RxSight, Inc. (RXST) Earnings Call Transcript & Summary

Hello, and thank you for standing by. My name is John, and I will be your conference operator today. At this time, I would like to welcome everyone to the RxSight preliminary second quarter financial results and product pipeline updates following collaboration agreement. [Operator Instructions] I would now like to turn the conference over to Oliver Moravcevic, VP of Investor Relations. Please go ahead.

Thank you, operator. With me on the call this morning is RxSight President and Chief Executive Officer, Dr. Ron Kurtz, and Chief Financial Officer, Mark Wilterding. Yesterday, RxSight released a pair of press releases, one reporting a new collaboration agreement with Alcon and the second reporting preliminary revenue results for the 3 months ending June 30, 2026, updated product pipeline and revised full guidance, copies of both press releases and corresponding 8-Ks are available on the company's website. . Before we begin, I would like to inform you that comments and responses to questions during today's call reflect management's views as of today, July 7, 2026 and will include forward-looking and opinion statements, including predictions, estimates, plans, expectations and other information. Actual results may differ materially from those expressed or implied as a result of certain risks and uncertainties. These risks and uncertainties are more fully described in our press release issued yesterday and in our filings with the Securities and Exchange Commission, or SEC. Investors are cautioned not to place undue reliance on forward-looking statements and will disclaim any obligation to update or revise these forward-looking statements, except as may be required by law. During today's call, we will discuss certain non-GAAP financial measures. I would also like to remind you that the preliminary results discussed on our call today are estimates and did our complete unaudited financial results for the second quarter of 2026, which are subject to the review of our independent auditor, are expected to be announced on Wednesday, August 5, 2026. Please note that this conference call will be available for audio replay on our Investor Relations website. With that, I'll turn the call over to Ron.

Good morning, and thank you for joining us. Over the last several years, the RxSight team has been developing proprietary hybrid IOL materials for next-generation light adjustable technology that can support a full suite of adjustable lenses across all premium categories, designed to enable expanded patient choice and customization along with the reduction in required postoperative treatments, these developments are being pursued both via our stand-alone product pipeline and through our collaboration with Alcon. Rx Sight's next-generation adjustable IOLs will build upon the quality of vision that has been a key attraction for LAL patients for many years. Our partnership with Alcon aims to leverage each company's expertise to develop adjustable presbyopia-correcting IOLs. That, for the first time, will enable doctors to refine visual outcomes noninvasively after surgery for patients who choose a PCIOL. Taken together, these technology-driven strategic initiatives solidify RxSight's position as the leader in postoperative adjustability, create a platform for high-margin future growth and accelerate expansion across a wider base of patients. While we believe these strategic developments will be key multiyear growth drivers for RxSight, last night's announcement also detailed the near-term challenges we experienced in the second quarter after several quarters of relatively stable utilization trends. Although we do not yet have Q2 data from other premium IOLs, we believe this retrenchment is linked to widespread competitive trialing activity associated with new product launches. While the LAL value proposition remains highly differentiated, these trial programs provide a significant short-term incentive to an already strained practice environment. While the effects of competitive trialing tend to wane as doctors determine the true value of a new offering based on their own clinical experience, we expect the heightened competitive environment to remain active through the end of the year. We also note that consumer sentiment remained under pressure, which we believe could have contributed to more deliberate patient decision-making and softer overall procedure activity. While cataract surgery typically cannot be deferred indefinitely, unusual declines in overall cataract volumes were observed in Q1 with patient confidence and the broader economic backdrop being 2 potential factors. We believe we can overcome these challenges by accelerating customer reengagement efforts that have shown success in targeted rollouts, and we are excited to be making additional investments in our U.S. LAL sales force to expand our depth of penetration within accounts. Coupled with our technology's unparalleled clinical outcomes, we remain confident in our team's ability to navigate these headwinds successfully. I'll now turn it over to Mark to provide select financial metrics related to our second quarter performance and updated thoughts on our full year 2026 outlook.

Thank you, Ron. As outlined in our pre-announcement press release last night, second quarter total company revenue is expected to be approximately $32 million to $34 million, including $5 million to $7 million related to the RxSight, Alcon strategic collaboration agreement. The final amount of revenue from the agreement that will be -- that we will recognize in Q2 remains subject to the completion of our quarter end close procedures and accounting assessment. We expect these actions to be finalized prior to reporting second quarter results in August. Preliminary total company sales, excluding revenue related to the agreement were approximately $27 million in Q2, down 20% versus the year ago period. During the quarter, we sold 24,917 LAL units, down 10% year-over-year, reflecting the headwinds that Ron outlined earlier. The company sold 11 LDDs and placed on LDD rental unit, growing our installed base to 1,166 units. Based on revenue implications from the collaboration agreement and preliminary second quarter sales, we are revising our full year 2026 outlook. We now anticipate 2026 full year revenue of $140 million to $160 million. This range reflects RxSight sales of $110 million to $120 million and revenue recognized from the RxSight, Alcon strategic collaboration of $30 million to $40 million. Our RxSight sales guidance assumes the continuation of headwinds experienced in the second quarter. Collaboration agreement revenue is subject to the terms and conditions described in the 8-K we filed with the SEC last night. Based on the favorable mix of LALs versus LDDs sold in the second quarter and our belief that this trend will persist for the remainder of 2026. We now expect full year gross margin in the range of 73% to 75% versus previous guidance of 70% to 72%. Despite the accelerating investments in our LAL sales force that Ron mentioned earlier and significant expenses related to the recently announced collaboration agreement, we continue to anticipate operating expenses at the high end of the $150 million to $160 million, in line with previous guidance. We ended the quarter with cash, cash equivalents and short-term investments of approximately $209 million. And with that, I'll turn the call back to Ron.

Thank you, Mark. Before taking questions, I want to thank my RxSight colleagues and our many partners in clinical practice who are improving cataract surgery outcomes every day by empowering patients to optimize and personalize their vision after surgery. Today's announcements highlight 2 ways we are continuing to advance that mission. In the near term, by redoubling our commercial and clinical reengagement efforts, so more patients can achieve the high-quality, precise customized clinical outcomes that have now been documented in multiple real-world and clinical study settings using current generation LAL technology. In the intermediate to longer term by continuing to innovate adjustability, which has been a long-standing focus for our team. In addition to next-generation LAL and LAL+, we are also working on LAL Toric, a new lens designed to combine built-in toric correction with postoperative refinement of residual sphere and cylinder. Each of these IOLs is designed to maintain the highest levels of visual quality and adjustability while also providing for improved workflow and fewer required postoperative treatments. Our collaboration with Alvin opens up a new path for innovation in the PCIOL space, offering doctors and patients a higher level of precision and confidence. While there are both near-term and long-term financial benefits associated with the agreement, we believe this collaboration also represents additional validation of our technology platform and intellectual property as well as the broader opportunity for adjustability in cataract surgery. Taken together, these development initiatives demonstrate our continued commitment to doctors and practices. By developing a family of adjustable premium IOLs that can be tailored to the needs of patients, our customers can leverage both the knowledge investments that they have made to become experts in postoperative adjustability as well as their capital investments in the light delivery device or LDD. RxSight entered the cataract market with a fundamentally different approach and a truly novel technology in a relatively short period of time, we established the clinical value of adjustability and a strong presence in the premium cataract market. Building on that base, these next-generation developments and adjustability represent significant opportunities for further growth. And with that, I'll ask our operator to open the call for questions.

[Operator Instructions] Our first question comes from the line of Larry Biegelsen with Wells Fargo.

Could you hear me okay, Ron?

Yes.

Great. I wanted to ask just 2 on the technology, the new technology, one on Alcon and one on the internal products you talked about. So starting with Alcon, it sounds like you're basically marrying your light adjustable technology to their trifocal and EDOF lenses. So my question is what are the technology challenges with that? In other words, what needs to be done to accomplish that? And what will the benefits be? What do you see the benefits being? And any color on the time lines? And I had one follow-up.

So let's start with the benefits. The reason why we both feel that this is a good idea. I think if you look at reasons for why outcomes or patients may be dissatisfied after PCIOLs at the top of the list is residual refractive error. So the ability to optimize visual acuity after surgery with a noninvasive light treatment, we believe will be a significant add to PCIOL technology. In terms of the time frame, we haven't laid that out other than to say that we believe it's within our planning period, which is typically in that 5-year period. I there are a number of technical and regulatory efforts that will be part of this collaboration. Those -- obviously, we've done some prework to get us to this stage, and we feel good about our ability to deliver on the promise of this collaborative effort.

That's helpful. And then, Ron, your internal products that you talked about, what's the time line for the next-generation LALs? And what does improve workflow and fewer required post-op treatment mean specifically, like how much do you think you can reduce the post-op treatments?

So what we've -- the way we've positioned this is that we would expect these developments to occur in the mid-range of our planning period. So that's -- that will continue to refine that over time. And there will be individual time lines, obviously associated with each of the efforts. In -- and I'm sorry, your second question was...

Well, how much -- what has improved workflow and fewer required postoperative treatment means? How much could you reduce the post-op treatments?

So if we look at the number of treatments that are currently used. On average, there's about 1.5 to a little bit more adjustments and on average, about 2 walk-in treatments. By -- we believe that by providing the potential for a single lock-in we obviously would have a significant reduction in required treatments. In addition, the times that we require more adjustments often are associated with higher levels of the stigmatism. And so being able to provide some built-in astigmatism potentially also reduces that. So we think there can be a very significant reduction in the number of required treatments.

Our next question comes from the line of Ryan Zimmerman with BTIG.

I want to follow-up a couple on Larry's question just on the technology. But when you think about the lens and the collaboration with Alcon, RxSight went through a PMA. There was clinical trials associated. Do you anticipate needing that with their current batch of lenses in order to bring a technology to market that would combine both years and their technologies?

We haven't commented on the specific regulatory path that we'll be taking. Obviously, we'll be collaborating with Alcon on that. And again, we think that there's a good history of both technologies. And obviously, we would plan to leverage that strong background as well.

Okay. The other question, Ron, is -- and again, maybe putting the cart before the horse here, but pricing in the PCIOL space. I mean if we think about the price points right now to physicians of PanOptix and I think about the price point of the LAL today, they're at the upper bound of kind of where PCIOLs can go. If you marry those 2 technologies, I would imagine that you would maybe bring the ceiling, if you will, on pricing. And so I'm just curious kind of your thoughts on if that's feasible, what combined technology would be from a value standpoint and how you think about preliminary pricing relative to kind of the price point in the PCIOL market today?

Well, obviously, those are great questions. I think they are questions for the future and primarily for Alcon. But the -- I'll concentrate on what the value proposition would be, which will be that the we would be presenting to patients top-of-the-line optical designs with the ability to refine refractive error postoperatively, noninvasively. That's really a level of confidence that doesn't exist today. what is the value of that to both doctors and patients. I think that's something that the market will determine. But it's usually listed as the topic for PCIOLs is residual refractive error.

Our next question comes from the line of Stephanie Algazi with Bank of America.

Just wanted to ask on how you decided that a strategic collaboration agreement with the best approach versus other strategic options like selling and maybe just how you think about the partnership opening the door for additional collaboration with Alcon or potential acquisition.

Well, we think that this is a great way for us to build value in RxSight right now, leveraging not only our technology for our own pipeline, but also leveraging it for an area that we don't currently participate in, namely the PCIOL space. And doing that with a market leader and without doing it well, we're able to continue to have a very positive balance sheet. So these are all, I think, positive for the collaboration. Obviously, we need to execute on all these efforts and with the collaboration with Alcon but we feel confident in our ability to do that and also in building our core LAL business as well.

Got it. And then, just wanted to follow up on the preliminary Q2 results. I think you had expected sublevel of competitive trialing. So what are you seeing from the trialing that made the headwinds maybe worse than expected? And then just what's factored into the guide overall from the competitive trialing and some of the other factors you mentioned like consumer sentiment?

Well, I'll start maybe at a higher level and then Mark, feel free to comment. But the -- I think that there has been a level of competitive trialing programs that we may not have fully anticipated. Some of that may be linked to the fact that now we have a second large company that has offerings in both the trifocal and EDOF space, and that can raise overall competition in the space, and we expect that to continue for the rest of the year. At the end of the day, the differentiating factor of the LAL is that we can fine-tune the vision to optimize binocular vision in patients in a way that just is not possible with these other technologies. And we think that in the end, that is going to be a significant differentiator and key to our success. And Stephanie, with respect to guidance for the remainder of the year, Ron alluded to it just now, but I think our expectation is for that competitive environment to remain active through the end of the year. And so that's what we factored into the guidance that we provided today.