the management team from RxSight. With us, we have Ron Kurtz, the CEO Shelly Tunin, the CFO and Oliver Moravsevich, Vice President of Investor Relations. The format is fireside chat. If anyone has a question, please raise your hand. So with that, we'll jump in. Ron and Shelly, thanks for being here. Thank you for having us. So look, let's start with the first half, which has been tough start for RxSight. Let's start at a high level. You've cut the guidance by about 35% since you initially issued it in January. And the new outlook implies almost a 30% year over year decline in sales in the 2025. Talk about where the business is today and how you're thinking about the rest of this year and beyond, Ron and or Shelly? Yes, maybe I'll start with just kind of an overview. As you said, we I think in the 2025, we saw a number of both external and internal factors that affected the business. From the external side, in Q1, we saw the first actual drop in total cataract procedures that I've known for that I've experienced for a long time. And that trend picked up a little bit, but still subpar growth in Q2. The overall cataract procedure market feeds into the premium IOL market, which is our specific submarket within cataract. But and that has been relatively flat as it has been for a number of years. Fact, most of the growth in that we've seen in premium over the last several years has been due to the LAL growing the overall market. So those were certainly fact that the macro and there's some underlying potential causes or reasons for that may have led to some trade downs at the consumer level, perhaps some pause on the practice level. In addition, it's been an unusual confluence of competitive events in the space for the last year or so with the introduction of major new products from all three of the major ophthalmic companies, first BNL, then J and J, then most recently Alcon. And as you of course know, Larry, that is often associated with a lot of incentivization of doctors and practices to try new product. And although they are not direct competitors with the LAL and we can talk more about why that is, It does take mindshare and has had some impact as well. But as we focused in our most recent calls, we are most focused on those things that are more internally driven and that we have more we can have more impact on. And so, if I go back to 'twenty three and first part of 'twenty four, we obviously were growing at a very fast rate, adding a lot of new practices. And in retrospect, I think what we've talked about is that as we added very large numbers of practices, we didn't have the ability and didn't necessarily go back to our most recent installations and have confidence that they were adopting the technology at the rate that some of our earlier customers were. And that some of that was a function of just the number and the pace that we were going at and some of it was organizational. So our focus really the last two quarters, but where we really have put a lot of our effort is to refocus the team on same store sales growth, because ultimately that's what drives not just LAL, but also new customer growth. Because as our most recent customer cohorts have slowed in terms of their growth that in turn affects the ROI calculation for our next group of customers. And so we're very focused on bringing up LAL use of all of our customers, but most significantly the ones that haven't grown as quickly as we would have liked. All right. Well, a lot to unpack here. We'll get to it during the conversation today. Your stock is down pretty significantly year to date. Correct me if I'm wrong, but I don't think we've seen a lot of insider share purchases. Is that fair, Kelly? I think that one factor is Ron owns a substantial number of shares, of course, as our CEO. And we did have share purchases at the beginning of the year. So you're going to see some slowdown, but also personal finances, we don't have the kind of money personally that big funds have or maybe others have as well. Okay. And Ray Cohen was recently appointed to your board. Ray obviously brings a lot of commercial experience with him. Talk about what Ray brings to the board and if you've been able to apply any of his ideas? Yes, Ray is a highly successful commercial CEO. On our board that was relatively underrepresented. We have Bob Palmazano who has that same experience. But otherwise, that's an area that we've wanted to strengthen for some time. And when somebody of Ray's caliber became available, we certainly wanted to jump at getting him interested in RxSight. He is local He's located in Southern California and so he's quite accessible. And we're definitely looking forward to tapping into his knowledge base and experience. Anything you can share? Well, as you I think you probably know, Ray, he is not a shy person. I know Ray. And he's been yes, he's definitely been a shot at B12. I think that he's it's early, he's been on the board less than a month. So but I think we're really focused on him for the long term as we make this transition from the low hundreds million in revenue to hopefully what we think is much higher, something that he's done several times. Okay. So exiting Q2, you said LAL volumes in June didn't see the typical acceleration. As you sit here today, two thirds of the way through the quarter, are you seeing any signs of recovery? And I would broaden the question. So this cataract procedure softness that you talked about, Alcon talked about it too. It just doesn't seem like cataract procedures, knowing what we know, are going to stay depressed forever. So the whole kind of everything you talked about cataract procedures, the LAL I'm sorry, premium IOL penetration, Alcon actually said it was up year over year in Q2. I don't know if you heard their comments, but all the metrics that we care about, is there anything you can talk about what you're either seeing or how you're thinking about those going forward? Yes. No, I think that overall, when we look at the environment, we don't think it's changed, right? And if we talk about the overall cataract market and then the premium market within it, the premium market overall is about 50% toric lenses. And of course, those are much lower price point for the patient and the doctor makes significantly less on that as well. And so if we look at the overall growth in the numbers we've seen, a lot of that was fueled by torque. And it kind of makes sense if patients are trading down a little bit as well. So if you look back, in the last couple of years, just as premium IOLs and take us down, everybody else has shrunk, right now. The players all have their own perspective of their market share. But the overall market trunk other than us and we have growth in the market if you look back a couple of years as well. So we're really pleased with where we stand there overall. But I think as we look forward, and I know you have a question going forward, what are we doing about that, right? How can we look at our organization to reinvigorate the type of growth we've had in the past? And we can talk about it now or we can wait for your question. I know you had given it to us earlier. Yes. I think I'm still struggling a little bit with the implied year over year growth in the second half. Because I think about cataract procedure growth, that's 3% typically. Let's say it was flat. That's not a big change. Premium IOL penetration, maybe that it's a pretty big decline, what's implied in the second half guidance. It sounds like it's mostly competition, if I think about it. No, I think some of it's macro and some of it some of the things that we think we need to do as an organization. And Ron alluded to it earlier. And I don't want to take his thunder on the reorganization at all. But if you look at the company, we were really focused on LDD sales, because that's how you get your more profitable LAL sale, right. And notwithstanding the environment, we also need to look at this. We certainly hope our guidance for the second half is substantially lower than the first half. And of course, what we've said about that is that it's an overall look at the business. We don't give guidance by product line. But what we have said is that the 40 units that we had in the second quarter was lower. And we think part of that and a good part of it is that our more recent cohorts have not grown as quickly as our previous cohorts. And we've had some flattening and decline also in our older cohorts, which Ron just spoke about. And so what we're trying to do is be conservative in our guidance. And Ron can talk about the reorganization we did to drive, LAL growth, which in turn makes customers buy the LDD. So it's a little change in focus and nuance as we've grown because we already have about 1,100 customers. So this is how we're looking at the organization and what can we do to reinvigorate the growth in the business, right? And how long is it going to take? And certainly, we wanted to be conservative in our guidance in the second half of this year, because we've got some changes that we're making. And we're making them against not a new backdrop, it's kind of been around since the third quarter of last year. And then we also want to we've said this and most analysts know this as well, is that we'll have some seasonality in the third quarter. That's what we would expect. So we can talk about the reorg or we'll wait till you have that question. I'll ask about the reorg and maybe Ron can also tell us how long it's going to take. Okay. So maybe I'll back up just a bit and we talked about competitive premium IOLs, but I think it's always important to remember what differentiates the LAL from all of those and that's really it's in the name, ability to adjust the power of the lens and the optics of the lens post operatively, which has never been able to be done before. And what does that give you? Well, it gives you the best refractive results, best distance vision and the ability to customize the patient's two eyes because ninety percent of people have cataract surgery in both eyes in a very short period of time to be able to customize that vision to give people a great range of vision binocularly with both eyes. That is a technique that has been used in contact lenses. It's the predominant technique in contact lenses for patients who are over the age of 45 or so. And it's commonly used in monofocal IOLs. But now you have this capacity to do this technique with unparalleled precision and accuracy and patient input. And that's a totally new process. And that I think is what we fundamentally have discovered as we moved into the next group of customers that expertise had to be developed and maintained and continue to grow. And so that's what really led to us doing some initial testing as we started to see that those trends towards lower utilization to say, gee, how can we reinvigorate that? And it's really through clinical education and clinical expertise. And so what we did initially with some trial efforts in Q1 and Q2 is that okay, we put additional clinical resources under a more wholesome management within an account is that going to drive LAL utilization. While the N was small, we got positive signals for that. And then what we did was, we obviously made the connection that well, just from an ROI perspective, new customers or prospective customers have to see that they're going to have that utilization ROI to be able to step up and make the not only the capital purchase, but also the commitment to this new clinical paradigm. And so our focus has been driving same store sales and what we the change that we made really was to take what had been two groups collaborating with each other, but not under the same management, our LAL sales team and our clinical team, which is actually the largest team and also includes some practice development folks, put those into the same organization with sales leadership and have them have exactly the same geographic and practice coverage. So that the same team is managing the same practices within the territory. We had grown very quickly. We had some discontinuities between those teams as well as some imbalances in the number of customers for each with our staff. And so we took the opportunity to put all those together. And and we did that starting at the beginning of this quarter. And so that transition is complete. It's been operating for about four to six weeks. And our early read just based mostly our internal enthusiasm is very positive. And so we believe that this is going to lead to a change in trajectory. You were asking how long it's going to take, obviously given the guidance that we put out, which is Shelly characterized as conservative. We're not expecting dramatic turnaround through the end of the year. But directionally, think that this is going to be in the right direction. And more importantly, it has a broader impact, not only on LALs, but secondarily on LDDs as those prospective customers see success and growth of their competitors. So that's very helpful. I guess maybe I'll ask, it's a little bit of a 26 question. But obviously, we're trying to if you based on the guidance that you provided for the second half of the year, which may turn out to be conservative, as you said, it's still negative year over year growth. I mean, obviously, unless you do way better. But how do we think about the path to growth again? It looks like is it just simply second half twenty twenty six, where you kind of start to lap comps, etcetera? How long does it take to return to growth? Yeah, I think that talking about lab and comps, the first quarter, the 2026 would be difficult for us to lap the '25 given where we are today, right. And so our focus isn't about the previous year, our focus is about continued sequential growth from going from Q4 of this year out into 2026. So I think that's a clarification for investors is look for sequential growth. I think very importantly, where we want to drive sequential growth is in the number of LALs, right. I think as we look at '26, while we're not giving guidance that LDDs might be a lagging indicator, because as Ron said, it's kind of circular today. Newer customers and potential customers want to be able to see that they can get the historic type of returns and the average return was about six months, which is a very fast ROI. But they also have to commit to the practice development, learning how to sell the product and how to organize their staff around this particular product as well. So I think that when we give guidance for 2026, it'll be more about what can we expect in sequential growth, even though we don't give quarterly guidance and how that's going to grow through the year. I think we'll have some indication by the end of this year, how well the reorganization is working, but we still have a long way. We have over 1,100 customers and we're adding to that. So I think we'll know a bit more than we know today. But I think as we approach '26, we probably will be more conservative. And then so when you look at the street, 7% reported growth, is there do you feel like you can grow year over year in 2026, Yes, positive I think we can over 25%. And certainly, that's our goal. Over time, we need to return to be a high growth company, because this is such a unique opportunity for both patients and customers. Doctors make more money. Medicare cuts again were 10%, 11%, 12% this year. So for practices, they need the premium IOL to stay in business, right? And they should adopt ours as well, because they get better results for their patients about twice as good as competitive products. And they can titrate very quickly. The capital has a very short payback period. And it allows people who may not have been doing a lot of premium to get in the market. It takes some of the pressure off of them to not have to predict, right, what they can do is titrate to the customer's specific needs and quantification. So we think that we've hit a blip, but we think that it's our job to return to those basics, which exists and where we think customers and patients really need this product to grow the premium market. Would you add anything to that, Ryan? Yes, no, I think that we're definitely have learned a lot just what those more recent cohort of customers need to acquire the skills that they need to acquire across not just the physicians, but also their practice. And that's something that we've incorporated into this program as well. It's not just it's very focused on the tools and specific expertise that is beneficial to adoption. Before I ask about international, I wanted to ask about the assumption for 2026 that you're going to you expect positive growth next year. There's more new premium IOLs coming. You're going to be going to S Chris. You're going to be hearing about J and J's Pure C, which they say is doing well. Alcon called it out on their call. Excitement around Rayner's Galaxy. When do you expect those to come to The U. S? And why won't we see another negative impact from competitor trialing like you've seen this year? Yes, mean, PUREC is an EDOF lens, there's been EDOF lenses in The U. S. For some time. The problem with an EDOF lens is that that is a fixed non adjustable lens. And this is generally the problem with multifocal lenses is in order to give significant near vision, you have a degradation in quality of vision. And the way that the field, the industry has dealt with that is generally to reduce the amount of multifocality, the EDOF lenses are a further extension of that. They have less glare and halo associated than some of the traditional multifocals or trifocals, but they also deliver much less near vision. And if you look at the trials, they're almost not much improvement over a monofocal lens. They provide a little bit of intermediate vision. And essentially they are a very similar range of vision in a single eye as an LAL or an LAL plus The advantage that we have is this customization of both eyes. And that's how you are able, that's the inherent advantage of the LAL that you know naturally people don't have the same vision in both eyes. Typically, you know our brains are made or built to take the slightly different images in both eyes and fuse them in our brains to give us a full picture of the world. We take advantage of that by allowing the patient to drive that customization where one eye is a little bit more for near and the other eye more for distance. But you can do that with a level of precision that you could really only do with contact lenses before. So I think that fundamentally it's just a different level for those patients who want to be able to and this is most patients want to be able to have very high assurance of both high quality distance, intermediate and near. There's really no way to achieve that with any fixed lens other than with ours. Now there is more work associated with it, both on the patient and on the doctor's part or on the practices part. But that's a very definable and it's work that can be done by non surgeons, it's work that's typically done by technicians and optometrists. And we've been able to really glean what are the key facets of that that need to be transmitted to the practice. And that's really the focus of that reorganization is being able to get that quickly and efficiently transmitted to the practices. Galaxy is a it's an interesting lens. It's at the end of the day, it's a multifocal lens. Was at the ACoS meeting in Europe, where it's already been, there's already experience with it. I think you're going to find that it's going to have the same side effect profile as other multifocal lenses, still splits light. It does it in a slightly different way. But at the end of the day, it reduces the amount of light that is going to each from each focal point to the retina. And that's it does it in a little discrete way, but at the end of the day, it's the same effect. Shelly, were you going to add something? Yes. I think it's important to remind investors also what adjustability does for the patient and the doctor. We have a study with more than 100 practices, more than 3,000 bilateral patients, and about eighty percent of patients opt for this blended vision, which can be titrated to exactly what the patient needs. And what that results in is the superior results that we get. And I'm going let Ron talk about the clinical results on that. And that's the impressive part of it, and also better business for the practice, right? They need to make money and this is a way for them to do it. But I think the clinical numbers. Well, and it's not just people have talked about blended vision for many years and you can do blended vision with fixed lenses. The problem is doing it specifically for each individual patient to meet their needs. And Shelly mentioned that eighty percent have blended vision, the twenty percent that don't, those people don't have it because they're seeing really well at NIER without the blended vision and that's just a function of their optics of their eyes and their brain. And so it's very unique that you're able to assess that postoperatively and then fit the needs to the patient based on the adjustment. And then the amount of blending that is done is customizable, which is also critical. When we compare or when people compare our results of even blended vision versus traditional blended vision with fixed technologies, we see a line to a line and a half improvement at near and intermediate from the effect of being able to customize that. And that's the difference between high satisfaction and modest to low satisfaction. Got it. All right. International, just Ron, remind us of where you are in international rollouts, markets, the timeline, just kind of level set us where you are, please? So we have approvals that we got in the spring in EU and UK through the MDR process. We just started to we have our first new commercial sites there and we'll be going as we talked about to the European Society of Cataract and Refractive Surgery, that's our kind of coming out party a little bit. But we'll be growing, we're obviously hiring our team and growing our presence there. The first step is always developing the KOLs and local clinical data. So we expect that to be a methodical process in 'twenty five and 'twenty six. But there's a lot of interest that the Europeans are very integrated with what's going on in The U. S. And there's I think a high degree of interest. In Asia, which is potentially an even larger market, the major countries in Asia, Japan and China have longer regulatory processes. We're in those currently, but we haven't given a timeline of when we expect approvals. We'll do that as we learn more. We do have approvals in South Korea, as well as Singapore, which is one of the Asian countries and gives us access to some of the Southeast Asian markets. And we've had our first installations there as well. That's again early, but we're generating some nice local excitement and we anticipate that those will be nice markets for us. So Shelly, when you talk about year over year growth in '26, how much is coming from international? Yes, we have said that the international contribution this year is modest and I would characterize '26 as modest as well, right? Just because the way you develop the market with your KOLs, make sure that they have data because people in country, they can see The U. S. Data, but they want to see it from their own KOLs and they want to see their KOLs be successful from a financial viewpoint as well. So I think it's going to be a slower momentum, think, very modest in '26 as a percent of revenue, 27% is where I think that we're going to start to see that impact more. And have you thought more about when you're going to start disclosing international placements or sales? I mean, the SEC by criteria is like 10%. Hopefully, I guess, hope is that you'll do it sooner. I won't comment on that, but I don't think it'll be '26, maybe '27. I've tended to go with more conservative guidance, which is the SEC guidance by region. So it wouldn't be by country, but more like EU, Asia, U. S. Or North America. But I think that that'd be a decision that we'd make in '27. Okay. And around the pipeline, what you have some enhancements coming in the second half of this year and beyond. What are the most impactful pipeline opportunities that you can highlight for us today, please? So I think that what we've talked about already and you mentioned it is we have an enhancement to the LDD. So the LDD is the device that delivers the patterns to the eye that mediate the changes in optical power and we have some new patterns that will be introduced in towards the end of the year Q4 that really for the first time in cataract surgery allow us to customize not only the what are called lower order aberrations or sphere and cylinder what's written on your prescription and glasses, but can also customize what are called higher order aberrations which are things that can be measured, but can't be corrected with glasses. And so that's an exciting thing. It's been something that has been available in corneal refractive surgery, LASIK for many years, but this is really the first time that that's customizable. So that'll be our first step into that. And that is itself a whole area of additional development. We've got a we've broadly talked about that this technology both on the IOL side, but also on the LDD side is rich for continued innovation. And we've done that consistently over the past five or six years. We've had 40 PMA supplements, which are major advancements that have been approved by the FDA. We'll continue that pace or we'll continue that trajectory with in the future addressing both opportunities to expand our market like we've what like what we're doing currently with the higher order operations. We most recently we increased the range of correction that we were able to do to very low diopters, which appeals to patients who have high refractive errors, which are particularly common in Asia, where myopia is very prevalent and as well as changes that improve efficiency for the product, reducing the number of required treatments, but at the same time maintaining the flexibility so that again, we get the benefit of this customization. Yes, Shelly, lastly. Yes, we have adequate cash to get to profitability. I also like to point out that we have between 27,000,000 and $30,000,000 in non cash stock based compensation in our OpEx. So we'll reach non GAAP profitability quite a bit sooner, but we have more than adequate cash to get to profitability. Right. Well, thank you. Again, I think that 2025 is definitely a transition year for us. But I would just say that if you look at the technology and the clinical results that are achievable with the technology, the future is very bright for LAL. Great. Thanks. Thank you very