RxSight, Inc. (RXST) Q1 2026 Earnings Call Transcript
Access earnings results, analyst expectations, report, slides, earnings call, and transcript.
Overview
The earnings call summary and Q&A reflect strong financial performance, positive product development updates, and strategic market expansion. Despite some uncertainties and lack of specific guidance for 2027, the company's focus on technological innovation, international growth, and shareholder return plans are favorable. The market cap suggests a moderate reaction, leading to a positive stock price movement prediction over the next two weeks.
Key Financial Performance
Q1 Sales $30.9 million, declined 18% year-over-year due to a step down in LDD unit volumes.
LDD Sales 20 units sold, accounting for approximately $2 million of quarterly sales.
Installed Base of LDD Units 1,154 units at the end of the quarter.
Q1 LAL Unit Volumes 27,472 units, in line with the year-ago period but down 4% sequentially due to typical first-quarter seasonality.
LAL Revenue $27 million, representing 88% of total company sales in the first quarter.
Gross Margin 76.1%, up from 74.8% in the prior year period, driven by a higher LAL revenue mix.
SG&A Expenses $31.9 million, up 11% year-over-year due to personnel-related expenses and investments in global commercial and support teams.
Research & Development Expenses $9.5 million, down 9% year-over-year.
Net Loss $15.9 million or $0.38 per share, based on 41.3 million weighted average shares outstanding.
Stock-Based Compensation $7.9 million, resulting in an adjusted net loss of $7.9 million or $0.19 per share.
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Operating Highlights
Light Adjustable Lens (LAL): Achieved a milestone of 300,000 implants in the U.S. since commercialization. Highlighted at the American Society of Cataract and Refractive Surgery meeting for its precision and versatility. Launched 'I Trust It With My Own Eyes' campaign to promote confidence in the product.
International Expansion: Received approval in New Zealand, marking a step in global expansion. Focused on building clinical, commercial, and operational infrastructure in new markets. International contributions expected to grow significantly by 2027.
Customer Reengagement Programs: Efforts to reengage with physicians and staff through clinical outcome reviews, training, and workflow support are showing early signs of success. LAL utilization has stabilized for three consecutive quarters.
Financial Performance: Q1 2026 sales were $30.9 million, with LAL contributing $27 million (88% of total sales). Gross margin improved to 76.1% from 74.8% year-over-year. Operating expenses increased due to investments in global commercial and support teams.
Strategic Focus on Adjustability: Reinforced commitment to adjustability as a key differentiator in the premium IOL market. Plans to introduce innovations to simplify implementation and reduce adoption friction for clinicians and patients.
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Risk or Challenges
Reimbursement Pressures: The company faces challenges due to recent reimbursement pressures, which are critical for the health of practices relying on premium revenue.
Decline in Sales and Unit Volumes: Q1 sales declined by 18% year-over-year, with LDD unit volumes also stepping down, reflecting a challenging sales environment.
Sequential Decline in Procedure Volumes: LAL unit volumes were down 4% sequentially, attributed to typical first-quarter seasonality, but still indicative of operational challenges.
High Operating Expenses: Operating expenses are forecasted to be at the high end of the $150 million to $160 million range, driven by accelerated investments in global commercial expansion, which could strain financials.
International Expansion Risks: The company is expanding internationally in a measured way, but contributions are expected to remain modest in the near term, posing risks to achieving significant growth outside the U.S.
Higher Cost Inventory Impact: Gross margins are expected to step down due to higher cost inventory manufactured in 2025, which could impact profitability.
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Guidance & Outlook
Revenue Guidance for 2026: The company reiterated its full-year 2026 revenue guidance of $120 million to $135 million. Quarterly sales growth rates are expected to improve throughout the year due to improving fundamentals and easing year-over-year comparisons.
International Expansion: International contributions are expected to remain modest in 2026, primarily driven by early capital placements. However, the company anticipates international markets to become a more meaningful growth driver in 2027 and beyond.
Gross Margin Guidance for 2026: Gross margin guidance remains at 70% to 72%, with a step down from Q1 gross margin due to higher cost inventory manufactured in 2025. Manufacturing absorption is expected to improve over time as production levels normalize.
Operating Expenses for 2026: Operating expenses are forecasted to be at the high end of the $150 million to $160 million range, reflecting accelerated investments in the global commercial organization. Quarterly operating expenses are expected to follow a pattern similar to 2025, with more pronounced spending in the first half of the year.
Stock-Based Compensation: Noncash stock-based compensation is expected to range between $30 million and $32 million in 2026.
Product and Operational Innovations: The company plans to introduce commercial innovations aimed at reducing adoption friction for clinicians and patients. These include streamlining clinical workups for post-op adjustments, reducing the number of required LDD treatments, and extending the range of correction.
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Shareholder Return Plan
The selected topic was not discussed during the call.
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Key Q&A
Q:What are you seeing in the field regarding the turnaround and potential green shoots for Q2?
A:Ronald Kurtz stated that feedback from customers and the team is very positive as reengagement programs are rolled out. These programs focus on reviewing clinical outcomes and refining actions, which are expected to result in further turnaround in utilization.
Q:How do you feel about your ability to grow in 2027 and reinvigorate interest in LALs?
A:Mark Wilterding mentioned that growth rates are expected to improve over the year, reflecting better fundamentals and easing comparisons. While no guidance for 2027 was provided, the company invests for long-term sustainable growth. Ronald Kurtz added that technological innovation and international expansion will drive growth, and there is still significant interest in LALs.
Q:How much of the stabilization in LAL adoption is due to the cataract market holding steady versus your efforts?
A:Ronald Kurtz acknowledged that it is hard to parse out contributors but believes the company's actions are having a positive impact. He also noted that a stable market is beneficial.
Q:Are you gating LDD sales or is it not prioritized among the sales force?
A:Ronald Kurtz clarified that they are not gating sales but are taking a measured approach to ensure customers are fully ready to adopt the technology and succeed with it.
Q:Is low single-digit LAL volume growth for the year still accurate, and how does it impact inventory?
A:Mark Wilterding confirmed that low single-digit growth is still accurate and that growth rates are expected to improve sequentially. Inventory assumptions remain unchanged, and gross margin guidance is 70%-72% for the year.
Q:What percent of accounts or territories have implemented the commercial pivot or reengagement strategy, and what is the resulting utilization?
A:Ronald Kurtz stated that they are in the early stages of reaching the installed base, which is large. Results will be gradual, but individual accounts are showing positive impacts.
Q:How are you addressing increasing competition from premium IOLs?
A:Ronald Kurtz noted that while new competitors bring more voices to the market, the clinical outcomes achievable with adjustability are superior and will ultimately prevail.
Q:What is the update on international efforts and expected contributions?
A:Ronald Kurtz mentioned progress in Asia (Korea, Singapore) and Europe, with approvals in Australia and New Zealand. Mark Wilterding added that international contributions are not yet material enough to break out but will be updated in the future.
Q:Are you seeing softness in the cataract market, and how does it impact your premium offering?
A:Ronald Kurtz acknowledged some softness in the non-premium cataract market but noted continued growth in the premium segment, consistent with their long-term view.
Q:What are the main areas of investment driving OpEx towards the higher end of the range?
A:Mark Wilterding highlighted investments in clinical training, field support, customer education, sales and marketing, and advancing the R&D pipeline.
Q:What is the current commercial headcount, and will OpEx continue at this pace?
A:Ronald Kurtz stated that there are about 130-150 field-facing employees, and decisions on additional spending will depend on the success of initiatives and business priorities.
Q:Can you elaborate on innovation efforts and their impact on growth?
A:Ronald Kurtz mentioned ongoing efforts to simplify LAL implementation, which take time due to regulatory processes. Updates will be shared as commercialization becomes visible.
Q:What are the key elements of the customer reengagement programs?
A:Ronald Kurtz explained that programs focus on tracking clinical results, sharing workflow pearls, and disseminating information through direct interactions, peer-to-peer interactions, and digital media.
Q:Are newer accounts with smaller LDD purchases showing different utilization patterns?
A:Ronald Kurtz stated it is too early to determine differences but noted that onboarding incorporates lessons from reengagement programs.
Q:What is the status of adjustable competition, including Perfect Lens?
A:Ronald Kurtz stated there are no significant updates on adjustable competition, and no competitors are close to regulatory approval in the U.S.
Q:What is your confidence in LAL's long-term growth potential in the U.S.?
A:Ronald Kurtz expressed confidence in LAL's potential to grow above market and gain share long-term, citing its broad applicability, flexibility, and appeal to patients seeking control and input in the process.
Q:Review of Unclear Management Responses
A:Management avoided providing specific guidance for 2027 growth, stating only that they invest for long-term sustainable growth. They also did not provide a clear timeline for when inventory absorption issues would lift or when international contributions would become material enough to break out. Additionally, they did not offer specific details on the impact of newer accounts with smaller LDD purchases or on the competitive landscape for adjustable lenses, including Perfect Lens.
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Earnings Word Cloud
The most frequently occurring keywords in this quarter's earning call
ASCRS world
Annual Meeting
DC meeting
Development loss
Eyes campaign
IOL counseling
LAL ability
LAL implant
LAL system
LAL unit
LDD unit
LDDs sale
Lens eye
Meeting American
compensation
confidence
doctor
effort
expansion
investment
level
loss share
margin
measure
ophthalmologist
outcome
period
practice
progress
step
support
surgeon
term
today RxSight
volume
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