Perfect. We're going to get started here. Welcome to the 2025 Piper Sandler Healthcare Conference. My name is Adam Maeder. I'm one of the med tech analysts here at Piper. Very pleased to introduce the management team from RxSight. With us, we have Ron Kurtz, President and CEO. We have Shelley Thunen, CFO, and we have Oliver from Investor Relations in the audience. Thank you so much for joining us this year. Thank you, Adam. Pleasure to be here. Maybe we can start the conversation with kind of just a bigger picture question and ask you, Ron, and Shelley to just kind of reflect on the business in totality. You know, 2025, there's been some bumps along the way after a lot of really good years of growth. I guess the question I most often get is, you know, what have been the challenges this year that have kind of hit the business? Is it penetration? Is it execution? Is it competition? Is it macro? You know, how would you answer that? Yeah, I think that, you know, obviously, each one of those plays a role. You know, early in the year, we saw that the cataract market, just the general cataract market, had contracted, which was very unusual. And while that has normalized more recently, you know, that was something that we noted earlier. We also, it's been an unusual year in the sense, really the last 12 months or so, where there were a number of competitive IOLs that were introduced in the premium space. Traditionally, the major players have kind of spaced out those launches, but for a variety of reasons, we had all three of the major companies introduce new products in the presbyopia correcting IOL space, as well as some of the smaller players also introduce technologies. And those have, you know, generally been associated with enhanced marketing efforts, sometimes referred to as trialing. And that, you know, did have an impact, although the LAL is quite differentiated in terms of the benefits that it provides patients as well as the patient population that we serve. It’s, you know, only a relatively small fraction, about a quarter of the patients who get an LAL would have gotten a presbyopia correcting IOL. And so, while those, you know, both the macro and competitive pressures are certainly factors, I think the, you know, the one that we have focused the most on is what internally we can impact. And, you know, that has really been around adoption of the technology and success of our customers with the technology. You know, as you noted, we had very rapid growth in adoption, you know, over the last several years, where, you know, currently we're about 10% of the premium IOL space coming from zero just a few years ago. While that growth has been great, and we certainly appreciated it, there comes a consequence to that. I think that the transition that we made around mid-year where we have focused not only on the continued growth of the installed base, but also more focus on the utilization growth within our customers, same-store sales has been an area that we've really seen as an opportunity now that we do have this very large installed base. Okay. Perfect. A lot of directions we can go with that, and certainly we'll touch on several of those topics. But you know, maybe we can jump to you know the guidance. And when I looked at your implied Q4 guide, sequential revenue step down in Q4, that's historically your strongest quarter from a seasonality you know standpoint. And I think on the Q3 earnings call, you talked about volume seeing a measured pace of stabilization and recovery. So you know, maybe you would have expected a little bit more, as it relates to the implied Q4 guidance. Maybe it's conservatism, not trying to get too far over your skis, but just any you know puts and takes you want to provide for us as we think about kind of Q4. And then I'm going to try my luck on 26 next. Okay. Thank you very much. Can you hear me? I think that as we gave our guidance at the end of the second quarter, we really positioned the second half. You know, in the first half, we did about $71 million, and we positioned the initially the second half at about $53 million. You know, at the mid, we're now at about $56 million at the mid. And so, I think that Q3 was definitely better than people expected, particularly on the LDD side. And I'm kind of looking at it as overall guidance for the second half, but also we're being conservative, and we're making a pivot in the business. And so it's especially, you know, to everybody's benefit for us to be conservative as well. Yeah. Okay. That's helpful color. Appreciate that, Shelley. Anything you'd add, Ron? Nope. Okay. And then looking at 2026, you know, I think you've talked previously about an expectation of showing sequential growth quarter over quarter. I have the street modeling $135 million of revenue next year. That's 5% full-year growth YoY. Any reaction to that figure? Do you expect to post positive growth in 2026? Any thoughts? Yeah. One thought is, of course, we haven't given guidance yet for 2026, and I know you expected me to say that. The one commentary that we have made because of our pivot, you know, to LALs, the implant being the leading indicator of success, is that we would expect to get sequential growth, you know, quarter over quarter in 2026, subject to some seasonality, and we certainly saw that this year as well. We were smaller. You grow through it, but we would expect seasonality in the first and third quarters. Okay. You know, maybe I'll try and not to poke and prod too much here, but you know, as I look at the comps, you know, one way that I'm potentially thinking about 2026, is it reasonable to assume that, you know, you're down YoY in the first half of 2026, but improving sequentially, and then you flip to positive growth in the back half of 2026? Yeah. You know, that's pretty granular right now. So I, I'd hold off on making commentary. And usually when we give guidance at the beginning of the year, we don't give quarterly guidance. And so, we give annual guidance. So I would expect probably we wouldn't answer that question right away, but it will be coming up as we give guidance. Totally fair. I had to test my luck there, you know. I guess as we talked a little bit about, you know, some of the headwinds, you know, hitting the business earlier this year, it's, I think, some of those are certainly, you know, temporal in nature, transitory in nature. But I guess I wanted to just kind of get your sense on the competitive lens trialing piece. Is that largely behind us at this point? I mean, what are you seeing in the market? And then, you know, I have heard some whispers that there might be some new IOLs coming to the market in 2026. So how do you think about kind of competitive dynamics from here on out? Yeah. I think that with the introduction by the three majors in the industry of new presbyopia correcting IOLs that, you know, largely we're through that. We've seen some other introductions, more recently, but again, they tend to be, you know, just less impactful. I'm not, you know, there will continue to be new entrants in the field. But primarily those are focused on what we would call, what is, you know, termed the presbyopia correcting IOL market. If you look at the premium space, there are, you know, three broad classifications. There's the presbyopia correcting IOL, which has been the focus for the larger companies in the space because that is the high traditionally was the highest ASB product. There have been toric IOLs, again, for over 20 years. Also, those provide benefits primarily for distance vision in some patients. And those have been, you know, generally priced at the manufacturer level about half and at the consumer level also about half. But they represent about 50% of the market as well or traditionally did. And then you've got us for the last four years, which currently is about 10% and has been responsible really in the last several years of the preponderance of growth in premium IOLs. And, you know, we don't, you know, the benefits that we provide and the way that we provide them are, you know, very unique and differentiated, and we don't see any, you know, anything directly competing in that in any of the near-term horizons. It's really, you know, we're focused on continuing to drive adoption both, you know, as we've talked about most recently in our current accounts with, you know, as we see that, you know, those successful accounts grow, that will drive further penetration into the market. That's really helpful color. I appreciate all that. You know, maybe we can spend a minute, you know, on, on the sales force or commercial organization changes that you've been making to drive same-store sales growth utilization going forward. That's been a big focus for the company. You know, would be helpful just to kind of give us a timeline of, you know, when those initiatives took place, where are we today, are you happy with what you're seeing, and, and just, you know, what are kind of the, the key activities or the, the key areas of focus that the commercial team is doing to drive same-store sales growth? Yeah. So, maybe I'll backtrack a little bit and just, you know, as we've talked about, you know, when you have an implant that also is associated with a piece of capital equipment that is required in our case to adjust, and provide the benefit of the technology to the patient, the first focus of everyone is getting that equipment out there so that patients can have access to the technology. And that was our focus for, you know, for the first several years of commercialization. And the, you know, the commercial team was really organized in that approach, as was our clinical support team. So we're introducing a new clinical modality. That it's not radically different than what doctors do in terms of surgery, it's the same, but postoperatively, there's a new procedure that they're doing to optimize a patient's vision, which has never been done before. That has, you know, in addition to the equipment, there's a clinical and a practice component to that. So we have a large clinical team, which is actually significantly larger than our sales team. That both those teams grew, and then we added subsequently a team that was focused more on LAL utilization. But there were some, you know, just because that growth is uneven, the geographic overlap between the clinical team and the sales team was not perfect. So we took the opportunity when we pivoted at mid-year to equalize and align the sales and the clinical team so that there's a one-to-one correlation, both geographically but also specific accounts so that, you know, a LAL salesperson has a set of clinical people that they're working across the same accounts, and they can collaborate on identifying the most promising areas for growth. What are the specific interventions that can help that? Is it more practice focused? Is it more clinically focused? And taking actions to affect that change. The LAL, the LDD sales force also has a role in that pivot as well. These are folks that have deep experience in IOLs and long relationships in their territories, and are really great at getting new doctors to adopt the technology, whether that's associated with an LDD sale or just a new doctor in the practice or in the community adopting the technology. So, just to summarize, you know, our focus has been aligning the teams to be more focused on LAL growth. And we think that subsequently will also drive LDD sales as new customers see or new potential customers see the success of our existing customers. That's really good color, Ron. Thank you for all that, and you know, clearly the focus is on same-store sales growth utilization, but you will, you know, obviously look to train more physicians, place more boxes as well. You know, I guess the question that I have is, for the folks that haven't adopted LAL technology, you know, what is the biggest area of pushback or the primary reason for not offering LAL? So I'll answer that two ways. First is, I don't think that the pushback has changed. You know, anytime you offer a new technology, the first reaction is always, "Well, what I'm doing is good, and I don't need that." And then the second reaction when you're introducing a capital piece of equipment is, "Oh, I don't wanna acquire a capital piece of equipment, and I don't." And then the third is, "Well, and there's more work associated with it." So our, you know, our sales teams are focused on, you know, breaking down each one of those, identifying the number one thing that we need to do is to make clear and obvious to the practitioner that this is the best clinical outcomes that have ever been achieved with cataract surgery. I think that battle has largely been won. If you know, we do an annual survey, and the results have been very consistent for several years. If you ask ophthalmologists and optometrists, what technology would they recommend for their family or friends or themselves? Nine out of 10 say an LAL. Very few talk about other technologies. I think that, you know, we've spent a lot of time generating a lot of clinical data, having that data presented, largest series in cataract surgery in recent memory, and that data continues to support the clinical value of the technology. The second, you know, with respect to the capital is ROI. You have the only answer to a piece of capital is that the return on that investment has to be significant and rapid. And that's where, you know, the drop in utilization, we believe, impacted and, you know, maybe we should have recognized that earlier, the drop in LDD sales. And the way to reverse that is to get to those very strong reference points that we had earlier in the adoption curve with our more recent adopting practices. And so hence the focus on same-store sales. And then, you know, the third aspect is we are introducing a new clinical modality, and there's both a clinical component to that and a practice flow component to that. You know, if we take the clinical component, you know, while there's nothing earth-shattering in it, you know, doctors know how to do. Have been doing refractions. You wear glasses, so you know what that is, better one, better two test, for 150 years. But there are nuances to doing that when you're doing that directly after cataract surgery, and you're relying on that information to provide you a basis to modify that lens. And how do you take that input from the patient and translate that into a great clinical outcome? You know, we've learned a lot. Our practitioners have learned a lot, and we're now much more purposeful in making sure that that peer-to-peer learning is translated across the field. And then similarly, the learnings that we've had from how to integrate this into a practice. You know, there's no disagreement that having patients come back and adjust their vision to fit their needs. That is the benefit of the technology, but it's also more work for the practice. Now, of course, they're getting paid for that with enhanced reimbursement and enhanced payment from the patient and new patients that otherwise would not be offered premium lenses, but it still needs to be done efficiently. Typically, that is through optometry, which is also in the practice, but which historically has not done these kinds of, you know, this level of involvement in post-operative care. And so there are learnings that have gone on to that, and now transmitting that to the wider base. Again, these are, you know, kind of what you would expect with a disruptive technology. and, you know, we're, you know, having gone through this before with other technologies, it's kind of what I would expect as well. That's very helpful. Maybe we can pivot to international, which is starting to become, you know, a bigger part of the conversation. I think, Shelley, you'll probably take this one. But, you know, maybe just from a revenue standpoint, how do we think about the international business in the coming quarters or years? When can we start to see a more kind of material revenue contribution? Yes. We have talked about that overall and you know, recently, we've hired a VP of International, a lot of experience both in Europe as well as Asia and so that's an evolving focus for us as well. You know, we recently got our approvals in the EU. We're approved in several Asian countries as well so it's about getting the LDD placed but I think that when we think about this, it's a $26 billion and probably more $27 billion story as we think about it and I think one of the things that Ron does talk about is as you start what you need is KOLs. In the U.S., of course, we had run a clinical trial and so those KOLs were some of our first purchases of the LDD and still that class is doing a lot of LAL treatments as well. We don't have that in Europe and Asia, meaning we need to go out and get those KOLs, and it's really country-by-country specific. Let them get their data. Their peers also wanna know, you know, how many procedures they're doing, what their payback is, and how they're doing economically, and we're focused really in about 20 countries, and those have similar reimbursement styles as we have here in the U.S., you know, kind of pricing as well as modeling. You know, it is patient pay, and so I think that that's why it's a build during 2026 and then more of a 2027 story that we'll talk about what we're getting, in terms of revenue, number of countries we're installed in, those kind of metrics. Ron, would you add anything? The only thing I would add is that, you know, the opportunity is quite large. So if you look at those 20 markets that Shelley mentioned, they represent, you know, doubling double the U.S. opportunity. So it's large. It's attainable in an approachable number of markets for a company our size. And it's also a fast-growing. So if you look at penetration of premium started in the U.S., we're at 20%. You know, we believe the projections of other players in the industry that that's gonna continue to grow, driven by continued pressures on reimbursements in and the opportunity for making up for that with premium. It's the biggest opportunity. But that process is earlier OUS. So the rate of growth of premium is about double OUS than in the U.S. And that dynamic is, we think, favors us as well as people are, you know, growing market is obviously an area of opportunity for us. Just one follow-up question quickly on international. For Asia, Shelley, I'm curious about the regulatory status of Japan and China. Maybe you haven't been that specific, but I figured I'd try and ask. Yeah. I'll let Ron comment on that. Yeah. So we've said that we're in the process, you know. The process in both Japan and China is, you know, more significant. We recently got our approval in Korea, which is a very nice market, but typically Japan and China are, you know, two to three times longer, but we're making progress, and we think that those markets will be very attractive markets. They again have been. Japan in particular, you know, traditionally the number two market. Now it's number three relative to China, but a very highly compensated market. I know we're at time here, but I'm just gonna try and sneak in one more on the P&L. Just leave it kind of open-ended for you, Shelley. You know, just any, any broad color you wanna give on gross margin and OpEx as we think about models for 2026. Yeah. I think we'll obviously give a lot of guidance when we typically do that, and I think we will again. And I think that on gross margin, the key really is mix. In the third quarter, we had a very high gross margin. I think I did comment at that point in time, it's unusual, 85% of our revenue in the third quarter came from LALs. We wouldn't expect that totally. And in addition to mix, the overall gross margin is also driven by the amount of product we make because, you know, like everybody else, we have some fixed overhead. So I think that's important. We are careful on our OpEx and always have been, but we are investing in more in sales and marketing. We wanna see how these initiatives work, but a lot of it is not just marketing. It's also people. We continue to invest in R&D. I think that's a driver for our growth as well. Perfect. We'll leave it there, but wanna say thanks again for joining us on stage and making the trip to New York. Thank you very much. Thank you very much.