RxSight Q1 Earnings Call Highlights

Key Points

• RxSight said clinical momentum is building—highlighting 300,000 LAL implants to date—and reported that utilization of the Light Adjustable Lens has now stabilized for three consecutive quarters after targeted re‑engagement programs with physicians and staff.
• First‑quarter sales were $30.9 million (down 18% YoY) as a drop in Light Delivery Device (LDD) placements (20 units, ≈$2M) offset stable consumable volumes (27,472 LALs, ≈$27M); gross margin rose to 76.1% and the company posted a net loss of $15.9 million (adjusted loss $7.9M).
• Management reiterated full‑year 2026 revenue guidance of $120M–$135M and gross margin guidance of 70%–72%, but warned margins will step down starting in Q2 due to higher‑cost 2025 inventory, while operating expenses are expected at the high end of the previously guided $150M–$160M range as commercial investments continue.

RxSight NASDAQ: RXST executives said the company is seeing early signs that customer re-engagement efforts are helping stabilize utilization of its Light Adjustable Lens (LAL) platform, even as first-quarter revenue declined year over year due to lower sales of its Light Delivery Device (LDD) capital equipment.

Commercial update: clinical momentum and utilization stabilization

President and CEO Dr. Ron Kurtz opened the call by highlighting visibility for the LAL at the American Society of Cataract and Refractive Surgery (ASCRS) meeting in Washington, D.C., where he said more than 30 papers and posters were presented on the technology. Kurtz also said RxSight marked “300,000 LAL implants since commercialization in the U.S.” at the meeting.

Kurtz said the company launched an “I Trust It With My Own Eyes” campaign featuring ophthalmologists who chose the LAL for their own eyes. He added that internal survey data shows “nearly 80% of ophthalmologists and optometrists say they would choose the LAL for themselves or a loved one,” which he said reinforces physician confidence in customized outcomes.

Operationally, Kurtz said re-engagement programs introduced in the second half of 2025 have become a key focus in 2026. He said “LAL volumes were consistent with prior year levels, and utilization has now stabilized for the third consecutive quarter,” adding that RxSight is beginning to see “clear early signs” of progress in practices where the company has re-engaged with physicians and staff.

He described the re-engagement initiatives as including clinical outcome reviews, targeted intraocular lens (IOL) counseling training, refresher education, and in-person workflow support. In response to Jefferies analyst Young Li, Kurtz said the company can track clinical results on “essentially every patient,” and is working to make those insights more visible across practices—from optometrists and ophthalmologists to counselors and support staff—to help demonstrate the value of adjustability in a more quantitative way.

First-quarter financial results

Chief Financial Officer Mark Wilterding reported first-quarter sales of $30.9 million, down 18% year over year, which he attributed to “a year-over-year step down in LDD unit volumes consistent with expectations.” RxSight sold 20 LDDs in the quarter, which Wilterding said accounted for approximately $2 million of sales. The company ended the quarter with an installed base of 1,154 LDD units.

For consumables, Wilterding said first-quarter LAL unit volumes were 27,472, “in line with the year-ago period and down 4% sequentially,” which he said was consistent with typical first-quarter seasonality. LAL procedure volumes generated about $27 million of revenue, representing 88% of total quarterly sales.

Gross margin was 76.1%, up from 74.8% a year earlier. Wilterding said the higher LAL revenue mix contributed to the improvement.

On expenses, Wilterding said SG&A was $31.9 million, up 11% year over year, driven by personnel-related costs as RxSight “continue[s] to prioritize investments in new hires and ongoing expansion of our global commercial and support teams.” R&D expense was $9.5 million, down 9% year over year.

RxSight posted a net loss of $15.9 million, or $0.38 per basic and diluted share, based on 41.3 million weighted average shares outstanding. Stock-based compensation was $7.9 million, resulting in an adjusted net loss of $7.9 million, or $0.19 per share, Wilterding said.

Guidance reiterated; gross margin expected to step down

Wilterding reiterated full-year 2026 revenue guidance of $120 million to $135 million. He said the company expects quarterly sales growth rates to improve throughout the year due to “improving fundamentals and easing year-over-year comparisons.” He also reiterated 2026 gross margin guidance of 70% to 72%.

Wilterding said the expected step down from first-quarter margin reflects “the flow-through of higher cost inventory manufactured in 2025,” and that the margin impact is expected to show up beginning in the second quarter and persist through the remainder of 2026. He added that manufacturing absorption is expected to improve over time as production levels normalize, but did not provide timing for when the inventory-related pressure would lift beyond the current-year guidance framework.

For operating expenses, Wilterding said RxSight expects 2026 operating expenses to be at the high end of its previously communicated $150 million to $160 million range, reflecting “accelerated investments in our global commercial organization.” He said spending is expected to be more pronounced in the first half of the year, consistent with the company’s 2025 pattern. The company continues to expect non-cash stock-based compensation of $30 million to $32 million, primarily included in operating expenses.

Competitive landscape and market commentary

On competition in premium IOLs, Kurtz told Wells Fargo analyst Larry Biegelsen that there is “not a lot new under the sun” in terms of fixed-lens product introductions, though he acknowledged that more competitors can increase marketplace noise and may cause “some transient impact.” Kurtz said RxSight believes adjustability delivers superior outcomes and will “ultimately…win the day.”

When asked about adjustable competition, Kurtz told Stifel analyst Tom Stephan he had no specific updates and said that, to his knowledge, there is nothing “getting close to a regulatory process, certainly not in the U.S.” He emphasized the complexity of meeting the regulatory bar and pointed to RxSight’s installed base and the knowledge developed among surgeons using its technology.

On broader cataract market conditions, Kurtz responded to Bank of America analyst Stephanie Elghazi by suggesting that reported softness from a competitor appeared concentrated in the non-premium segment. Kurtz said that competitor also noted continued growth in the premium segment, which he said was consistent with RxSight’s long-term view.

International expansion and pipeline priorities

Internationally, Kurtz said RxSight is pursuing “a measured and thoughtful approach” designed to build a durable foundation, including clinical, commercial, and operational infrastructure and relationships with leading surgeons. He noted the company received approval in New Zealand in the prior month.

In response to questions about international traction, Kurtz cited early efforts in Asia, including Korea and Singapore, and said the company received approval in Europe more recently, with initial efforts focused on building awareness across larger European countries. He also referenced Australia and New Zealand as markets that mirror where premium IOL adoption has historically been strong, while noting that Japan, China, and India have longer regulatory cycles that the company is still working through.

Wilterding declined to quantify expected international revenue for 2026, reiterating that the contribution is expected to be modest and “primarily driven by early capital placements,” but not yet material enough to break out separately.

Looking ahead, Kurtz said RxSight plans technical innovations intended to “reduce adoption friction” by streamlining clinical workup for post-operative adjustments, reducing the number of required LDD treatments, and extending the range of correction. He said the company is working through the PMA supplement process and would provide more visibility as commercialization timelines become clearer.

On the company’s field organization, Kurtz said RxSight has “about 150 fields, 130-150 field-facing employees,” and that staffing has grown with the installed base and recent initiatives, with future investment decisions tied to priorities and the success of current programs.

About RxSight NASDAQ: RXST

RxSight, Inc is a medical technology company focused on the development and commercialization of advanced intraocular lens (IOL) systems for patients undergoing cataract surgery and lens replacement procedures. The company's flagship product, the Light Adjustable Lens (LAL), is designed to provide customized vision correction by allowing non‐invasive post‐operative adjustments. Using ultraviolet light, surgeons can fine‐tune the lens power after implantation to achieve optimal visual outcomes, reducing reliance on glasses or contact lenses and enhancing patient satisfaction.

Founded in 2011 and headquartered in Aliso Viejo, California, RxSight has pursued regulatory clearances and market access across multiple regions.

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