Earnings call transcript: RxSight Q1 2025 sees revenue growth, stock dips

RxSight Inc. reported its Q1 2025 financial results, showing a 28% year-over-year increase in revenue to $37.9 million, despite a 6% sequential decline. The company revised its full-year revenue guidance downward, citing macroeconomic factors and competitive pressures. In premarket trading, RxSight’s stock fell 33.58% to $17.35. According to InvestingPro data, the company maintains strong financial health with a current ratio of 11.36, indicating robust liquidity. The stock has experienced significant volatility, with a 45% decline over the past six months.

Key Takeaways

• Revenue grew 28% year-over-year to $37.9 million.
• Full-year revenue guidance was reduced to $160-175 million.
• Premarket trading saw a 33.58% decrease in stock price.
• European regulatory approval achieved for key products.
• Premium IOL market facing macroeconomic challenges.

Company Performance

RxSight’s performance in Q1 2025 was marked by significant year-over-year growth, with revenue reaching $37.9 million. The company experienced a 6% sequential decline, partly due to a softening premium intraocular lens (IOL) market and broader economic challenges. InvestingPro analysis reveals the company holds more cash than debt on its balance sheet, with a minimal debt-to-equity ratio of 0.04. The company continues to innovate, with new product enhancements and a strong focus on expanding its European market presence.

Financial Highlights

• Revenue: $37.9 million, up 28% year-over-year, down 6% sequentially.
• Sold 73 Light Delivery Devices (LDDs), up 11% year-over-year.
• Sold 27,579 Light Adjustable Lenses (LALs), up 36% year-over-year.
• LDD installed base increased to 1,044 units, up 43% year-over-year.

Outlook & Guidance

RxSight revised its 2025 revenue guidance to $160-175 million, down from the previous $185-197 million. The company maintains its gross margin guidance at 71-73% and has reduced its operating expense guidance to $150-160 million. Despite current challenges, RxSight remains optimistic about long-term growth, particularly in the European market. InvestingPro’s Fair Value analysis suggests the stock is currently overvalued, though analyst price targets range from $22 to $56, indicating potential upside opportunity. Get detailed insights and 6 additional ProTips with an InvestingPro subscription.

Executive Commentary

CEO Ron Kurtz expressed confidence in the company’s ability to reshape the premium cataract surgery market, stating, "We believe RxSight’s adjustable technology will continue to reshape the premium cataract surgery market." CFO Shelly Tunin reassured investors about the company’s financial health, noting, "We have more than adequate cash to get to cash flow breakeven and profitability."

Risks and Challenges

• Macroeconomic pressures affecting consumer sentiment and market demand.
• Competitive product launches disrupting market dynamics.
• Potential delays in regulatory approvals in Asia.
• Market saturation in premium IOL segment.
• Volatile stock performance impacting investor confidence.

RxSight’s Q1 2025 earnings call highlighted both the company’s innovative strides and the challenges it faces in a competitive and economically pressured market. Despite a significant drop in stock price, the company’s leadership remains focused on long-term growth and market expansion. With a beta of 1.22 and strong financial health metrics, RxSight demonstrates resilience amid market volatility. Access comprehensive analysis and the full Pro Research Report for RXST, along with 1,400+ other stocks, through an InvestingPro subscription.

Full transcript - Rxsight Inc (RXST) Q1 2025:

Conference Operator: Thank you for standing by, and welcome to the RxSight Conference Call. All lines have been placed on mute to prevent any background noise. After the speakers’ remarks, there will be a question and answer Thank you. I would now like to turn the call over to Oliver Morasevich, VP of Investor Relations. Please go ahead.

Oliver Morasevich, VP of Investor Relations, RxSight: Thank you, operator. Presenting today are RxSight President and Chief Executive Officer, Doctor. Ron Kurtz and Chief Financial Officer, Shelly Tunin. Yesterday evening, RX site released preliminary revenue results for the three months ending 03/31/2025 and revised full year guidance. A copy of the press release is 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, 04/03/2025, 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. Our SEC filings can be found on our website or the SEC’s website. Investors are cautioned not to place undue reliance on forward looking statements, and we disclaim any obligation to update or revise these forward looking statements except as may be required by law.

During today’s call, we will also discuss certain non GAAP financial measures. I would also like to remind you that the preliminary results discussed on the call today are estimates and are complete unaudited financial results for the first quarter of twenty twenty five, which are subject to the review of our independent auditor, are expected to be announced on Wednesday, 05/07/2025. Please note that this conference call will be available for audio replay on our Investor Relations website. With that, I will turn the call over to our President and Chief Executive Officer, Doctor. Ron Kirk.

Ron?

Ron Kurtz, President and Chief Executive Officer, RxSight: Good morning and thank you for joining us. I want to first recognize the entire RxSight team as well as our partners in clinical practice for all of their efforts to provide high quality customized vision to patients undergoing cataract surgery. During today’s call, we will be offering additional color on the factors that affected Q1 revenue and have led us to revise our 2025 guidance. We will also outline additional actions we are taking to reinvigorate our growth trajectory. Our preliminary analysis indicates that the top line miss in Q1 was due to several factors, including a weakened premium IOL market and unusual sequential launches of new premium IOLs that have extended from mid-twenty twenty four and into Q1 of twenty twenty five.

These factors subsequently combined with abrupt changes in consumer sentiment that occurred later in Q1, resulting in our first year over year drop in same store LAL sales, most commonly measured as LALs per LDD per month. During most of 2024, this metric saw strong year over year increases, which along with new LDD placements resulted in high year over year procedural growth rates. Since nearly half of LAL procedures come from patients who would have otherwise received standard monofocal IOL, when volume from the LAL is excluded, the remaining premium IOL market would have likely seen declines beginning in mid-twenty twenty four. Due to the older demographic and medical necessity associated with cataracts, premium IOL surgery has historically been less sensitive to macroeconomic trends. This is in contrast to other patient pay procedures like LASIK that target younger individuals who can usually delay procedures indefinitely by continuing to wear their glasses or contact lenses.

However, a softening of the overall premium IOL market in the second half of twenty twenty four would be consistent with reports of a much more markedly depressed U. S. LASIK market during this period. While LALs per LDD per month also decelerated in Q4 twenty twenty four, they remain near their earlier highs, leading us to underappreciate the likely downward trend in the overall premium market. This phenomenon likely also led us to underestimate the impact from sequential market launches of new premium IOLs by two major competitors in Q3 and Q4 of twenty twenty four.

Historically presbyopia correcting IOL market share dynamics have been temporarily disrupted by incentives to surgeons trialing new newly launched lenses. While typically transitory, the sequential product cycles continued to be a market distraction in Q1, which when coupled with a soft overall premium market likely provided less reserve for additional disruptions. Although small sequential declines in LALs per LDD per month were observed from Q4 to Q1 in both 2023 and 2024, we saw a much more pronounced decline from Q4 twenty twenty four to Q1 of twenty twenty five. While procedure volumes were consistent with our recent history in early and mid Q1, lower procedure volumes extended through the month of March when they have historically ramped up. Given the widely reported and rapid changes in the macro environment, including significant declines in the S and P and NASDAQ during the latter part of the quarter, we believe that negative wealth effects may have impacted premium IOL procedure decision making, leading to potential trade downs to lower priced or nonpremium alternatives.

Though we believe these factors are also likely transitory, when coupled with a third sequential product cycle from our largest competitor, they justify a swift and strong response on our part. This starts with leveraging our dedicated commercial and clinical teams to execute refined clinical education and practice adoption programs for both existing and new customers, focusing on those that have experienced procedural declines or slower growth in the first quarter of twenty twenty five. We have also accumulated extensive clinical experience with both the LAL and LAL plus that we believe will help doctors better counsel patients on the durable benefits of high quality customized vision that is uniquely enabled by RxSight’s adjustable IOL platform. As an example, our recently completed post approval study demonstrated that compared to eyes receiving a monofocal IOL, eyes with an LAL were 14 times more likely to have what is considered to be an outstanding refractive outcome. Further, our continued rollout of product enhancements provides our teams additional opportunities for meaningful interactions with our doctors and clinical practices to convey their important clinical and efficiency benefits.

In addition to these efforts with our traditional customers, we also intend to strongly support the acceleration in new customer business models, including those that offer doctors and patients centralized third party light treatment options that may further lower the threshold to adopt our technology. Though our focus remains on expanding adoption within The U. S. Market, we are also pleased to report European regulatory approval for our LDD and LAL. While we are excited about the long term commercial opportunity in The EU, our priority in 2025 will be to build a base of European clinical expertise and practice experience, while we also push ahead with approval of LAL plus We are simultaneously pursuing our regulatory approvals in Asia, while gaining early clinical experience in Japan, Hong Kong and South Korea.

While we remain highly confident in our long term opportunity to reshape the premium eyewall market, we also acknowledge the need to reset our 2025 guidance due to the time that may be required for these efforts to have meaningful impact and for the headwinds discussed earlier to subside. For more on these changes, I’ll now turn the call over to Shelley.

Shelly Tunin, Chief Financial Officer, RxSight: Thank you, Ron. I will briefly review the preliminary first quarter revenue results and updated guidance for the remainder of 2025 that were included in our preannouncement press release. Consistent with the press release, our preliminary first quarter twenty twenty five revenue was $37,900,000 up 28% compared to the year ago quarter, and down sequentially 6% from our fourth quarter twenty twenty four revenue. During the first quarter, we sold 73 LDDs, up 11% from the year ago period, and down 12% from the fourth quarter of twenty twenty four. We ended the first quarter with an LDD installed base of ten forty four units, up 43% compared to the end of the first quarter of twenty twenty four, and 8% compared to the end of the fourth quarter of twenty twenty four.

We also sold 27,579 LALs in the period, up 36% from the first quarter of twenty twenty four and sequentially down 5% from the seasonally stronger fourth quarter of twenty twenty four. While we will provide a full financial report on May 7, based on the preliminary revenue results, and informed by the multiple dynamics just discussed by Ron, we are revising the guidance we provided in January as follows: We are reducing revenue guidance from $185,000,000 to 197,000,000 to $160,000,000 to $175,000,000 thereby reducing implied growth compared to 2024 from the previous 32% to 41% range, to 14% to 25%. We continue to believe that we will sell more LDDs in 2025 than in 2024, with economic headwinds likely having a greater impact on procedures that are more directly tied to consumer decision making. In contrast, as demonstrated by the relatively stable LDD sales in Q1, doctors and practices continue to invest in private pay procedures that deliver better outcomes for their patients and counteract ongoing reimbursement cuts and drops in more economically impacted private pay procedures such as LASIK. Our gross margin guidance is unchanged at 71% to 73%, representing an implied increase of 30 basis points to 130 basis points compared to 2024.

We also remain committed to aligning operating expenses with the pace of revenue growth, with a significant reduction in operating expense from the previous guidance of $165,000,000 to $170,000,000 to $150,000,000 to $160,000,000 representing a change in the implied increase compared to 2024 from 22% to 25% to 10% to 18%. Our revised operating guidance of $150,000,000 to $160,000,000 is higher as a percentage of revenue and gross margin than our previous guidance in January, taking into account the anticipated increase in one on one interactions with customers. Included in our costs, primarily in operating expense, is non cash stock based compensation expense, which we now project to increase from the previous $22,000,000 to $25,000,000 to $27,000,000 to $30,000,000 This revision reflects higher than anticipated option grants issued in March 2025 to existing employees for performance, adjustment to market comps, and retention compared to our original guidance provided in early January twenty twenty five. And with that, I’ll turn the call back to Ron.

Ron Kurtz, President and Chief Executive Officer, RxSight: Thank you, Shelly. With customer satisfaction at an all time high of 97%, we believe that RxSight’s adjustable technology will continue to reshape the premium cataract surgery market by offering the only IOL that allows patients to customize their vision after surgery. By delivering exceptional clinical outcomes in one of the most important markets in ophthalmology, we believe RxSight remains central to the growth story for both practices and the overall IOL industry. While our large customer base now exposes us more to market wide dynamics, we believe it also provides us with the opportunity to leverage our platforms for sustained growth through targeted educational efforts and innovative product enhancements. In addition, we believe new clinical delivery channels offer alternative opportunities for growth in The U.

S, while we continue to make progress towards commercialization in key markets outside of North America. And with that, I’ll ask our operator to open the call for questions.

Conference Operator: Thank you. We will now begin the question and answer session. If you are called upon to ask a question and are listening via loudspeaker on your device, Your first question comes from the line of Ryan Zimmerman with BTIG. Please go ahead. Your line is open.

Ryan Zimmerman, Analyst, BTIG: Okay, and thanks for taking our questions.

Ron Kurtz, President and Chief Executive Officer, RxSight: Good morning, Ryan.

Ryan Zimmerman, Analyst, BTIG: Morning. So, let’s start with the guidance, if we could. I appreciate your comments, Shelley, on guidance, but if we could talk a little bit about kind of the subcomponents or the underlying assumptions on guidance, particularly as it relates to productivity, expect LDDs to grow, but maybe you could elaborate a little bit further on kind of how you’re thinking about productivity of LALs per LDD going forward, given the dynamics you laid out.

Shelly Tunin, Chief Financial Officer, RxSight: Yes. Thank you very much, Ray. I think the, biggest driver, obviously, other than Q1 performance to our guidance is the fact that the typical significant increase that we see in March in terms of number of LAL procedures since we’ve been commercial did not happen, and it was relatively flat to January and February. I think our guidance really reflects the change in the number of LALs we expect to sell, offset in part by strong LDDs that we expect to be higher than 2024. In terms of the number of LALs for LDD, we certainly model those increase over the year.

Typically, you see is sequential growth up in Q2, down in Q3, up in Q4. I’m a little reluctant to say that the typical seasonality will be in place this year until we get through the second quarter and just see what the economic impacts are to the economy and how customers are selling to their clients and what we hear back from our ophthalmic customers about the responses of patients to a premium IOL procedure versus sticking with a monofocal.

Ryan Zimmerman, Analyst, BTIG: Shelley, just to be clear, the math would suggest declines on productivity through the year. And I just want to be clear, is that your assumption given the increase in LDD?

Shelly Tunin, Chief Financial Officer, RxSight: I think that other than absent perhaps the fourth quarter, that’s going to be true on a much larger LDD base relative to the number of LALs, but I’m not exactly predicting that. I think second quarter is probably the biggest risk quarter until we understand what is happening with the economy and how it’s affecting our customers and whether, in fact, that’s prolonged.

Ryan Zimmerman, Analyst, BTIG: Okay. Then the second question is just and this is arguably an impossible question, but I’m going to ask it anyway, Ron, which is, as you think about the components of what led to the miss, kind of broke down some of it, meaning there was a weakened premium IOL market, there was new product launches. You also alluded to just broader macroeconomic dynamics. And in the press release, I think some of your customers are newer and maybe taking longer to ramp. And so I don’t know if you can parse this out, Ron, but there’s a lot of things kind of thrown in there.

And I don’t if you can prioritize kind of where you think the biggest drivers are in terms of the impact, what’s transient, what’s not transient or maybe out of your control such as the macroeconomic conditions. I think that would be helpful for everyone to understand.

Ron Kurtz, President and Chief Executive Officer, RxSight: Yeah, I would say that as you described, there’s been a confluence of factors that happened in Q1, particularly in the latter part of Q1. And I think that all of them are transitory to some extent. Those product launches are something that are planned years in advance. It’s unusual to have two, let alone three sequential launches in relatively short space. And while we’re not directly affected by those, they do, cause a distraction in marketplace, as doctors are incentivized to trial new lenses.

I think the obvious thing that changed, in Q1 was the macro environment. And that’s a more complicated question. I certainly am hopeful that that will also, improve. But as we’ve seen from the events even from last yesterday, there’s going to be some additional changes.

: Thank you.

Conference Operator: Your next question comes from the line of Yong Lee with Jefferies. Please go ahead, your line is open.

Yong Lee, Analyst, Jefferies: Thanks for taking our questions. The first one, I’m wondering regarding utilization by cohort, when we do some checks, obviously some surgeons can do a lot more than average. Wanted to get a better understanding, if you look at the cohorts from earlier years 2122, how does their utilization rate compare versus the average? You know, where do you see sort of like a natural ceiling or pain point before some of the practice management things you’re gonna put into place can help them further become more efficient?

Shelly Tunin, Chief Financial Officer, RxSight: Thank you for the question, Young. We have always spoken about the fact that the cohorts of installed LDDs in 2021 and prior 2022 and ’23 have been relatively the same, and they kind of move in concert. We saw that again in the first quarter. So where the number of LALs per LDD went down, it went down in all cohorts, They’re very tight in their distribution, and that continued to be true. Also, as we look across our territories in The US, the change and the effect in March were consistent, throughout The US.

The 24 class cohort of LDDs installed, it’s probably only relevant to look at those installed in the first and second quarter. What we did see is that they’re not growing quite as quickly as the 23 class did during comparable quarters, particularly in the first quarter. It doesn’t have an outsized or even a major effect on the number of LALs per LDD because our installed base is so large. It is something that is a pain point, although small in terms of the total number, but we would like to see them be more confident, particularly in this economic environment.

Yong Lee, Analyst, Jefferies: Okay, got it. Very helpful. I guess the follow-up is regarding, driving innovation and product enhancement. You know, now that we have a better understanding about where Alcon’s program’s at, know, Bausch and Lomb also has announced a program, but they also had to deal with a recall. You know, it seems like, at least on the competitive front, there’s a little bit more visibility.

Can you maybe talk a little bit more about the product pipeline or new lenses coming out and what we should expect on that front?

Ron Kurtz, President and Chief Executive Officer, RxSight: Yeah, thanks for the question, Young. We would agree with you and I think we’ve been pretty consistent that we don’t see anything on the horizon that is directly competitive to the LAL. And we also believe that continued innovation has been an important driver for growing adoption over the past five years that we’ve been commercial. These have primarily been incremental enhancements that really allow us to get that next group of doctors and patients to adopt the technology. Examples of that have been ActiveShield, LAL plus In the fall we introduced low diopter LALs which are now beginning to be used in the field.

And soon we’re going to be launching our first foray into the correction of higher order aberrations and I mentioned that on our last earnings call. So I would expect continued such product enhancements to be steadily introduced. And this enables our customers to leverage not only their investment in the capital equipment, but also the investment in their time and that of their employees learning the clinical skills associated with our technology. And then they can then apply that to more and more of their patient population.

Yong Lee, Analyst, Jefferies: Thank you very much.

Conference Operator: Your next question comes from the line of Robbie Marcus with JPMorgan. Please go ahead. Your line is open.

Robbie Marcus, Analyst, JPMorgan: Great. Good morning. Wanted to try and take Ryan’s question a different way. Shelly or Ron, you raised guidance in the second quarter of twenty twenty four. And then you were in line on third quarter and you were in line on fourth quarter.

And it’s the two first in line quarters you had, I believe since being public and really not, I would imagine, how you thought the second half of the year would turn out. And if you look at street models, it was on better LDD placements and missed both quarters LAL utilization. So from our point of view, we started seeing LAL utilization slowdown in the back half of the year. Then when you provided guidance for 2025, you actually guided a pretty good amount above the street. So clearly, you were seeing something that we weren’t.

And even just as late as last week, competitor Alcon had an Analyst Day and they didn’t bring up any of the same market concerns that you had. So I guess the question is really, now with a lot of hindsight, did this start much earlier than you’ve acknowledged? And is it really a market trend, even though we’re not necessarily hearing all of those market trends called out by your peers? And we’ve all known and been publishing on those competitive launches for months now? Or is it just a utilization issue specifically to LALs?

And how do you discern between the two? Thanks.

Ron Kurtz, President and Chief Executive Officer, RxSight: Maybe I’ll start, Ravi. So, you know, I think while our LAL procedural growth didn’t meet some of the expectations that were out there, the LALs per LDD metric continued to be high through the year. And given our growth in installed base, that drove continued growth overall. And so I think that and we in fact, if you look at the overall market and take out LAL growth, the overall market was not growing and was negative. And that was commented at the time, as I recall.

And that probably, was under, because of our growth, led

Yong Lee, Analyst, Jefferies: us

Ron Kurtz, President and Chief Executive Officer, RxSight: to under appreciate the softening in the market as well as the impact of these, you know, competitive trialing incentives that, others had also mentioned. So I think that led to a, you know, perhaps underestimate of those impacts. And again, laid a foundation which when coupled with, you know, very significant disruption in consumer sentiment, you know, led to the effects in Q1.

Shelly Tunin, Chief Financial Officer, RxSight: Yeah, and to address your comment more specifically about the third and fourth quarters, you are correct. We beat and raised in the first half, both in the first quarter and the second quarter, and raised guidance both times, and then of course over exceeded in the second quarter. We raised guidance for the second half, and we met that increased guidance, but we did not exceed it in the second half. And so I do think that Q3 definitely was affected by more vacations as we discussed. Q4, I think that it was strong, but certainly not as strong as the street expected.

It was consistent with our raised guidance, but we weren’t able to rise above that. And as Ron said, I think that we were less aware of market dynamics, and, you know, the rest of the market was shrinking, and and certainly, we recall our competitors talking about that as well. But it was really masked by our own performance. And so I think as we, you know, went through the second half, we didn’t recognize the overall market dynamics and, and the shrinkage in the second half. As you know, since 2022 or so, the market has remained roughly at 18 to 19% of total IOL procedures, and that really was because of us.

I think that we looked into 2020 with the ’25 with the same confidence that we had in 2024, up until the point that March LALs did not increase substantially as they typically do in that first quarter period.

Robbie Marcus, Analyst, JPMorgan: Thanks. Maybe a follow-up. Shelly, you raised you lowered the guide on sales ballpark $30 ish million for 2025 and OpEx about $10,000,000 There’s still a big let’s just say, current rates, there’s really no crossover into free cash flow generation, at least not for a very long time, assuming trends change or hold. How are you thinking about timelines on cash flow breakeven, your cash needs and any possibility for a need for a raise? Thanks.

Shelly Tunin, Chief Financial Officer, RxSight: Okay. Yeah. Thank you very much. And I think that that’s a, astute point you brought up. We’re bringing down kind of in the mid of the range guidance by $23,000,000 and OpEx down by 10,000,000 So in our previous guidance, we were putting more money down to the bottom line, each and every quarter except the first quarter typically, which is a heavier cash use quarter due to payment of prior year bonuses.

In this guidance, we are assuming that we need to put, relative to our revenue, more resources into sales and marketing in particular. I think we need to be very active with our customers, which we have about 200 people that are customer facing. We’ll continue to add to those as we add customers, so I’m not expecting that we’re dropping that gross margin increase to the bottom line in the OpEx guide as well. However, as you know, we have more than adequate cash to get to cash flow breakeven and profitability, but it does impact the timing of when we may meet cash flow breakeven as well as GAAP breakeven because, of course, we’ll continue to have investments in inventory and accounts receivable as we grow. That is deliberate on our part in terms of guidance.

We want to make sure that during this period of time, we don’t under resource, and we continue to stay close to our customers. Do you add anything to that, Ron?

Conference Operator: No. Your next question comes from the line of Steve Lichtman with Oppenheimer. Please go ahead. Your line is open.

Steve Lichtman, Analyst, Oppenheimer: Thank you. Good morning. Just to follow-up on that last point in terms of where the spend is going to be focused. During the prepared remarks, Ron, you also highlighted strongly supporting acceleration of new customer business models. Can you sort of can you double click on that a little bit, talk about what your efforts are going to be there?

Because I guess to the extent you can further streamline those efforts that could have an impact on the end customer price and therefore potentially offset some of the macro headwinds. So maybe you could talk a little bit more about what you’re doing what you’re going to be doing specifically on those centralized business models.

Ron Kurtz, President and Chief Executive Officer, RxSight: Yeah, again, these are third party innovators who are seeing the opportunity with the LAL technology to make it potentially more approachable for some ophthalmic practices across the country. And that’s been going on actually for a number of years. And we’ve seen several individually successful efforts in this. Our role in that is similarly supportive to what we do with our traditional practices, providing both marketing and training and clinical support, not only to the standalone light treatment center, but also to the individual doctors who make use of that. And providing them with, you know, both the clinical and marketing materials and education that helps them offer the LAL to more of their patients.

So I think that it’ll be an expansion of those activities, very similar but directed in a slightly different way than what we have traditionally done.

Steve Lichtman, Analyst, Oppenheimer: Okay, got it. Just wondering on the recent recall announcement from one of your competitors. How are you thinking about that in terms of potential upside to your revised guidance or are you not factoring that in at this point? How are you thinking I know it’s fresh, but how are you thinking about that?

Ron Kurtz, President and Chief Executive Officer, RxSight: Yeah, I would agree with you Steve that there’s no way for us to know what the duration of that would be. I think it’s largely, you know, not, going to be as impactful on us as it would be for, some of the other competitors. But certainly anything that gives us an opportunity to let surgeons and patients see the benefits of the LAL approach to high quality customized vision, that’s an opportunity that we’re going to take.

Steve Lichtman, Analyst, Oppenheimer: Just quickly, obviously not the focus of this call, but you did mention the CE Mark. I assume no revenues built in for this year at this point. But which countries are you going to be focusing on as you sort of build toward that for, I guess, 2026?

Ron Kurtz, President and Chief Executive Officer, RxSight: So as we’ve talked about in the past in Europe, we’ll focus on the major economies in Europe that already have strong premium IOL markets, similar to the approach that we’ve taken in Asia. And so those are gonna be, you know, the major markets that everyone’s familiar with. And, you know, while we don’t see, you know, significant revenue in 2025, you know, we will start to, grow our presence there. It takes time, and in Europe, you know, it takes, you know, it takes some things, sometimes a new product introductions take a little bit more time. So we certainly don’t wanna we’re not going be going slow.

Steve Lichtman, Analyst, Oppenheimer: Great, got it. Thanks Ron.

Conference Operator: Next question comes from the line of David Saxon with Needham and Company. Please go ahead, your line is

Yong Lee, Analyst, Jefferies: open.

: Yes, thanks. Good morning, Ron and Shelly. Thanks for taking my questions. So I wanted to maybe first ask on LDD. So on the market, if the premium IOL market volumes are softer, are you assuming in guidance that that translates into softer LDD demand or longer sales cycles?

Or kind of how does that market view inform how you think about LDD placements and kind of customers or prospective customers’ appetite

Shelly Tunin, Chief Financial Officer, RxSight: Yes, thank you. That’s a good question. We did again say that we would expect more LDD sales in 2025 than we had in 2024, but the overall guidance does assume in our internal numbers that that number is a bit lower. That would certainly be consistent with our guidance. As Ron had said earlier, practices still are struggling with profitability because of Medicare cuts, other reimbursements across other product lines.

As far as we know, premium IOLs are the only product where they can bill Medicare for the minor amount that they provide as well as a direct cost to the consumer. It’s a profitable procedure for them, and during these periods of time, LASIK drops precipitously. That just goes with the economy because that certainly can be put off, and it’s a younger population. The population of roughly 65 year olds, of course, remain a bit more isolated. But certainly turmoil, and particularly in their assets such as stocks, can result in some delay or different choices temporarily.

We do think that this is temporary, though.

: Okay. Great. And then, Shelley, you mentioned profitability, and obviously that’s a focus for docs and practices. So I guess how are you thinking about pricing at this point? You’ve held pricing on the LAL side at least.

So does this change how you think about pricing? And then in the I forgot if it was in the script or to a question, but you talked about how the 2024 class utilization was slower than prior cohorts, at least in the first half of ’20 ’20 ’4. So what does that mean in terms of like the cohorts you’ve penetrated so far? Have you kind of fully penetrated the higher volume group or segment of ophthalmologists? And now are we kind of in the average to lower volume practices?

Thanks so much.

Ron Kurtz, President and Chief Executive Officer, RxSight: Maybe I’ll start. So with respect to the last question, I don’t think that we’ve fully penetrated any group. There are, a wide variety of practices that have not yet adopted our technology. You know, we have about 1,000 LDDs, there are about 2,000 surgeons. There are 10,000 cataract surgeons out there with, you know, at least several to more thousands of offices where cataract surgery patients are seen.

So I certainly don’t believe that we’re, anywhere near a saturation point and even by class of surgeon. And then the, sorry, the second, the first question was Yeah,

: around pricing. I mean, LALs are kind of the highest. Yeah. So, you know, how are you thinking about that in terms of like, you know, trying to allow doctors to kind of protect some level of profits while the market volumes are kind of weaker? Thanks so much.

Ron Kurtz, President and Chief Executive Officer, RxSight: Yeah, so, in terms of pricing, you know, the cost of the LAL is a relatively small fraction of the price that doctors charge to their patients. So we believe that the value provided by the technology justifies its cost, which is somewhat higher than the highest level presbyopia correcting IOLs. We have kept pricing stable since our introduction into the market about five years ago. And part of the ways that we’ve been able to do that is through efficiencies. And we fully manufacture all the components of the technology in The U.

S, specifically here in California. And so we’re not going to be significantly impacted by tariffs. And I think that we’ll try to maintain a good relationship between the value and the price that we charge to our customers.

: Great, thank you.

Conference Operator: Your last question comes from the line of Daniel Antalffy with UBS. Please go ahead. Your line is open.

David Saxon, Analyst, Needham and Company: Hey, good morning, guys. Thanks so much for taking the question. My question is really just pretty straightforward, I think. I mean, I I guess I am just a little concerned about whether or what gives you confidence that, you know, this hasn’t been the last few years. You guys just got the low hanging fruit here, and you’ve now sort of penetrated what you are gonna penetrate of the premium market.

So I appreciate all the commentary on the the economy, macroeconomic environment affecting the premium market, but more if we’re just looking at LAL penetration within the premium market. Ron, maybe you can talk about what gives you confidence that that’s not what’s happening here. Thanks so much.

Ron Kurtz, President and Chief Executive Officer, RxSight: Well, would say two things give me confidence. One is just my interactions with doctors and practices throughout the country. And the vast number of practices that not only haven’t adopted our technology but don’t know too much about our technology. It’s very clear that we’re still at a relatively early phase of the market penetration for this technology. And I would just point out that, you know, it would be a really amazing coincidence if we peaked out in the adoption curve exactly when there has been a confluence of macroeconomic and market trends over a short period of time.

You know, I just don’t believe in those kinds of coincidences. So, you know, I’m confident that these are going to, that, you know, these things will pass and that will continue to penetrate the market, which is, you know, the largest opportunity certainly in anterior segment ophthalmology.

David Saxon, Analyst, Needham and Company: Okay. Thanks for that.

Conference Operator: There are no further questions at this time. I would now like to turn the call back over to Ron Kurtz, CEO, for closing remarks. Please go ahead.

Ron Kurtz, President and Chief Executive Officer, RxSight: Thank you, operator. And thank you all again for your interest in RxSight. We look forward to seeing some of you later this month in Los Angeles at the meeting of the American Society for Cataract and Refractive Surgery, as well as providing further updates at our regularly scheduled first quarter twenty twenty five conference call in early May. Goodbye.

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