Q3 2025 RxSight Inc Earnings Call
Speaker #3: Hello , everyone . Thank you for standing by . My name is Gill and I'll be your operator for today . At this time , I would like to welcome each and every one of you to the RxSight, Inc. .
Speaker #3: Third quarter 2020 Earnings Conference call . All lines have been placed on mute to prevent any background noise . After the speaker's remarks , there will be a question and answer session .
Speaker #3: If you would like to ask a question during that time , simply press star , followed by the number one on your telephone keypad .
Speaker #3: I will now turn the call over to Mr. Oliver Savage , Vice President of Investor Relations . Please go ahead .
Speaker #4: Thank you . Operator . Presenting today are Rxsight President and Chief Executive Officer . Doctor Ronald Kurtz and Chief Financial officer , Shelley Thunen .
Speaker #4: Earlier today , Rxsight released its financial results for the three months ending September 30th , 2025 , and updated its full year guidance .
Speaker #4: A copy of the press release is available on the company's website . Before we begin , I would like to inform you that comments and responses to questions during today's call reflect management's views .
Speaker #4: As of today , November 5th , 2025 , and will include forward looking and opinion statements including predictions , estimates , plans , expectations and other information .
Speaker #4: Actual results may differ materially from those expressed or implied as a result of certain risks and uncertainties . These risks and uncertainties are more fully described in our press release issued today and in our filings with the Securities and Exchange Commission , or SEC .
Speaker #4: Our SEC filings can be found on our website or the SEC's website . Investors are cautioned not to place undue reliance on forward looking statements , and we disclaim any obligation to update or revise these forward looking statements .
Speaker #4: We will also discuss certain non-GAAP financial measures . Disclosures regarding non-GAAP financial measures , including reconciliations with the most comparable GAAP measures can be found in the press release .
Speaker #4: Please note that this conference call will be available for audio replay on our Investor Relations website . With that , I will turn the call over to our President and Chief Executive Officer .
Speaker #4: Doctor Ronald Kurtz Ron .
Speaker #5: Good afternoon , everyone , and thank you for joining us . During the third quarter , we've made meaningful progress strengthening our commercial execution in the US while laying the groundwork for our broader global growth .
Speaker #5: We aligned our clinical and sales teams to create a more integrated approach for customers , enabling us to improve training and engagement and approach that we continue to view as the most consistent driver for both future Lal and LD growth .
Speaker #5: We launched the first of several new practice , development and clinical engagement programs , including the master Class and Elevate programs that are designed to share learnings from over 250,000 Lal cases , helping practices optimize Lal workflow , enhance clinical confidence and accelerate their path to becoming experts in post-operative adjustability .
Speaker #5: During the quarter , more than 2000 ophthalmologists implanted the light adjustable lens , representing roughly one fifth of the estimated total number of US cataract surgeons , with approximately 1100 lhds in the field .
Speaker #5: We have ample opportunities to expand access to the Lal to more patients , and we continue to see healthy demand and growing interest from new doctors and practices .
Speaker #5: Our focus is on strategically expanding our base of leads and implanting surgeons while positioning our customers for success and sustained growth . Internationally , we're making steady progress on our deliberate and focused rollouts in Asia and Europe , with key regulatory infrastructure and commercial initiatives underway to support our multiyear expansion across priority global markets .
Speaker #5: During the third quarter , we also added an executive vice president of international to lead this expansion . We recognize there's more work ahead , but the engagement we're seeing across our customer base gives us confidence that we are building a strong foundation for the future .
Speaker #5: With that , I'll hand it over to Shelly , who will review our third quarter financials and updated guidance . Thank .
Speaker #6: You Ron . Good afternoon everyone . Our site generated third quarter revenue of $30.3 million , down 14% compared to $35.3 million in the year ago quarter and down 10% compared to the $33.6 million in the second quarter of 2025 .
Speaker #6: During the quarter , we sold 26,045 Lals , generating $25.7 million in Lal revenue , up 6% compared to the third quarter of 2020 .
Speaker #6: Four and down 5% compared to the seasonally stronger quarter of 2025 . In the third quarter of this year , Lal revenue represented 85% of total revenue and increase from 69% in the third quarter of 2024 and an increase from 80% in the second quarter of 2025 .
Speaker #6: We sold 25 Ldds in the quarter , down 68% from 78 units in the prior year period and down 38% from the 40 units in the second quarter of 2025 .
Speaker #6: During the quarter, LD sales generated revenue of $3.2 million, down 69% compared to the third quarter of 2024 and down 38% versus the second quarter of 2025.
Speaker #6: As of September 30th , 2025 , our LD install base totaled 1109 units , representing a 25% increase year over year . Gross margin in the third quarter of 25 was 79.9% , representing an 844 basis point increase compared to 71.4% in the year ago period , and a 496 basis point increase compared to 74.9% in the second quarter of 2025 .
Speaker #6: The increase , primarily reflects the shift in product mix with higher margin , Lal revenue rising to 85% . Total revenue in the third quarter , combined with lower period costs as compared to the second quarter of 2025 , in addition , lower unit costs each for both the Lal and LD contributed to third quarter gross margin improvement compared to the same period last year .
Speaker #6: G&A expenses in the third quarter of 2025 were $27.3 million , representing an increase of $1.7 million , or 7% , versus $25.6 million in the year ago quarter .
Speaker #6: This year over year increase was primarily due to a rise in personnel costs , stock based compensation expense , and marketing studies . On a sequential basis , SG&A expenses decreased 6% due primarily to lower marketing studies and trade show expenses .
Speaker #6: During the third quarter of this year , R&D expenses rose 3% to $9.1 million , compared to $8.8 million in the third quarter of 2020 .
Speaker #6: For this year over year change , primarily reflects an increase in overhead costs , offset by lower materials costs . Sequentially , R&D expenses in the third quarter decreased by 11% , primarily driven by a decrease in overhead costs .
Speaker #6: We reported a GAAP net loss in the third quarter of 2025 of $9.8 million , or a loss of $0.24 per basic and diluted share .
Speaker #6: Using weighted average shares outstanding of 41 million shares , this compares to a GAAP net loss of $6.3 million , or $0.16 per share , on a basic and diluted basis in the third quarter of 2020 .
Speaker #6: For . Note also , the stock based compensation in the third quarter of 2025 was $8.1 million . Therefore , on a non-GAAP basis , we reported a net loss of $1.7 million or a loss of $0.04 per basic and diluted share , compared to an adjusted net gain of $200,000 , or $0.01 per basic and $0.00 per diluted share , in the third quarter of 2020 .
Speaker #6: For please refer to the unaudited non-GAAP reconciliation and disclosure included in today's press release . For more comparative information . We ended the third quarter of 2025 with cash equivalents and short term investments of $227.5 million , unchanged from June 30th , 2025 .
Speaker #6: Moving on now to our 2025 outlook . We are narrowing our full year 2025 guidance for revenue . Increasing gross margin guidance and reiterating our operating expense guidance as follows .
Speaker #6: Based on our Q3 results , more consistent Lal procedure trends and our strategic approach to LD sales , we are narrowing our full year guidance range to 125 million to 130 million from the prior range of 120 million to 130 million .
Speaker #6: Maintaining a conservative outlook , we narrowed full year guidance range implies year over year decline of 11% to 7% , and Q4 revenues in the range of 23 to $28 million .
Speaker #6: At the top end of the range . Our guidance assumes flat to slightly higher , Lal procedures sequentially . Gross margin of 76 to 77% .
Speaker #6: An increase from our previous guidance of 72 to 74% , representing an applied increase of 529 to 629 basis points compared to 2024 .
Speaker #6: We estimate gross margin improvement will be driven by a higher Lal mix and the strategic approach to capital sales , Ron mentioned earlier operating expenses are expected to remain in the range of 145 million to $155 million , representing an applied increase of 7% to 14% over 2024 .
Speaker #6: We remain disciplined in managing operating expenses as we realign resources and clinical and sales teams to support long term growth in Lal adoption and support the strategic expansion of our LD installed base .
Speaker #6: Despite a 6% sequential operating expense decline in Q3 . We expect a sequential increase in Q4 , driven by the AAU trade show expenses , increased marketing expense , initial international hiring , and stock based compensation .
Speaker #6: Also note that the operating expense estimate includes non-cash stock based compensation expense between 30 and $32 million in increase compared to our previous estimate of 27 to $30 million .
Speaker #6: And with that , I'll turn the call back to Ron .
Speaker #5: Thank you . Shelly . We continue to see strong global , clinical and market enthusiasm for the light adjustable lens at the September Escrs meeting in Copenhagen .
Speaker #5: The level of international interest was the highest we've seen with physicians recognizing the unique value , the light adjustable lens brings to achieving personalized visual outcomes .
Speaker #5: Separately , a couple of weeks ago at the AAO meeting in Orlando , the light adjustable lens was again a focal point of discussion , underscoring its growing position within the global premium IOL landscape and the expanding recognition of its differentiated value for patients seeking optimal visual outcomes .
Speaker #5: As Medicare's 2026 physician fee for cataract surgery is declining , 11% , we expect practices to continue placing greater emphasis on premium IOL options , especially the Lal that improves both patient outcomes and practice economics .
Speaker #5: Internationally , we are progressing in key markets , building strong relationships with early kols and preparing for broader expansion . We expect these efforts to begin to contributing more meaningfully , more meaningfully over time as procedural volumes grow and local clinical experience deepens .
Speaker #5: As always , our R&D team remains focused on improvements that can simplify workflows , broaden the range of patients who benefit from our technology , and continue to extend our leadership in adjustable vision correction .
Speaker #5: Before I close , I want to thank all of my colleagues for their continued dedication and adaptability during this period of change . I also want to thank our many partners in clinical practice for their commitment and expertise .
Speaker #5: Bringing a new clinical paradigm to patients worldwide . Together , we're helping to redefine what people can expect from a customized lens replacement solution .
Speaker #5: Overall , I'm encouraged by our progress with an aligned organization showing early signs of improved execution toward disciplined growth , customer success , and continued innovation to deliver lasting value .
Speaker #5: With that , I'll ask the operator to open the call for questions .
Speaker #3: At this time, I would like to remind everyone that in order to ask a question, you may press star, then the number one on your telephone keypad.
Speaker #3: We will pause for just a moment to compile the Q&A roster. Okay, so your first question comes from the line of Orion Zimmerman with BTIG.
Speaker #3: Your line is open .
Speaker #7: Hi , Ron . This is Izzy on for Ryan . Thank you for taking the questions . Just to start out , it looks like you guys had a nice beat to our utilization expectations in third quarter .
Speaker #7: I was curious what other metrics you're going to be looking at that will continue to evaluate that the changes that you're implementing are starting to take hold .
Speaker #6: I think that , you know , the key metric for us and the leading metric for us is number of Lal procedures . And that to us is an absolute number .
Speaker #6: We also look at internally , you know , the number of physicians that are implanting each quarter as well . And , you know , I know that the street has been focused on a number of lals per LD .
Speaker #6: It is certainly a measure we continue to use . But the absolute number of lals that we have implanted each quarter is the leading indicator , because then that , of course , grows the number of lals per LD .
Speaker #7: That's helpful . Thank you . And you know , they have been a couple of new entrants coming into the market . So I was curious how you're thinking about the potential impacts to demand for the Lal and whether or not you expect to see similar levels of competitive trialing with these lenses , especially when we think of the broader context of reimbursement rates coming down for 2026 .
Speaker #7: Thanks for taking the questions .
Speaker #5: Thank you . Maybe I'll take that one . So , you know , I think that the lowered reimbursement for for traditional cataract surgery , standard cataract surgery will generally be continued tailwind for premium iols generally .
Speaker #5: But , you know , we anticipate that there will be continued . Entrants into the field for the same reason . However , you know , they're really more of the same , you know , whether they're different manufacturers of presbyopia correcting iols there more similar than not .
Speaker #5: While there is some impact as as there's individual incentives to trial the lenses , the overall impact to us , we think over the long term is modest .
Speaker #6: Ron , can I add one thing to that ? You know , when we look at the numbers over the last several years of market penetration , if we go back to 2022 versus , you know , where we're at in 2025 , Pciols have gone down by about 2% .
Speaker #6: Obviously , we've gone from no market share to about 10% . And toric iols , which are included in the premium market . But are not as much talked about , still remain .
Speaker #6: About 50% of the overall market . And so if you think about where we're going , there's still a lot of room for penetration .
Speaker #6: And our focus continues to be the emphasis on total Lal procedures and helping our 1100 customers grow their practice with the Lal .
Speaker #3: Your next question comes from the line of David Thaxton with Needham and Company. Please go ahead.
Speaker #8: Great . Hi , Ron and Shelly , thanks for taking my questions . Congrats on the improvement here in the third quarter . I guess just on the 2000 active surgeons , you called out , I believe last third quarter active surgeons per lead was like 1.5 or 1.6 .
Speaker #8: So that is a meaningful increase . Just considering kind of what you're seeing . So we'd love to hear , you know , what's driving that .
Speaker #8: What are you seeing in terms of the sales force realignment and kind of how to think about active surgeons going forward, especially in the fourth quarter?
Speaker #8: In 2026 ?
Speaker #6: Yeah . So I think that , yes , the number of active surgeons has gone up slightly . It's , you know , between 1.7 and two , depending on the time that we , we measure that .
Speaker #6: And if we think about active surgeons , they really come to us in several different ways . One is that , you know , we look for surgeons coming in to the funnel from new LD sales , but more importantly , we're looking for new surgeons coming in in an existing practice that may not have been doing the Lal previously .
Speaker #6: And also , while it's still a very small portion of our business , open access . So open access is typically , you know , doctors that may not have enough volume that go to open access centers .
Speaker #6: And so just like any other new customer , we train them . And then they have their they do the surgery themselves . And then LD treatments are done at the open access center .
Speaker #8: Okay . Thanks for that . And then just maybe my my second one is just on guidance . So I think , Shelly , you talked about the top end of the guide implying a sequential increase in Lal volumes .
Speaker #8: I mean , that makes sense just given seasonality . You know , a larger base LD base and , you know , benefiting some from some of these initiatives you have going on , I believe that implies pretty much like mid-single digit LD placements .
Speaker #8: So kind of help us work through like why that would be , especially in in the fourth quarter , where capital placements should be stronger .
Speaker #8: You know , how does the LD pipeline look and kind of how we should think about that implied fourth quarter LD placement number as we think about 26 placements ?
Speaker #8: Thanks so much .
Speaker #6: Yeah , I'll talk about the 25 guidance . First . And I think that the way I'm looking at it is a little bit more holistically around the second half .
Speaker #6: And so , you know , with our initial lower guidance of 120 to 130 million , and then now we've increased it at the mid of the range by about 2.5 million .
Speaker #6: I'm kind of looking at at the mid of the guidance that the second half is around 56 million , as you know , the top end of the range is a bit higher .
Speaker #6: And the LD sales I'm kind of looking holistically at the entire second half . So you're correct . You know they would be much lower in the fourth quarter .
Speaker #6: But I'm not reading anything into it other than the strategic imperatives that we set up . As to the type of customers that we're adding .
Speaker #6: And our field personnel , what they're doing . And so what we're really pushing for them to do is increase volume , right , of lals in our existing practices .
Speaker #6: And that's important for our future growth . As well . We don't want to , you know , you know , not say that we're going to do LD .
Speaker #6: You know , we placed 1100 since we , you know , commercialized . And that's providing the basis for what we're doing . So yes , you're correct in terms of the math , but I'm also not implying something about that relative to 26 guidance .
Speaker #6: More just grounding us in the second half of of this year . And then Ron , would you add anything to that at all ?
Speaker #5: Yeah , I think , you know , you've said it well , but I would just reiterate that , you know , our growth model is evolving .
Speaker #5: You know , we we obviously early on were focused on a classic playbook that prioritized new systems to build access and awareness of the Lal .
Speaker #5: But we have , you know , a more diversified approach now , which Shelly outlined that , you know , still includes the strategic addition of new practices and doctors , but that can be through a traditional LD sales , open access models or as as we just said , more importantly , growing the number of Lal procedures performed by our existing accounts with existing and new doctors .
Speaker #5: So it's just a much more diversified approach .
Speaker #8: Okay , great . Thanks so much guys .
Speaker #3: Your next question comes from the line of Larry Biegelsen with Wells Fargo . Please go ahead .
Speaker #9: Hi . Good afternoon . This is Simran on for Larry . Thanks for taking the questions here . Maybe just following up with the prior line of questioning around sort of Q4 and , you know , like what this implies for 2026 .
Speaker #9: Shelly , the last time we talked , you mentioned , you know , as we think about 2026 , we should be thinking about sequential growth through the year from Q4 .
Speaker #9: I guess I'm just trying to understand what kind of a recovery are you seeing here in the quarter . And , you know , if you can return to that year over year growth in 2026 , given sort of the implied trough in Q4 ?
Speaker #6: Yeah , no , that's a very good question . And while we're not giving 2026 guidance yet , I do think that that in 26 , what we're looking for is sequential growth .
Speaker #6: And that is really lals with the strategic direction that we've taken on Ldds and that would be sequential . You know , subject to , you know , some seasonality .
Speaker #6: I can't predict that a year ahead of time right now. But our goal still is to have a measured pace of growth throughout 2026.
Speaker #9: Okay . That's very helpful . And you know , congratulations on a really stand out gross margin quarter here . I guess as we think about , you , the business model evolving from here on out , you know , is a high 70% gross margin , sort of a baseline that we should be thinking about going forward .
Speaker #6: Yeah , I think that that's a pretty good assumption . You given our results in the second half , you know , so far our second quarter and third quarter , I think that it really depends on mix .
Speaker #6: You know , in the last quarter , our third quarter , it was really heavy . Lal at 85% of our total revenue .
Speaker #6: So it'll depend on that a little bit . But you know , I think the range that that we just guided , you know , 77 to 78% is , is a reasonable range given that kind of of mix .
Speaker #6: Now , of course , mix could change a little bit . We're really heavy in the third quarter at 80% . But I think that that's generally where we want to be .
Speaker #9: Got it . That's helpful . Thank you .
Speaker #6: Thank you .
Speaker #3: Your next question comes from the line of Patrick Wood with Morgan Stanley . Please go ahead .
Speaker #10: Beautiful . Thanks so much for the question , guys . Oh obviously . Good to fill the role there . You know you've talked about a sort of a rational and sort of stable launch profile .
Speaker #10: There . Any updated thoughts on like timeline how we should think about that . And contribution over the next year or two ?
Speaker #5: Well , as we've said , Patrick , you know , we're excited about the opportunity outside the US . You know , if you look broadly at the premium market , two thirds of the premium procedures are performed outside the US .
Speaker #5: And , you know , approximately 20 individual markets , which we're focused on . And we've made excellent progress . You know , having regulatory access in Europe as well as some of the markets in Asia and are continuing to work on those .
Speaker #5: And then beginning to introduce the product beyond Canada , where , of course , we've been for several couple of years . And those those efforts are still at an early stage , but making good progress .
Speaker #5: And we would expect those to take a similar course to what we saw in the US , where we're establishing , you know , Kol relationships , the clinical value of the technology within each of those markets , data sets that local surgeons and can see and experience themselves , and then build from there .
Speaker #10: Appreciate that . Thanks . The I guess as a second and just a quick follow up , you know , obviously , you know , we had a bit of noise in Q1 and Q2 in the in the market overall with Monofocal getting kicked out and then Monofocal toric picking up in Q2 .
Speaker #10: And I know the dangers of looking at this data in a short term time horizon that , you know , given all that , how would you characterize the health of the underlying IOL market and the consumer within that ?
Speaker #10: Have you seen anything as kind of , you know , better or worse , just trying to get a sense of how you feel about the consumer and the demand structure over and above the reimbursement changes that are happening in Monofocal ?
Speaker #5: Well , you know , the the it depends which consumer we're talking about . Typically the Monofocal consumer is going to be more affected by economic headwinds .
Speaker #5: And so I think that's why we saw some of that earlier in the year. And they're still under pressure. And you know, with inflation still being relatively high.
Speaker #5: And so I think that those those will still be in play . But at the higher end of the market where we tend to to play , I think that we're probably a little bit less impacted and our , you know , we would we would hope that that our demand would continue to be strong in that end of the market .
Speaker #10: Awesome . Thanks , guys .
Speaker #6: Thank you .
Speaker #3: Your next question comes from the line of Robbie Marcus with J.P. Morgan . Your line is open .
Speaker #11: Thanks for the question. This is Alan on for Robbie. I just had a quick one again, kind of on just how to think about 2026.
Speaker #11: You know , fully understand you're not guiding but given you know , it sounds as though fourth quarter isn't exactly the right run rate to use going forward .
Speaker #11: You said , you know , you're looking at Lals and LEDs a little bit more holistically . Should we think about , you know , just the back half of the year on average , as being kind of the right place to be from an LD and Lal perspective ?
Speaker #11: Just wanted to get a little help thinking about that . Thank you .
Speaker #6: Yeah . I think what you're saying is that is the run rate of the second half of 2025 indicative of the start of 26 .
Speaker #6: Is that what you're asking ? I just want to make sure I understood .
Speaker #11: Yeah . Just like is that the right kind of baseline for us to then maybe forecast , you know , recovery or stability or whatever our assumptions on going into 2026 given , you know , you have this first half versus second half dynamic this year .
Speaker #6: No , I think it is a good way of looking at it . And I think what it really does is provide the baseline of the way we're thinking about the business for 26 , not necessarily the specifics .
Speaker #6: So the second half of this year is where we're making a shift in our business model , right away from the leading indicator being sales of leads .
Speaker #6: We built an installed base . We've been successful at that . We now need to optimize the value of that with Lal sales .
Speaker #6: Right . And and those coming from our existing customers with , you know , a strategic approach about who we're going to add as customers for leads .
Speaker #6: And so I think that approach and the philosophy will guide 26 without specifically trying to get into numbers . So I think it's going to be much heavier in L a s .
Speaker #6: I'm not so sure it'll be 85% like it was in the third quarter , but I do think that that's important to the way we'll be running the business and how we'll be measuring our own success .
Speaker #6: Would you add anything about that , Ron ?
Speaker #5: No , no , I think that's well said .
Speaker #6: Thank you .
Speaker #3: Your next question comes from the line of Adam Mader with Piper Sandler . Please go ahead .
Speaker #11: Hi , Ron and Shelly , congratulations on the progress and thank you for taking the question . I'll keep it to one .
Speaker #12: And you know , one thing that's I guess , come up in our physician checks is the post refractive and Lasik patient opportunity .
Speaker #12: And , you know , it feels like that's a potentially sizable opportunity for the company to , you know , go after . And so I guess from your vantage point , how do you think about the opportunity for Lals and this patient segment ?
Speaker #12: You know , what percent of the volumes go towards these patients today ? And where can that go over the future ? Thank you .
Speaker #5: Well , thank you for the question . So I you know , as as you pointed out , a number of physicians have recognized the benefits of the Lal .
Speaker #5: You know , more broadly . But in particular for patients who've who have had previous corneal refractive procedures , like Lasik , where the ability to predict the outcome of a of of a procedure is more difficult because of the changes that have been made to the cornea and the demands of the patients are quite high .
Speaker #5: Since , you know , they've already demonstrated the desire to have , you know , a spectacle . Independence . And so that's a natural population , often a place where our customers will start , you know , it .
Speaker #5: If you look at the , you know , the US population , you know , it could it could represent about 5% of the overall cataract patients , but probably represents double that in in our customer profile .
Speaker #5: When we look at our post , I'm sorry , when we look at our phase four studies , we typically see post cases representing somewhere between 10 and 20% of the patient population .
Speaker #5: So it's significant . But not , certainly not the majority . But it's a nice it's a natural place for doctors to begin internationally .
Speaker #5: Of course , that's you know , there are markets where those percentages are even higher and and a nice feature of our technology is that we have the broadest range of spherical correction as well , spherical powers , which from minus two to plus 30 diopters for an astigmatism correcting lens , which means that this can be used over the broadest range of of patients as well , who would be that population ?
Speaker #5: Who who likely would have undergone corneal refractive procedures ?
Speaker #3: Your next question comes from the line of Danielle Antalffy with UBS . Please go ahead .
Speaker #13: Hey , good afternoon guys . Thanks so much for taking the question . And congrats on on making some good headway here this quarter .
Speaker #13: It's good to see you, excuse me, Ron. I was just curious if you could talk a little bit about what I appreciate.
Speaker #13: There's a lot of moving moving parts in the market right now . So maybe this is a little bit of an unfair question .
Speaker #13: But when you think about your penetration at your highest penetrated practices and the incremental runway you have there , I mean , how are you how do you feel about some of the statements you may previously , you know , thinking this will get to standard of care and premium IOL ?
Speaker #13: Do you do you still have conviction that that's the case ? Anything you can add to that that gives you confidence that we'll get there and sort of what needs to happen to accelerate towards that .
Speaker #5: Well , you know , just the first part of your question relating to , you know , where we sit at different practices , you know , we've already achieved standard of care at some of our practices where we represent , you know , the majority of their premium procedures that means that the that the doctors at that practice have have made the decision and the commitment to , to offer this , you know , maybe not exclusively , but predominantly to their patients because of the results that they that they see .
Speaker #5: And I would say that this is consistent with the surveys that we've done of our doctors , which indicates that upwards of 80% of them would choose the Lal for their own eyes or for that of their family members .
Speaker #5: So , you know , obviously , we're not there across our entire base , but that's still remains , you know , where we would like to get to over time .
Speaker #5: But we recognize that , you know , we need to that , you know , we need to build that over time . And , you know , first , our first job was to get the technology out there .
Speaker #5: Shelly . Shelly mentioned earlier we've you know , we've had a lot of success for that . And now we're focused on going deeper at those accounts to achieve exactly what you've what what you what you were asking about .
Speaker #13: Okay . That's helpful . And then the commentary on the reduction in in reimbursement , I thought that was at the that's important .
Speaker #13: And maybe something , you know , I personally hadn't been thinking about for 2026 . I mean , what kind of how much of an impact do you think , do you think that could could have , I guess , I guess the question is how financially motivated are these physicians , which who isn't financially motivated ?
Speaker #13: But I don't know . Is there is there any are there any guardrails you can put around how that could swing Lal adoption one way or the other in 2026 ?
Speaker #13: Thanks so much .
Speaker #5: Well , I think this is just a continued trend that's been going on for the last 25 years . If we look at , you know , reimbursements for cataract surgery in real terms , they're down , you know , 80 , 90% , you know , now , you know , in 2026 , I think the average reimbursement is going to be around $450 .
Speaker #5: There's just it's just very , very difficult for practices where cataract surgery is still represents , you know , the number one surgical procedure they're doing to be able to just stay profitable at those levels of reimbursement .
Speaker #5: And , you know , something that , you know , that I try to convey to to ophthalmologists , my ophthalmology friends that I there's , you know , there's a reason why airlines have business class and , and economy class that , you know , the bulk of the revenue comes from that business class .
Speaker #5: And they are able to service all their customers by by servicing a having a diverse , diversified offering . And so it's really a requirement to be able to offer care to all your patients , to be able to offer premium iols to those who desire .
Speaker #5: Spectacle , independence .
Speaker #14: Thank you .
Speaker #3: Your final question comes from the line of Tom Stephan with Stifel . Please go ahead .
Speaker #15: Great . Hey , guys . Thanks for taking the questions . One . To start off with , kind of the commercial changes and the new practice development programs .
Speaker #15: Ron , maybe for you , can you just elaborate a bit on , I guess what exactly is going well in resonating with with customers ?
Speaker #15: And then I guess , more importantly , how much runway do you have with these initiatives taking hold across your entire installed base ?
Speaker #15: Kind of just wondering if we're maybe only in , call it like the first or second inning with the impact of these changes in the commercial approach .
Speaker #5: Yeah . Thanks for the question . So , you know , I think if I was to put an overall definition around what we're focused on , it's really a increasing the efficiency and confidence of our user base in our technology .
Speaker #5: We've introduced this new capability , a new category in ophthalmology called postoperative adjustability . And we expanded very quickly . It's natural that we need to , you know , bring bring a level of expertise and education across our user base .
Speaker #5: And that's what we're focused on . And the programs that we're we're using , they make use of , you know , peer to peer primarily peer to peer , which is the way people learn both digital and and user groups and , and , and and other efforts to to convey that information that that has been learned by our our user base , by our doctors over the last 4 or 5 years in terms of what that runway is , it's extensive .
Speaker #5: I mean , this , you know , as you know , we have 1100 leads out there . We have a lot of room for expansion of utilization and and I would definitely say that we're in the early innings of of the efforts that we've put together .
Speaker #5: You know , most recently in order to leverage that , that installed base . .
Speaker #15: That's great . Thanks , Ron . And then my follow up , I guess , is just kind of on the the US installed base .
Speaker #15: So I think you mentioned 2000 surgeons today previously , if I'm not mistaken , kind of 3000 to 4000 US surgeons was viewed as sort of the optimal addressable opportunity , if you will .
Speaker #15: So I guess just given call it , the more deliberate and measured approach to LD placements , as well as surgeon trainings , is there any renewed thinking around the surgeon Tam here in the US ?
Speaker #15: Thanks .
Speaker #5: Yeah , I think that I would just refine the numbers a little bit . The , you know , the total number of cataract surgeons is in the 9 to 10,000 range .
Speaker #5: We , you know , initially focused our efforts on , on doctors who were performing the , you know , a larger percentage of premium iols since that was a natural target for us .
Speaker #5: Those were natural practices for us to do . But , you know , quite honestly , as I was saying earlier , premium Iols have have become an essential part of all practices and therefore , you know , we view the opportunity .
Speaker #5: To , you know , more extensive in that , in that 9 or 10,000 range . And we have a lot of those customers already , and they they provide an aggregate , a significant number of procedures .
Speaker #5: So , you know , whether that's through , you know , whether they're part of practices that are already have access to an LD or whether they're part of a practice that will eventually acquire an LD , or they make use of an open access center .
Speaker #5: It really doesn't matter . We we want to educate that physician to the benefits of adjustability . And , you know , make them make them a customer .
Speaker #5: And successful long term .
Speaker #15: That's great . Thanks , Ron . Congrats on the progress .
Speaker #5: Thank you .
Speaker #3: Thank you everyone . And that concludes our Q&A session for today . I will now turn the call back over to Mr. Ronald Kurtz for the closing remarks .
Speaker #3: Please go ahead .
Speaker #5: Well , thank you all for your time and attention today . We appreciate your interest in our site and look forward to updating you on our progress in future quarters .
Speaker #5: Goodbye .
Speaker #3: And gentlemen , that concludes today's call . Thank you all for joining . You may now disconnect . Have a nice day ahead .