LENSAR, Inc. (LNSR) Q1 2026 Earnings Report, Transcript and Summary

Thank you for standing by, and welcome to the LENSAR First Quarter 2026 Results Conference Call. [Operator Instructions] As a reminder, today's program is being recorded. And now, I'd like to introduce your host for today's program, Lee Roth, President of Burns McClellan, Investor Relations Adviser to LENSAR. Mr. Roth, please go ahead.

Thanks, Jonathan. Good morning, everyone, and welcome to the LENSAR First Quarter 2026 Financial Results and Strategic Update Conference Call. Earlier this morning, we issued a press release providing an overview of our financial results for the first quarter ended March 31, 2026. A copy of this press release is available on the Investor Relations section of the company's website at www.lensar.com. Joining me on the call is Nick Curtis, Chief Executive Officer; and Tom Staab, Chief Financial Officer of LENSAR, who will provide an overview of recent developments, our go-forward strategy and financial results. Following these prepared remarks, we'll turn the call back over to the operator to take your questions. Before we begin, I'd like to remind you all that today's call will contain forward-looking statements, including statements regarding future results, unaudited and forward-looking financial information as well as information about the company's future performance and/or achievements. These statements are subject to known and unknown risks and uncertainties, which may cause our actual results, performance or achievements to be materially different from any future results or performance expressed or implied on this conference call. You should not place any undue reliance on these forward-looking statements. For additional information, including a detailed discussion of the risk factors, please refer to the company's documents filed with the Securities and Exchange Commission, which can be accessed on our IR website. In addition, this call contains time-sensitive information accurate only as of the date of this live broadcast, May 8, 2026. LENSAR undertakes no obligation to revise or otherwise update any forward-looking statements to reflect events or circumstances that may occur after the date of this live conference call. With that said, it's now my pleasure to turn the call over to our Chief Executive Officer, Nick Curtis. Nick?

Thank you, Lee, and good morning to everyone. Thank you for joining us today. Near the end of the first quarter, we turned the page, marking a new beginning for LENSAR as we exited the transaction-related holding pattern we are operating in for the past year and began to once again carve our own path as an independent organization. With the termination of the merger not happening mid-March, we spent most of quarter 1 in the state of limbo, and that state of being was reflected in our results for the quarter. However, in a positive light, the FTC position and deal termination validated, we have the best technology in the market. Subsequently, we have made substantial progress since March 16 and look forward to expanding our global footprint, allowing more surgeons and their patients to experience the life-changing benefits of ALLY without the uncertainty of a pending transaction. While our near-term financial and operating -- operational performance will no doubt be watched closely, it's important to understand that for the next several quarters, success won't be measured by any metric on our P&L, but rather by progress towards reestablishing the solid foundation and momentum for growth that we were building on prior to the announcement of the merger at the end of Q1 2025. We're returning to the fundamentals of growing new placements and the resulting recurring revenue in and outside the U.S. with purpose. It has been almost 8 weeks since announcing the termination of the Alcon transaction and the progress we've made in that short time gives us cause for optimism over what the future holds for LENSAR. As I shared on our fourth quarter call, we continue to believe strongly in our ability to deliver value over the long term for all of our key stakeholders, including our surgeon partners in the U.S., international distributor partners. Let's not forget about the patients that our end-user partners serve and ultimately, our shareholders. In parallel with these efforts to complete this organizational and mind reset, we are working diligently to return to the level of growth we were enjoying pre-transaction. We're taking a matter-of-fact, business-as-usual approach with a very clear path forward and a keen focus on rebuilding momentum throughout the business, and I'm pleased to share that we're making some great progress. We generated total revenue of $13.4 million in the quarter, which was down about 5% from $14.2 million a year ago. That decline, however, was a result of lower system capital sales, down roughly $1.8 million year-over-year as opposed to the placement revenue. This was partially offset by increased procedure revenue driven by continued growth in global procedure volumes. One of the most important takeaways I'd like to highlight from this quarter's financial performance was the continued growth in our recurring revenue, which was up $1.1 million, or 9%, compared to the first quarter of 2025, representing 94% of our total revenue for Q1 2026. We expect recurring revenue growth in 2 ways. The first is to increase as we begin again to expand the installed base of ALLY. The second important initiative is to continue to leverage our existing installed base to grow recurring revenue driven by the materially industry-leading utilization rates of the ALLY System. As system installations and base ramp back up, procedure-based recurring revenue will accelerate further. In the coming quarters, I look forward to tracking and updating you in this regard. We placed 7 ALLY systems during the quarter, bringing our ALLY installed base to 205 systems approximately, with another 11 systems in backlog pending installation. The total installed base of ALLY and LLS systems reached approximately 440, up 12% compared to March 31, 2025. ALLY now accounts for nearly half of our global installed base, demonstrating the strong adoption we continue to see for our next-generation platform. It's important to recognize that this growth in the ALLY installed base has been achieved despite limited contribution from our OUS markets the past year. As I pointed out on the last call, the initial ALLY launch outside the U.S. was very successful, but the momentum that we were building came to a halt just as quickly as it started given the uncertainty over the post-acquisition business integration and ALLY distribution plan forward. While complexities around the go-forward commercial dynamic created a headwind for us, physician interest in ALLY and its numerous benefits have never subsided. Now that we and our distributors have clarity, I'm confident we can rebuild the strong international presence over time. So while placement activity in the quarter was down, I want to draw attention to the more important story, which is the continued strength in the recurring revenue. We're reaching an inflection point where the size of our installed base is increasingly supportive of the recurring revenue growth even during periods of slower system placements. That represents materially a much stronger and more durable business model than the one we had in the early days of the ALLY launch. Procedure volume also continued to trend in the right direction. We performed approximately 54,000 procedures in the first quarter, up from about 52,000 last year and 39,000 in 2024. Our U.S. procedure market share at the end of the first quarter was 23.4%, consistent with reported market share on December 31 and expected given the fewer laser installations in Q4 '25 and Q1 2026, which generate share growth for LENSAR. I believe that we will get back to the recent trend of quarter-to-quarter market share gains moving forward as we continue to convert competitive system users and attract additional femto-naive surgeons into the ALLY ecosystem. My strong conviction is grounded in firsthand observations from the field. LENSAR has maintained a presence at the key ophthalmology meetings and with the knowledge that we will be moving forward as an independent company, our attendance at these key industry congresses is expected to return to pre-acquisition levels. While our booth at the ASCRS Annual Meeting last month in Washington, D.C. was smaller than we've had historically, it was no less productive. As you know, these meetings are planned months in advance, and we had precious little time or the opportunity to expand our footprint as an independent company following the decision to terminate the merger. Although we didn't have prime real estate in the exhibition hall and overall meeting attendance was lower than previous conferences, booth traffic was incredibly high, which resulted in more than 50 system demos. That's a great indicator of interest and engagement from potential surgeon partners and a very encouraging way to reinitiate LENSAR's presence at these important industry events. I'm really proud of what our team accomplished at the ASCRS, pulling it together with such professionalism and pride in a matter of weeks, and I look forward to a more visible presence at the upcoming major conferences. This conference was a bright spot and everyone on the team is reenergized as the enthusiasm and interest in the benefits of ALLY was reaffirmed for our entire organization. While the workflow and practice efficiency benefits of ALLY are well known throughout the community, we see a significant opportunity to continue building upon the robust body of clinical evidence supporting that ALLY enables surgeons to consistently deliver optimal outcomes for patients. In the coming months, we'll have podium presence at several key industry congresses with ALLY continuing to represent a leading voice in the ongoing clinical discourse around the benefits of laser-assisted cataract surgery to surgeons, their staff, and the patients that they serve. Before wrapping up my prepared remarks, I'd like to quickly share a recent interaction with one of our surgeon partners, a reflection -- a perfect reflection of why we're so enthusiastic and optimistic by what the future holds for LENSAR. I've known this particular doctor for years. She was using a competitor's first-generation laser and struggling with the inefficiencies of that technology. She had reached a point where she was considering stopping laser-assisted cataract procedures altogether because she just couldn't justify the cost of premium surgeries for her patients given the limited benefit she was realizing with this competitive system. Her facility ultimately upgraded to an ALLY System and saw the difference almost immediately. Based on early experience, this included not only improved efficiencies, but also the outcomes and extending to improving the patient experience in their cataract procedure. With ALLY, her perspective on laser-assisted cataract surgery changed completely, and she is now recommending it to all of her patients. I spoke with the surgeon in a recent users call that we had, and the comments she made was quite telling. She said, "Nick, I will never do another premium procedure without using ALLY. " For us, that really captures what this is really all about, delivering on the promise of our technology. ALLY isn't simply an incremental step forward. It improves the experience for all surgeons and their ability to optimize treatment for premium cataract patients. The big players in our industry who thought they'd be eating our lunch are instead trying to catch up. We welcome their advancements, which no doubt bring greater attention to the market, and we look forward to not only maintaining but also extending our technological lead. I'll now turn the call over to our CFO, Tom Staab, to cover the financial highlights for the quarter. But before doing so, I'd like to acknowledge that after today's call, Tom will be leaving us and going back to his biotech roots as well as locating closer to his home. On behalf of the entire organization, I'd like to thank him for the 6-plus years he served alongside me and the numerous contributions he's made to help us get to the point we're at today. He's been a trusted colleague and a dear friend, and I wish him the very best as he starts his next chapter. Tom?

Thank you, Nick, for your kind words, and good morning, everybody. Before I begin, I'd like to thank the entire LENSAR team for 6 incredible years. It has been a rewarding experience launching ALLY and helping grow the company to its current state with recurring revenue annualizing over $50 million and ALLY continuing to reign over all other inferior first-generation lasers. LENSAR's future is bright, and I leave the organization in a strong position to reclaim the success we experienced in 2024. I look forward to watching LENSAR build momentum and advance its mission of delivering next-generation care in refractive cataract surgery. With that, let me turn to a brief conversation of our financial results for the first quarter, and there are only a few items to discuss in greater detail. Our total revenue for the first quarter of 2026 was $13.4 million compared with $14.2 million in the first quarter of '25. The year-over-year decline was primarily due to lower system revenue, which was partially offset by continued growth in recurring revenue. System revenue was approximately $800,000 this quarter compared with $2.6 million in the prior year quarter, reflecting lower placement activity from our acquisition malaise Nick discussed earlier. Recurring revenue continued to be the bright spot in our performance with total recurring revenue of $12.6 million, up 9% from the $11.5 million in the prior year quarter. Gross margin for the first quarter was approximately $6.4 million or 48% of revenue compared to $7.1 million or 50% in the first quarter of 2025. Our gross margin percentage is squarely in the range of 46% to 49% discussed in our fiscal '25 results call and as discussed then, reflects the higher cost of production associated with inflationary increase and tariffs that we have chosen not to pass on to our customers. Total operating expenses were $4.1 million compared with $12.9 million in the first quarter of last year. Specifically, SG&A expenses declined significantly to $2.5 million from $11.1 million, primarily due to a credit of $4.4 million associated with unpaid acquisition costs that were eliminated or written off through concession of our acquisition advisers. When you exclude acquisition-related costs, SG&A costs were consistent at $6.9 million for both first quarters ending March 31, '26 and '25. Net income from the quarter was $36.3 million or $1.56 per basic share compared to a net loss of $27.3 million a year ago. It's important to note that this quarter's net income was largely driven by noncash items, including a $23.9 million gain related to the change in fair value of warrant liabilities, along with the recognition of $10 million acquisition deposit into our other income in our first quarter results associated with the termination of the acquisition. This recognition did not increase our cash balance as funds were already in our operating accounts, but funds were not owned by us until the acquisition termination. Moving on to adjusted EBITDA, which was negative $311,000 versus a positive $165,000 in the prior year quarter. We expect upon achieving a rebound of our quarterly placements to see our adjusted EBITDA will return to positive territory and thereby again generate cash from operations. We ended the quarter with $13.5 million in cash, cash equivalents and investments, and we continue to manage our liquidity carefully while we cautiously rebuild our business and keep ALLY as the premier robotic laser in the marketplace. That concludes my comments. And now I'd like to turn the call over to Jonathan, and we look forward to answering your questions.

And our first question for today comes from the line of Frank Takkinen from Lake Street Capital Markets.

Tom, wish you the best. Congrats on your transition. I was hoping to start with just an update on kind of current state of affairs. I know we've talked about a number of different things you're rebuilding, Nick, from internal on the U.S. side as well as OUS with distributors. I was just hoping to get a general update on how all of that is going and then the primary goal of kind of getting to when can the business get back to some of the prior growth rates we've seen based on the progress you've made thus far?

Yes. Thanks, Frank. I hope you're doing well today. I appreciate your question. So we've been doing exactly that. You and I had a chance to meet at ASCRS, and we talked about some of this. I've been meeting with -- and I've met individually with each of our distributors. We're getting people back on board. I don't want to say too much, but we have received purchase orders from our distributors, which is very positive because that indicates that they're getting back on track and have orders. We should ship some systems this quarter outside U.S., which will be the first time in about a year. So optimistic about that and restarting that business. And we've got some POs that will take us into the fourth quarter as well here. So I'm optimistic about that. Activity, those 50 demos, and we did a conference call as well. We did like a Webex. We had about 77 participants on that Webex just to talk about LENSAR's going-forward plan and strategy. And the doctors couldn't have been more supportive of the company and our initiatives there. And peer-to-peer activity is very strong. We've got some conferences coming up this summer. And I'd say that I'm pretty pleased with the activity that we've got and the increase in activity that we've seen in the U.S. post termination of the deal.

That's helpful. And maybe just a follow-up on that, the distributor POs. Is that something that's included in the backlog today? Or was that post quarter end?

That's post quarter end. It's going to take us -- just to very succinctly, it's going to take us the next couple of quarters. I really expect the next few quarters to be this like steady progress of rebuilding and improvement here. I think the really great story is that our recurring revenue is so strong and that it continues to grow. And I feel that's going to continue. So now as we start adding additional placements, I think really looking toward '27 is going to be really, really good for us.

Got it. Very helpful. And then maybe just one more for Tom would be great to get a sense of how we should think about operating expense. Is that $6.9 million adjusted figure, how we should be thinking about that for quarters moving forward in 2026? And then if you could refresh us on kind of cash use expectations as we work through the transition and get back to growth and profitability.

Yes. Good question, Frank. And the easiest way to respond to your question is over the last 12 months, we've kind of not rebuilt our human resource system. And so we're going to -- and some of our people have left the thinking that the Alcon was going to take the reins and went to other opportunities. And so our SG&A expenses are actually going to increase now organically from the $6.9 million. Obviously, we had acquisition costs in there, and we won't have any of those going forward. But we need to build our service and customer application specialists as well as our regional sales representatives to support the growth that we're going to do. But we're going to do it judiciously as we go forward. And so I think the best way to look at this and as you reflect on the fourth quarter, our system placements were down, but it was simply because we had no placements in the first quarter outside the United States versus we had 8 placements in the quarter of first quarter of '25. So that's a huge governor on our business when we were being so successful outside the United States. And as Nick's comments allude to, we're just getting those distributors back on board, and they're excited to get back on board, but it's not something that you just flip on a light switch. And so as we increase those number of sales, then we're going to devote that cash back to the business. And we're in a strong financial position right now, but we do have to be judicious in how quickly we build just because of paying the transaction costs and because of getting the distributors back in the saddle. And so the good news, as you compare the first quarters of '25 to '26 in the United States, we actually increased placements in the United States. And so that's a good thing. So all indicators, as Nick mentioned, are that we're going to grow the business. It just may take a couple of quarters for the distributors to get back on the horse and for the U.S. business based on the sales cycle to get back to where we were in 2024.

And our next question comes from the line of Ryan Zimmerman from BTIG.

Tom, great working with you these past few years and enjoy being back in the Carolinas. I want to just kind of pick up a number of things. And so one of the things is if you go back to first quarter '25, you guys had very strong procedure growth. So it was a tough comp this quarter. But Nick, can you talk about both the U.S. -- like parse out the U.S. versus international procedure growth this quarter relative to maybe what you saw in first quarter '25. And then the second question is just I appreciate you're not giving guidance. It's a very unique dynamic in terms of kind of getting things going post the transaction. But help us with some broad strokes about how you think about the pace of recovery as we think about both procedures and recurring revenue and system placements. And again, I recognize the challenge of it, but how you see that playing out over the course of the year, I think, would be helpful.

Can you hear me? I'm sorry.

Yes. Now we can hear you, sir.

Okay. Great. So I appreciate the thoughtful question here. So whether -- we've talked a little bit about this before, but I'll give a little color to it and how it relates to now. When you -- when we install a system, due to the training and the integration of the -- especially if they're moving it into the OR for the first time and learning how to do fully sterile procedures, so on and so forth with the system, we look at about 30 to 90 days to sort of -- depending on the account and their experience and whether we have a fewer number of surgeons or a larger number of surgeons to get trained. Obviously, it takes longer with a higher number, and it could be much more concentrated with a fewer number of surgeons that are performing the volume in any given facility. So it takes 30 to 90 days to really to ramp up a system where they're doing productive procedure revenue, if you will. So in current installed base, you should think about the -- where we talk about the 7 systems in the first quarter, 11 on backlog, those systems will start to be installed. And from the fourth quarter now, those systems are starting to produce in the way of paid systems. So recurring revenue kind of comes a little bit in waves from the growth side of it. And so new systems will bring completely fresh revenue. Existing systems will grow but will grow at a slower rate. And what we see on average is -- as compared to a competitive device, on average, we perform, this is MarketScope data now, 27% higher procedure numbers on average than -- and I alluded to this in my remarks, than a competitive system that's been installed. And we see about an 11% increase if we're upgrading from an LLS to an ALLY as well, somewhere around 11% increase in procedures. And so take the new systems and project those out 30 to 90 days from the revenue increase perspective. And so as we start to get more placements into the field, that recurring revenue begins to grow a little more exponentially. And that's why I'm being very cautious about the next 2 quarters because we're just getting back to the point where now people know who they're dealing with. And so they're getting back to that decision-making relating to installing of the systems. And so 27% increase over competitive devices on average and about 11% on upgrades. And so cataract volumes in 2025 and heading into 2026 were somewhat flat in overall cataract volumes. And subsequently, as you see, just with the larger companies that are selling the premium lenses, -- if they haven't taken market share from one of the other companies, you see fairly flat numbers from them. So we're actually doing pretty well from a procedure and integration perspective once we get it. But don't forget that little bit of a lag. In OUS, where we recognize revenue immediately upon selling of a system when it leaves LENSAR different than revenue recognition in the U.S. So as we see some systems go there, we'll recognize revenue immediately on that, but a similar time from -- on the ramp-up of procedures there as well to what you see here. And procedure numbers have been pretty strong outside U.S., which actually has been a pleasant surprise with the existing systems that are in. So as we start getting more systems out there, I'd expect to get a little bump there, too.

Very helpful, Nick. And if we go back, and this goes back even when you guys came out of PDL BioPharma, the intent of the system was to do a combined femto and phaco, right? And we lived through the early dynamics with FDA, et cetera. But now as you guys kind of refocus the company, what is your thoughts around the technology -- the ALLY technology itself? I mean, what do you want to do with it? What enhancements do you want to make? What's the kind of pipeline road map, if you will? Because we know that the market will get more competitive. There are some companies developing new FLACS systems over time here. And so how do you sustain this momentum and advantage over time, technologically speaking?

Yes. So I love this question because this is really -- I feel, especially as an independent company, this is really important for us on a going-forward basis, right? Because now we're getting some critical mass, and I talked about that in my remarks as far as the procedures are concerned. And so there are several applications that we're looking at enhancing the ALLY device. And all of this was kind of put on hold during the transaction because we didn't really know what the acquiring party was going to do or not want to do or what was going to be important. So now to be able to restart that and from a LENSAR position, I would say that -- so we're going to -- I'm going to talk about some of this at the upcoming meeting at the AECOS meeting in Madrid, but I would say that it's probably pretty obvious that we would start looking at something like flaps and looking at some other corneal procedures. And I won't get too specific about that. I want to be able to make an announcement to talk to surgeons about some of those things when I present. But with the system having the capability it does with the dual-pulse laser, we certainly have the capability of doing more in the cornea than what you've seen to date. The other thing is that since we have the makings of a robotic technology here, you'll see us move towards more robotic function, continued enhancement, robotic function of the device. And suffice to say that one area that we could look at very closely, and I will talk more specifically about this as we go forward would be in terms of some of the docking and the docking of the PID to make that more automated and to make it less surgeon-dependent but surgeon guided as we go forward there. On the phaco side, I remain open-minded because we have very strong intellectual property around the integration of the phaco device. And so we'll see what's best. Obviously, it's highly unlikely that LENSAR is going to take the time or the resource to develop a phaco. That's not going to happen. But would we revisit integration? It depends on market dynamics and sort of what a deal would look like for us.

So I was just going to address your procedure question, which is when you look at the procedure growth in the quarter, it is solely related to U.S. activity. So Nick and I can't -- I guess we can't emphasize enough that when the acquisition was announced, there was a slow turn-off of our distributor activity. And so you see that in not only procedure volume, but more importantly, in placements. And so right now, the U.S. business is still doing pretty well. But outside the United States, you're kind of like a flat line up until the activity that Nick just mentioned.

But Tom, I think it's important to call out that in the 52,347 from 1Q '25, there is procedure volume outside the U.S. in that comp, right? So yes, so you're comping a U.S. number against both a U.S. and OUS number, just to be clear.

What I'm saying is the increase is solely associated with the United States as you're comparing those numbers and that the procedure volume outside the United States was effectively flat from Q1 of '25.

Okay. Yes, I can take that offline. But just last one for me, Nick. I mean, with Alcon terminating the agreement, they have this significant LenSx installed base now. And I'm curious, given how old that technology is these days, what the response has been from the Alcon users who are sitting on these older LenSx systems. And for you guys, does that represent meaningful opportunity because they thought maybe they would -- there was a pathway to get to LENSAR or to get to ALLY, I should say, excuse me. I'm just curious kind of what you're hearing from those users or that segment of the market.

Yes. That's a really good question. There is no doubt that it is delaying surgeons decisions. I like an analogy that's very simple, like when do you buy a new car? And when people evaluate when they're going to get a new car, they many times will try to drive the car that they've got until they simply -- their maintenance bills get high, they just don't want to continue to deal with what they're dealing with, with their older vehicle. And I think that's kind of where we're getting to, and I believe we're going to get to an inflection point. I don't want to get ahead of myself here, but we're looking at certain multisystem opportunities that have older technology and specifically, in cases, the LenSx installed. And I think people need to come to their own realization that despite a vast portfolio of product, arguably, that product is old and is getting towards the end of its useful life. So I'm looking forward to continuing to go after those systems. We're pretty disciplined, though, because it won't be at any cost. We're pretty disciplined about our pricing, and we're creative about how we can put a deal together, which is one of the nice things about having this be the only product that we deal with. But at a certain point, from a pricing perspective, we bring way more efficiency. The doctor can do many more cases in a day than they can do with any of the other devices. I'm not talking about full treatments, and they can save time for their patient, they can save time for themselves. That allows them to do additional premium procedures that bring in a premium of revenue for them as well and higher EBITDA for them and their practices and particularly with the PE groups. We shouldn't have to compete on a price basis. And so -- because we bring higher benefits. So there's a fine line there between the incumbent using all of their resources to try to keep the incumbent in place versus at what time will they switch. And so it's not if, it's when.

This does conclude the question-and-answer session of today's program. I'd like to hand the program back to Nick Curtis for any further remarks.

So I really appreciate everybody joining the call today and even more so, your continued interest in LENSAR. I look forward to updating you as we continue to make further progress throughout the year and look forward to our next call.

Thank you, ladies and gentlemen, for your participation in today's conference. This does conclude the program. You may now disconnect. Good day.