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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Operating Activities      
Net income (loss) $ 15,424 $ (12,951) $ (92)
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities:      
Depreciation and amortization 6,306 6,264 5,482
Amortization of lease right-of-use assets 3,557    
Deferred income tax benefit (66,306)    
Loss on disposal of fixed assets 430 156 6
Stock-based compensation 36,393 25,704 17,592
Fair value of cash-settled stock options 3,088    
Unrealized foreign currency losses (gains) 194 1,647 (951)
Amortization of (discount) premium on short-term investments (338) (295) 20
Deferred rent and other liabilities 5,352 1,919 722
Changes in operating assets and liabilities:      
Accounts receivable, net (6,632) (2,252) (2,181)
Inventory, net 4,078 (2,303) (4,162)
Prepaid expenses and other current assets (917) (1,756) 494
Accounts payable and accrued liabilities 779 2,527 9,741
Deferred tax asset and receivable, net     (235)
Other assets (1,777) 204 (345)
Net cash (used in) provided by operating activities (369) 18,864 26,091
Investing activities      
Cash acquired due to acquisition 49,652    
Purchases of property and equipment (4,724) (10,315) (6,311)
Purchases of short-term investments (80,388) (93,696) (94,307)
Proceeds from sales and maturities of short-term investments 80,494 78,851 88,891
Investment in company-owned life insurance (1,608) (1,240) (663)
Net cash provided by (used) in investing activities 43,426 (26,400) (12,390)
Financing activities      
Proceeds from exercise of stock options 15,064 18,654 3,699
Share purchases under Employee Stock Purchase Plan 3,388 3,509 968
Payments of employee taxes related to vested restricted stock units (5,601) (587)  
Payment of debt assumed on the Avedro Merger (22,496)    
Net cash (used in) provided by financing activities (9,645) 21,576 4,667
Effect of exchange rate changes on cash and cash equivalents (252) 48 (434)
Net increase in cash, cash equivalents and restricted cash 33,160 14,088 17,934
Cash, cash equivalents and restricted cash at beginning of period 38,596 24,508 6,574
Cash, cash equivalents and restricted cash at end of period 71,756 38,596 24,508
Supplemental schedule of noncash investing and financing activities      
Shares issued and Replacement Awards assumed in connection with Avedro Merger 437,751    
Debt assumed in the Avedro Merger 22,496    
Purchase of property and equipment included in accounts payable and accrued liabilities 995 152 749
Reduction of liability upon vesting of stock options previously exercised for unvested stock     4
Supplemental disclosures of cash flow information      
Taxes paid, net of refunds 171 $ 401 $ 12
Interest paid $ 2