xFEFF; FOR IMMEDIATE RELEASE  Alimera Sciences Announces 2022 Financial Results and Business Update · 2022 Product Revenue Increased to $54.1 Million, Up 13% over 2021 · Global End User Demand Increased

Alimera Sciences Announces 2022 Financial Results and Business Update

ATLANTA, March 31, 2023 -- Alimera Sciences, Inc. (Nasdaq: ALIM) a global pharmaceutical company whose mission is to be invaluable to patients, physicians, and partners concerned with retinal health and maintaining better vision longer, today announced financial results for 2022.

Alimera will host a conference call today at 9:00 a.m. ET to discuss these results. Details for the call can be found below.

We have begun to see positive results from the growth initiatives we commenced over a year ago, with 22% global end user demand growth year over year in ILUVIEN sales driven by our U.S. segment growth of 23% followed by our international segment growth of 21% , said Rick Eiswirth, Alimera's President and Chief Executive Officer. Building on the improved foundation of our strengthened capital structure and balance sheet, we are looking forward to continued growth in 2023.

Operational Highlights:

Financial Highlights:

Net Revenue for FY 2022

Product revenue from ILUVIEN sales increased by $6.1 million, or 13%, to $54.1 million for 2022, compared to $48.0 million in 2021. The increase was primarily attributable to increased unit sales volume. Net revenue decreased by approximately $4.9 million, or 8%, to approximately $54.1 million for 2022, compared to approximately $59.0 million for 2021. The decrease was primarily attributable to (i) the $11.0 million of recognized license revenue from our transactions with Ocumension and (ii) the recognition of $1.0 million in deferred product revenue associated with the termination of our Canadian distribution agreement with Knight Therapeutics which were both only recognized in 2021.

U.S. net product revenue increased by approximately $7.5 million, or 28%, to approximately $34.2 million for 2022, compared to approximately $26.7 million for 2021. The increase was primarily attributable to our end user demand, which increased 23% in 2022 to 4,053 units compared to 3,287 units for 2021 as we focused on increasing face-to-face interactions with customers across multiple formats and the publication of our PALADIN Study. End user demand represents units purchased by physicians and pharmacies from our distributors.

International net product revenue decreased by $1.3 million, or 6%, to $19.9 million for 2022. The decrease in international net product revenue among our direct and distributor markets in Europe was primarily the result of deteriorating foreign exchange rates for the Euro and British Pound Sterling, which had an unfavorable impact on our international revenue of approximately $2.4 million in 2022. The impact of the foreign currency exchange rates was offset by a 24% increase in units shipped in our international segment.

International net revenue decreased by approximately $12.4 million, or 38%, to approximately $19.9 million for 2022, compared to approximately $32.3 million for 2021. International net revenue in 2021 was composed of $21.2 million in product revenue and $11.0 million in license revenue from the Ocumension transaction, which was recognized in 2021, but not in 2022.

Total operating expenses increased by approximately $5.6 million, or 11%, to approximately $57.8 million for 2022, compared to approximately $52.2 million for 2021. The increase was predominantly due to our decision to invest in growth as we emerged from the pandemic to regain commercial momentum.

Cash and Cash Equivalents

As of December 31, 2022, we had approximately $5.3 million in cash and cash equivalents, a decrease of $200,000 at September 30, 2022, and a decrease of $11.2 million at December 31, 2021. We raised gross proceeds of $12.0 million in our March 2023 equity financing, as described above.

ALIM 2022 Financial Results Conference Call Details

Conference Call to Be Held March 31, 2023

A live conference call will be hosted today, March 31, 2023, at 9:00 a.m. EST by Rick Eiswirth, president and chief executive officer, and Russell Skibsted, chief financial officer, to discuss Alimera's financial results and provide an update on corporate developments. Please refer to the information below for conference call dial-in information and webcast registration.

Conference date: Friday, March 31, 2023, 9:00 a.m. EST

Conference dial-in: 844-839-2190

International dial-in: 412-717-9583

Conference Call Name: Alimera Sciences (Nasdaq: ALIM) 2022 Financial Results and Corporate Update Conference Call

Conference Call Pre-registration: Participants are asked to pre-register for the call by navigating to: https://dpregister.com/sreg/10176894/f8ba5ff46a

Please note that registered participants will receive their dial-in number upon registration and will dial directly into the call without delay. All callers should dial-in approximately 10 minutes prior to the scheduled start time and ask to be joined into the Alimera Sciences call.

The conference call will also be available through a live webcast which is also available through the company's website, www.alimerasciences.com in the Events section under Investor Relations.

A replay will be available on Alimera's website, www.alimerasciences.com, under Investor Relations one hour following the live call.

Conference Call replay: US Toll Free: 1-877-344-7529

International Toll: 1-412-317-0088

Canada Toll Free: 855-669-9658

Replay Access Code: 5931698

End Date: April 14, 2023

Webcast Replay End Date: July 1, 2023

About Alimera Sciences, Inc.

Alimera Sciences is a global pharmaceutical company whose mission is to be invaluable to patients, physicians and partners concerned with retinal health and maintaining better vision longer. For more information, please visit www.alimerasciences.com.

Non-GAAP Financial Measures

This press release presents Adjusted EBITDA and Adjusted net product revenue, each as defined below, which are non-GAAP financial measures. Alimera uses these measures to supplement the financial information presented on a GAAP basis. Alimera believes that excluding certain items from its GAAP financial results allows management to better understand its ongoing operations and analyze its financial performance from period to period and provides meaningful supplemental information to its investors.

Alimera defines Adjusted EBITDA as earnings before interest, taxes, depreciation, amortization, stock-based compensation expenses, net unrealized gains and losses from foreign currency exchange transactions, gains on extinguishment of debt, severance expenses and change in fair value of warrant asset. Beginning in the first quarter of 2023, Alimera also expects to begin reflecting preferred stock dividends in its calculation of Adjusted EBITDA to reflect the securities issued in the March 2023 equity financing, as described above.

Alimera believes that Adjusted EBITDA, when taken together with its corresponding GAAP financial measure, provides meaningful supplemental information to its investors regarding its performance by excluding certain items that may not be indicative of its business, results of operations, or outlook. Accordingly, Adjusted EBITDA for the three months and year ended December 31, 2022 and 2021, together with a reconciliation to GAAP net income or loss, its most directly comparable GAAP financial measure, has been presented in the table entitled Reconciliation of GAAP Loss to Non-GAAP Adjusted EBITDA.

Alimera is subject to variability of its reported U.S. dollar results due to changes in foreign currency exchange rates. Those changes have been volatile over the past several years. The adjustment of the effects of foreign currency exchange [in its international segment] as if foreign exchange rates had remained constant with the same periods of 2021, or what Alimera refers to as Adjusted net product revenue, is a non-GAAP measure. Alimera believes that this non-GAAP measure provides additional information that enables enhanced comparison to prior periods and additional insight into the underlying performance of its business outside of the U.S. Accordingly, Adjusted net product revenue for the three months and year ended December 31, 2022

and 2021, together with a reconciliation to GAAP net product revenue, its most directly comparable GAAP financial measure, has been presented in the table entitled Reconciliation of GAAP Net Product Revenue to Non-GAAP Adjusted Net Product Revenue.

These non-GAAP financial measures may not be comparable to similarly titled measures reported by other companies, including companies in Alimera's industry, because not all companies calculate Adjusted EBITDA or Adjusted net product revenue in an identical manner or may use other financial measures to evaluate their performance. Therefore, these non-GAAP financial measures may be limited in their usefulness for comparison between companies.

The presentation of these non-GAAP financial measures is not intended to be considered in isolation from or as a substitute for other financial performance measures prepared in accordance with GAAP and should be read only in conjunction with financial information presented on a GAAP basis. The principal limitation of these non-GAAP financial measures is that they exclude significant elements required by GAAP to be recorded in Alimera's financial statements. In addition, these non-GAAP financial measures are subject to inherent limitations because they reflect the exercise of judgments by management. Investors are encouraged to review not to rely on any single financial measure to evaluate Alimera's business.

Forward Looking Statements

This press release, and the conference call in which executives of Alimera will discuss this press release, include forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 regarding, among other things, Alimera's expectations with respect to potential acquisition and growth opportunities, the use of proceeds from its credit facility, the value recovered for common stockholders, the commencement, enrollment, timing and outcome of its clinical studies, demand for its product, its business strategy, future operations, future financial position including the timeline for achieving positive Adjusted EBITDA, future revenues, projected costs, prospects, plans and objectives . Words such as anticipate, believe, estimate, expect, intend, may, plan, contemplates, predict, project, target, likely, potential, continue, ongoing, will, would, should, could, or the negative of these terms and similar expressions or words, identify forward-looking statements. Forward-looking statements are based on current expectations and involve inherent risks and uncertainties (some of which are beyond Alimera's control), including factors that could delay, divert or change any of them, and could cause actual results to differ materially from those projected in these forward-looking statements. These risks and uncertainties include, but are not limited to, those factors discussed in the Risk Factors and Management's Discussion and Analysis of Financial Condition and Results of Operations sections of Alimera's most recently filed Quarterly Report on Form 10-Q, most recently filed Annual Report on Form 10-K, and any of Alimera's subsequent filings with the Securities and Exchange Commission (SEC) and available on the SEC's website at www.sec.gov.

All forward-looking statements contained in this press release and the accompanying conference call are expressly qualified by the cautionary statements contained or referred to herein. Alimera cautions investors not to rely on the forward-looking statements Alimera makes or that are made on its behalf as predictions of future events. These forward-looking statements speak only as of the date of this press release. Alimera undertakes no obligation to publicly update or revise any of the forward-looking statements made in this press release, whether as a result of new information, future events or otherwise, except as may be required under applicable securities laws.

For investor inquiries: For media inquiries:

Scott Gordon Jules Abraham

for Alimera Sciences for Alimera Sciences

scottg@coreir.com julesa@coreir.com

ALIMERA SCIENCES, INC.

CONSOLIDATED BALANCE SHEETS

ALIMERA SCIENCES, INC.

CONSOLIDATED STATEMENTS OF OPERATIONS

FOR THE THREE AND TWELVE MONTHS ENDED DECEMBER 31, 2022 AND 2021

(In thousands, except share and per share data)

RECONCILIATION OF GAAP MEASURES TO NON-GAAP ADJUSTED MEASURES

RECONCILIATION OF GAAP NET LOSS TO NON-GAAP ADJUSTED EBITDA

RECONCILIATION OF GAAP NET PRODUCT REVENUE TO NON-GAAP ADJUSTED NET PRODUCT REVENUE