RxSight (NASDAQ:RXST) reported fourth-quarter 2025 revenue of $32.6 million, down 19% year-over-year, driven primarily by lower Light Delivery Device (LDD) sales following an unusually strong prior-year comparison. Management said results were consistent with the company’s January pre-announcement and highlighted a growing installed base and improving procedure trends late in the year as the company refocused commercial efforts on utilization and practice support.
Fourth-quarter results: mix shift toward lenses
Chief Financial Officer Mark Wilterding said the year-over-year decline in fourth-quarter revenue was largely attributable to LDD placements. RxSight sold 25 LDD units globally in Q4 2025, generating $3 million in LDD revenue, compared with 83 units and $11 million in revenue in the year-ago quarter. Despite the slower pace of capital sales, the company ended 2025 with an LDD install base of 1,134 units, up 17% from 971 at the end of 2024.
The higher lens mix contributed to fourth-quarter gross margin of 77.5%, up from 71.6% in the year-ago period. Operating expenses were modestly lower year-over-year in the quarter, with SG&A of $27.7 million (down 2%) and R&D of $8.9 million (down 3%). RxSight posted a fourth-quarter net loss of $9.2 million, or $0.22 per share. Excluding $7.8 million of stock-based compensation, adjusted net loss was $1.3 million, or $0.03 per share.
Full-year 2025: revenue up 4%, losses widened
For full-year 2025, revenue increased 4% to $134.5 million. Wilterding said results reflected a 48% decrease in LDD revenue, partially offset by a 12% increase in LAL sales. Gross margin improved to 76.6% from 70.7% in 2024, primarily due to the higher lens revenue mix.
Total operating expenses rose 11% to $151.2 million, driven by higher personnel costs and continued investments in R&D and commercial activities. Net loss for 2025 was $38.9 million, or $0.95 per share, compared with a $27.5 million net loss, or $0.71 per share, in 2024. Excluding $31.6 million in stock-based compensation, adjusted net loss was $7.3 million, or $0.18 per share.
RxSight ended the year with no debt and approximately $228 million in cash, cash equivalents, and short-term investments.
2026 outlook: revenue down at midpoint, margins pressured by inventory costs
For 2026, RxSight guided to revenue of $120 million to $135 million, implying an approximate 5% year-over-year decline at the midpoint. Wilterding said the outlook is primarily driven by expectations for lower LDD sales versus the prior year and incorporates year-to-date trends. He noted that Q1 2025 represented difficult comparisons, as it was the company’s best LDD volume quarter and second-best LAL unit volume quarter, with total company sales up about 30% year-over-year.
Management said sales are expected to be lowest in the first quarter due to seasonality and challenging comparisons, with another seasonal headwind anticipated in the third quarter. The company expects year-over-year growth rates to improve as 2026 progresses, and Wilterding said the business could see a rebound in total company sales growth in the second half as comparisons ease and commercial initiatives gain traction.
Gross margin guidance for 2026 is 70% to 72%, down from 2025. Wilterding said the company took a “prudent view” to reflect sell-through of higher-cost inventory tied to lower-than-anticipated production levels in 2025, with manufacturing absorption headwinds expected to ease over time. In Q&A, he added that Q1 gross margin could be above the annual range as the company works through lower-cost inventory early in the year, with higher-cost inventory beginning to flow through in the second quarter and persisting into the third and fourth quarters.
Operating expenses are expected to be $150 million to $160 million in 2026, reflecting continued investment in U.S. sales and marketing and international expansion, with R&D spending “relatively in line” with 2025. The company expects non-cash stock-based compensation expense of $30 million to $32 million.
Commercial strategy: utilization focus and disciplined placements
CEO Dr. Ron Kurtz said 2025 results were below initial expectations but described the year as one of “meaningful progress,” citing continued engagement with LAL technology and the establishment of adjustability as a category. He said adjustable procedures represent about 10% of the U.S. premium market by volume and about 15% by revenue. Following several years of rapid expansion that resulted in roughly 25% of U.S. cataract surgeons being trained on the paradigm, Kurtz said RxSight made strategic decisions in 2025 to strengthen clinical and practice expertise across the user base, sharpening training, education, and support.
Management pointed to sequential improvement in procedure volumes during the fourth quarter, driven primarily by utilization within the installed base. Kurtz emphasized that with more than 1,100 LDDs in the field and a larger number of practitioners, RxSight sees significant opportunity to increase “same-store” sales and outcomes by improving utilization. At the same time, he said the company has adopted a more disciplined approach to capital placements aimed at supporting sustainable execution and efficient workflows.
In Q&A, Wilterding said guidance assumes a “slight acceleration” from the 2025 exit rate of about 25 LDD units per quarter, with the lowest unit sales expected in Q1. He also said it is fair to assume low single-digit unit growth for LALs in 2026, and later clarified that this implies utilization stabilizing around eight lenses per LDD per month.
When discussing the top end of the revenue guidance range, Wilterding cited three factors: stronger traction from internal initiatives, faster utilization uplift—particularly in the second half—and less headwind from competitive trialing.
Clinical data and international foundation
Kurtz highlighted recent clinical and real-world evidence supporting the LAL platform. He said data from the company’s post-approval study were accepted for publication in the Journal of Cataract & Refractive Surgery, reporting that 93% of LALs achieved both spherical equivalent and residual cylinder within a half diopter of target, which he said demonstrated statistically superior refractive accuracy versus historical studies of contemporary toric IOLs. He also referenced a registry of more than 20,000 eyes presented at the American-European Congress of Ophthalmic Surgery, which he said showed similar outcomes.
On innovation, Kurtz said RxSight has received approximately 20 FDA approvals in support of product development over the past five years, with several new submissions planned over the next 18 months. He added that these efforts are intended to make the technology easier to adopt and to expand the value proposition for physicians and patients.
Internationally, Wilterding said the company expects a relatively small revenue contribution in 2026, primarily from early capital placements, as it takes a methodical approach focused on building key opinion leader relationships and collecting country-specific clinical data. Kurtz said RxSight has approvals in the European Union and the U.K., as well as in South Korea, Singapore and other Asian countries, and more recently Australia. He said the company is pursuing regulatory approvals in China and Japan and expects to provide updates later in the year.
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.
