RxSight Q2 Earnings Call Highlights

Key Points

• Q2 revenue was $33.7 million, including $6.5 million from the Alcon collaboration, while core product sales fell 19% year over year to $27.2 million and LAL unit volume declined 9% to 24,917 units.
• RxSight withdrew its full-year 2026 guidance as new CEO Aziz Mottiwala conducts a review of the company’s commercial model, execution and strategy. Management plans to focus on increasing utilization of its installed base, strengthening sales execution and improving forecasting.
• The company reported a $12.1 million net loss and ended the quarter with about $209 million in cash and short-term investments, excluding a subsequent $60 million Alcon upfront payment. RxSight expects to recognize $30 million–$40 million from the Alcon agreement in 2026.

RxSight NASDAQ: RXST reported second-quarter revenue of $33.7 million, including $6.5 million recognized under its strategic collaboration with Alcon, while management withdrew its full-year 2026 financial guidance as new Chief Executive Officer Aziz Mottiwala conducts a broader assessment of the business.

Excluding the Alcon-related revenue, product sales were $27.2 million, down 19% from the prior-year period. The company said the decline reflected heightened competitive trialing and broader marketplace headwinds. Light Adjustable Lens, or LAL, unit volume fell 9% year over year to 24,917 units.

LAL procedure volume generated $24.5 million in second-quarter sales, representing 90% of RxSight product revenue. The company placed 12 Light Delivery Device, or LDD, units during the quarter, generating $1.3 million in revenue, and ended the period with an installed base of 1,166 LDD units.

Margins and Losses

Excluding collaboration revenue, gross margin was 71.2%, compared with 74.9% a year earlier. Chief Financial Officer Mark Wilterding said the year-over-year decline primarily resulted from higher inventory-related costs associated with slower-than-expected inventory flow-through. Including the favorable impact of collaboration revenue, gross margin was 76.7%.

Selling, general and administrative expense rose 5% year over year to $30.4 million, primarily due to legal and consulting expenses connected to the Alcon collaboration. Research and development expense declined to $9.2 million from $10.2 million, mainly because of lower personnel-related costs.

RxSight reported a net loss of $12.1 million, or $0.29 per basic and diluted share, based on 41.5 million weighted average shares outstanding. Stock-based compensation was $7.5 million, resulting in an adjusted net loss of $4.6 million, or $0.11 per share.

The company ended the quarter with approximately $209 million in cash equivalents and short-term investments. That figure did not include the $60 million upfront payment from the Alcon agreement, which RxSight received after the quarter ended.

Guidance Withdrawn During Business Assessment

Mottiwala, who recently joined the company after serving as chief commercial officer at Tarsus Pharmaceuticals, said RxSight is evaluating its commercial model, execution capabilities and strategy to improve adoption and utilization of the LAL platform.

“While underlying trends remain generally consistent with what we've previously guided,” Mottiwala said, “this work will require time, and we should not allow our prior outlook to constrain actions we may ultimately determine are appropriate.”

Management said it will resume formal guidance when it reports fourth-quarter 2026 results in early 2027. Wilterding added that the company expects to recognize between $30 million and $40 million of revenue from the Alcon strategic agreement during 2026. RxSight expects limited contribution from that agreement in the third quarter, with the balance expected in the fourth quarter, depending on the timing of performance obligations.

For the core business, Wilterding said quarter-to-date trends had been encouraging, but the company expects competitive activity, product trialing, typical third-quarter seasonality and broader market trends to continue affecting results through the remainder of the year.

Focus on Utilization and Commercial Execution

Mottiwala said the company has developed a substantial installed base and strong physician confidence in its technology but is not yet achieving the procedure volume and utilization it believes the platform can support. He cited competitive launches, market conditions, seasonality and patient affordability as factors affecting quarterly performance.

RxSight’s immediate priorities include:

• Completing a comprehensive assessment of the business and commercial model.
• Strengthening the commercial organization and increasing utilization across the installed base.
• Doubling its U.S. sales team over time, primarily through reallocating internal resources without meaningfully increasing overall operating expenses.
• Improving forecasting, operating discipline and the company’s ability to respond to market changes.
• Advancing next-generation adjustable lenses intended to improve workflow, performance and patient eligibility.

In discussions with physicians, Mottiwala said he has heard continued confidence in the LAL technology and has not encountered doctors who believe they have reached the maximum number of LAL procedures their practices could perform. He said the company’s challenge is to help practices improve workflow, identify appropriate patients and better integrate the technology into their cataract surgery offerings.

“We’ve established a broad user base, and pivoting to depth takes a little bit of time, takes a different strategy,” Mottiwala said.

Alcon Agreement and International Opportunity

Mottiwala described the Alcon collaboration as external validation of RxSight’s technology and a source of non-dilutive capital. The agreement includes $200 million in upfront and potential future milestone payments, along with the potential for long-term royalties, according to management.

The CEO said the partnership is non-exclusive, but that RxSight’s current focus is on achieving development milestones and maximizing the value of the relationship with Alcon. He said the collaboration is designed to expand adjustability across a wider range of intraocular lens platforms and potentially to a broader patient population.

Outside the U.S., management said RxSight continues to see opportunity in international markets, including recently approved markets such as New Zealand, while seeking to expand selectively where it believes there is customer access and commercial potential. The company also completed its first LDD rental contract during the second quarter and said it may pursue additional rental arrangements, particularly as it expands internationally.

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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