RxSight, Inc. (RXST) Earnings

Management highlights

- Strategic Collaboration with Alcon * RxSight entered a collaboration to develop adjustable presbyopia-correcting IOLs (PCIOLs), combining RxSight's light adjustable technology with Alcon's PCIOL market leadership. This allows RxSight to enter the PCIOL space, where it did not previously participate, while leveraging existing clinician investments in LDD equipment and adjustability expertise. * The collaboration validates RxSight's technology platform and intellectual property, and creates a path for long-term multi-year growth. - Product Pipeline * RxSight is developing a full suite of next-generation adjustable IOLs, including next-gen LAL, LAL+, and LAL TORIC, which combines built-in toric correction with post-operative refinement of residual refractive error. All new products are designed to improve clinical workflow by reducing the number of required post-operative treatments while maintaining high visual quality. * Internal pipeline developments are expected in the mid-range of RxSight's 5-year planning period, while the Alcon PCIOL collaboration falls within the same 5-year planning window. - Commercial Operations * Q2 2026 saw unexpected near-term headwinds driven by widespread competitive new product trial programs that offer short-term incentives to clinics in a strained practice environment, plus pressured consumer sentiment that slowed patient decision-making and overall cataract procedure volumes. * RxSight is accelerating customer re-engagement efforts (which have shown success in targeted rollouts) and investing to expand its U.S. LAL sales force to increase penetration in existing accounts. The commercial expansion combines added headcount with refined sales team techniques.

Guidance

- Full-year 2026 total revenue guidance is revised to $140 million to $160 million, split between $110 million to $120 million in core RxSight product sales and $30 million to $40 million in revenue from the Alcon collaboration. The core sales guidance assumes the competitive headwinds seen in Q2 2026 will continue through the end of the year. - Full-year 2026 gross margin guidance is revised upward to 73% to 75%, from the prior guidance range of 70% to 72%, driven by a more favorable product mix of LALs that is expected to persist for the rest of the year. - Full-year 2026 operating expenses are expected to remain at the high end of the prior guidance range of $150 million to $160 million, despite increased sales force investment and collaboration-related expenses. - No changes to LAL ASP expectations are made; LDD ASP is still expected to decline slightly over time consistent with prior guidance, as is typical for capital equipment with the addition of international sales and rental units.

Segment performance

RxSight reports only one core product segment, Light Adjustable Lenses (LAL) paired with Light Delivery Devices (LDD): - Total company preliminary Q2 2026 revenue is expected to be $32 million to $34 million, including $5 million to $7 million in revenue from the new Alcon strategic collaboration agreement. - Core RxSight product sales (excluding collaboration revenue) were approximately $27 million in Q2 2026, representing a 20% year-over-year decline. - LAL unit sales totaled 24,917 units in Q2 2026, a 10% year-over-year decrease. Average selling prices (ASP) for both LALs and LDDs remained consistent with prior periods with no material changes. - 11 new LDDs were sold and 1 LDD rental unit was placed in Q2 2026, growing the total installed LDD base to 1,166 units.

Risks & headwinds

- Intense near-term competitive pressure from new product launch trial programs is expected to remain through the end of 2026, and has negatively impacted Q2 LAL unit sales and LDD placement activity. While competitive trial effects typically wane as clinicians assess new product value, the heightened competitive environment will create ongoing headwinds in the near term. - Pressured consumer sentiment and broader macroeconomic conditions have contributed to unusual declines in overall cataract procedure volumes, as patients delay care, which negatively impacts RxSight's premium IOL sales. - The Alcon collaboration is a multi-year development program, and future R&D investment requirements for the partnership are not yet fully quantified, creating uncertainty around long-term expense levels. - All forward-looking statements are inherently uncertain, and actual results may differ materially from current expectations due to unforeseen risks and uncertainties, as detailed in RxSight's SEC filings.

Analyst Q&A

• Q: What is the timeline for internal next-generation LAL development, and how much can post-operative treatments be reduced?

  A: Next-gen LAL developments are expected in the mid-range of RxSight's 5-year planning period, with individual timelines for each product. Currently, LAL patients average 1.5+ adjustments and 2 lock-in treatments; built-in astigmatism correction in next-gen models is expected to deliver a very significant reduction in the number of required treatments.

• Q: Why did RxSight choose a strategic collaboration with Alcon instead of other strategic options, and could this lead to further collaboration or an acquisition?

  A: The collaboration lets RxSight build value by leveraging its technology in the PCIOL space, which it does not currently participate in, alongside the market leader Alcon, while maintaining a strong balance sheet and continuing to grow its core LAL business. RxSight focused on the strategic benefits of the current structure and did not comment on potential future acquisition scenarios.

• Q: Is the adjustable PCIOL from the Alcon collaboration additive to existing LAL sales or will it cannibalize current business, and how is it positioned?

  A: Data shows less than a quarter of current LAL patients come from the PCIOL segment, so overlap is very small. The collaboration brings adjustability to a large patient population RxSight does not currently serve, and is expected to grow the overall premium IOL market similar to LAL's expansion in the monofocal and monofocal toric segments.

• Q: What is RxSight's strategy to manage ongoing competitive trial headwinds as more new lenses launch in the next 12 months, and what is the advantage over LASIK touch-ups for PCIOL residual error?

  A: Competitive trial programs are ultimately self-limiting and not sustainable long-term. RxSight's key lever is highlighting its unique differentiation: customizable post-operative adjustment that balances vision for individual patients, compared to the side effect profile of fixed multifocal PCIOLs. For residual error, non-invasive light adjustment is lower risk than LASIK (a second invasive surgical procedure with dry eye risks), and allows for refinement after patients experience their post-surgery vision, which cannot be done with fixed IOLs.