RxSight's Q4 2024: Navigating Contradictions in LAL Utilization, Gross Margins, and Competitive Pressures

These are the key contradictions discussed in RxSight's latest 2024Q4 earnings call, specifically including: LAL Utilization Growth and Scaling Expectations, Gross Margin Improvement Sustainability, LAL Utilization Growth Expectations, and the Impact of Competitive Trials:



Revenue Growth and Market Share:
- RxSight reported a fourth-quarter 2024 revenue of $40.2 million, up 41% compared to the year-ago quarter.
- This growth was broad-based, driven by strong growth in LAL procedure volume and the expansion of LDD installed base, attributed to surgeons' increasing appreciation of the clinical advantages and economic value of the RxSight system.

Product Sales and Market Expansion:
- The company sold a record 29,069 LALs in the fourth quarter of 2024, up 61% from the fourth quarter of 2023.
- This significant increase reflects the increased preference among surgeons and patients for adjustable IOLs, resulting in enhanced clinical outcomes compared to monofocal and toric IOLs.

Adoption and Market Penetration:
- As of the end of 2024, RxSight had an LDD installed base of 971 units, up 46% compared to the 666 units installed at the end of 2023.
- The growth in installed LDD units is crucial for expanding access to adjustability in cataract surgery, which is expected to continue as a key driver of business growth.

Gross Margin Improvement:
- RxSight's gross margin expanded to 71.6% in the fourth quarter of 2024, up from 61.8% in the same period last year.
- This improvement came from a shift in revenue mix, with LAL revenues accounting for 71% of total revenue, up from 62% in the previous year, due to the lower manufacturing costs and higher average selling price of LDD sales.