                   1,780,000 6,143,000 1,108,000
Change in tax rate                   419,000 (250,000) 1,013,000
Tax Cuts and Jobs Act                       25,216,000
ASU 2016-09 Implementation & ASC 842 Adoption in 2019                   (104,000)    
Valuation allowance                   (50,400,000) 6,019,000 (19,813,000)
Income tax (benefit) provision   (65,841,000) $ 187,000 $ 72,000 $ 122,000 530,000 $ 37,000 $ 11,000 $ 5,000 (65,460,000) 583,000 $ 93,000
Components of deferred tax assets                        
Net operating loss carryforwards   69,571,000       40,041,000       69,571,000 40,041,000  
Tax credits   11,590,000       7,754,000       11,590,000 7,754,000  
Depreciation and amortization           9,356,000         9,356,000  
Stock-based compensation   19,268,000       9,838,000       19,268,000 9,838,000  
Reserves and accruals   7,996,000       5,030,000       7,996,000 5,030,000  
Lease liability   18,422,000               18,422,000    
Other, net   147,000               147,000    
Other, net           (65,000)         (65,000)  
Total deferred tax assets   126,994,000       71,954,000       126,994,000 71,954,000  
Depreciation and amortization   (81,174,000)               (81,174,000)    
ROU Lease Asset   (17,333,000)               (17,333,000)    
Inventory   (6,030,000)               (6,030,000)    
Total deferred tax liabilities   (104,537,000)               (104,537,000)    
Valuation allowance   (32,089,000)       $ (71,954,000)       (32,089,000) $ (71,954,000)  
Net deferred tax liability   $ (9,632,000)               (9,632,000)    
Net decrease in valuation allowance                   $ (39,900,000)    
Avedro                        
Components of deferred tax assets                        
Total deferred tax liabilities $ (75,900,000)                      
Valuation allowance (10,700,000)                      
Net decrease in valuation allowance $ (66,300,000)