What RxSight (RXST) Said on Its Q3 Earnings Call

Key Points

• Q3 revenue fell 19% to $24.6 million, while LAL procedure volume declined 11% to 23,128 units amid competition, seasonality and disruption from a sales-force expansion. RxSight posted a $16.2 million net loss and ended the quarter with $254.7 million in cash and short-term investments, including Alcon’s $60 million upfront payment.
• RxSight is redirecting commercial resources toward boosting LAL use among its existing physician customers, nearly doubling its sales organization and making LDD placements a lower priority; management expects LDD sales to remain limited.
• The company expects Q4 LAL sales to rise sequentially by a mid- to high-single-digit percentage, but offered no full-year 2026 guidance. Restructuring savings are expected to help lower 2027 operating expenses, while next-generation lens approval could be no earlier than 2028.

RxSight NASDAQ: RXST reported third-quarter revenue of $24.6 million, down 19% from $30.3 million a year earlier, as the company faced competitive pressure, seasonal effects and disruption tied to a commercial restructuring and sales-force expansion.

Light Adjustable Lens, or LAL, procedure revenue totaled $22.8 million during the quarter. LAL procedure volume declined 11% to 23,128 units from 26,045 units in the prior-year period. Chief Financial Officer Mark Wilterding said the decrease primarily reflected ongoing competitive pressures.

The company reported a net loss of $16.2 million, or $0.39 per basic and diluted share, compared with a stock-based-compensation-adjusted net loss of $8.6 million, or $0.21 per share. RxSight ended the quarter with $254.7 million in cash equivalents and short-term investments, including a $60 million upfront payment related to its collaboration with Alcon.

Commercial Reset Focuses on Existing Install Base

President and Chief Executive Officer Aziz Mottiwala, who said he had been in the role for just over 90 days, outlined three priorities: strengthening the U.S. LAL business, advancing the company’s next-generation adjustable-lens pipeline and executing its collaboration with Alcon.

Mottiwala said the company sees an opportunity to increase use of LAL among its existing physician customers through more frequent engagement, practice workflow support, education and peer-to-peer advocacy. He said high-utilizing practices have demonstrated a model the company believes can be replicated more broadly.

“We have a substantial install base and a large community of physicians who believe strongly in the value of adjustability,” Mottiwala said during prepared remarks.

RxSight recently appointed Taryn Conway as chief commercial officer and Frank Shields as executive vice president of sales and commercial strategy. The company also nearly doubled the size of its sales organization. Mottiwala said the newly hired representatives largely have eye-care experience and established physician relationships, though their impact is expected to build as training and territory assignments are completed.

Management said the sales-force expansion itself contributed to near-term disruption, as it required territory remapping, onboarding and management time devoted to recruiting. Mottiwala identified three principal factors affecting third-quarter performance: typical third-quarter seasonality, continued competitive pressure and internal commercial disruption.

He said competition has included product sampling and free lenses intended to encourage physicians to trial competing offerings. However, Mottiwala said physicians continue to view LAL as differentiated, particularly for post-refractive-surgery patients and certain patients requiring personalized visual outcomes.

Financial Results and Restructuring

Third-quarter gross margin was 73.6%, compared with 79.9% a year earlier. Wilterding said the decline primarily reflected higher inventory reserves, partly offset by favorable product mix. He also noted that the prior-year gross margin was unusually high because of the sell-through of lower-cost LAL and Light Delivery Device, or LDD, inventory.

Selling, general and administrative expenses were $27.4 million, roughly flat from the prior-year quarter. Research and development expense was $9.2 million, compared with $9.1 million in the third quarter of 2025.

RxSight completed a restructuring affecting manufacturing, corporate functions and international operations. Wilterding said the actions are expected to create meaningful expense savings in the company’s base business, with the financial impact expected in 2027 and beyond.

The company plans to direct resources toward the U.S. commercial organization, next-generation LAL development and the Alcon collaboration. Mottiwala said international efforts will continue but will receive less emphasis than those three priorities.

Management did not quantify expected restructuring savings, but Wilterding said the company expects operating expenses in 2027 to be lower than in 2026 despite incremental investment in commercial expansion, the Alcon collaboration and pipeline development.

LDD Sales to Be More Selective

RxSight sold three LDD systems and recorded one rental during the third quarter. Wilterding said LDD average selling prices remained stable, while the rental option provides flexibility for customers.

Still, management indicated that LDD placements will no longer be the primary commercial focus. Mottiwala said the company is reallocating resources previously dedicated to LDD placements toward increasing LAL procedure volume within the installed base.

“Our focus is primarily on driving LAL utilization within our current install base,” Mottiwala said. Wilterding added that investors should expect “fairly limited” LDD sales going forward.

Alcon Partnership and Product Pipeline

The company said it has passed the initial 120-day period under its Alcon agreement, a milestone that Mottiwala said finalized the upfront payment and solidified the companies’ ability to move forward with the collaboration. He said the teams have met several times and are making progress, while additional details on milestones are expected when RxSight provides 2027 guidance.

Management also discussed the next-generation adjustable-lens program, which is intended to expand the eligible patient population, reduce the workflow associated with adjustments and lock-ins, and improve the surgical user experience. Mottiwala said 2028 would be the earliest possible timing for approval, but the company has not provided a formal approval target date.

RxSight is not providing formal guidance for full-year 2026 and expects to resume guidance when it reports fourth-quarter results early next year. For the fourth quarter, Wilterding said LAL sales are expected to be more in line with the second quarter, implying a mid- to high-single-digit sequential increase from third-quarter levels, based on reduced seasonal impact and October trends. He cautioned that competitive activity and the effects of recent restructuring could continue to influence results.

About RxSight (NASDAQ:RXST)

RxSight, Inc is a medical technology company focused on improving visual outcomes for patients undergoing cataract surgery. The company develops and commercializes ophthalmic products that allow surgeons to customize a patient's vision after surgery.

Its primary product is the RxSight Light Adjustable Lens, an intraocular lens implanted during cataract surgery. After implantation, the lens can be adjusted using ultraviolet light treatments delivered by the company's Light Delivery Device, enabling physicians to refine the lens power based on the patient's postoperative visual needs.

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