Summary of Sight Sciences FY Conference Call (September 10, 2025) Company Overview - **Company**: Sight Sciences (NasdaqGS:SGHT) - **Industry**: Interventional Glaucoma and Dry Eye Treatment Key Points on the MIGS Market - **Market Growth**: The MIGS (Minimally Invasive Glaucoma Surgery) market is expected to return to growth in 2026 after facing headwinds due to LCD (Local Coverage Determinations) and payment changes in 2025 [3][4] - **Clinical Need**: Glaucoma is the leading cause of irreversible blindness globally, necessitating more interventional options for patients [3][5] - **Patient Visits**: There is a continuous increase in patient visits, indicating a growing demand for glaucoma treatments [3][4] - **Commercial Strategy**: The company aims to position itself strongly to capture growth when the MIGS market rebounds, emphasizing the importance of innovation and effective commercial execution [4][10] Insights on Glaucoma Treatment - **Interventional Approaches**: The future of glaucoma treatment is expected to be more interventional, with a focus on sustained release interventions and early use of SLT (Selective Laser Trabeculoplasty) [7][9] - **Patient Compliance**: The company recognizes the challenges of patient compliance with traditional treatments like eye drops, advocating for more effective interventional methods [6][9] Performance Metrics - **Q2 Performance**: Surgical glaucoma revenue was down mid-single digits, significantly better than the anticipated 15% decline due to MIGS restrictions. The company reported a 12% sequential increase in utilization [10][11] - **Surgeon Engagement**: The company has seen record numbers of ordering accounts, indicating strong engagement with its commercial team [10][11] Regulatory and Payer Dynamics - **Payer Scrutiny**: The rapid growth of the MIGS segment has led to increased scrutiny from payers, necessitating robust clinical evidence to support reimbursement [14][15] - **Clinical Evidence**: The company is focused on generating compelling clinical evidence to demonstrate the efficacy of its products, particularly the OMNI platform [16][50] OMNI Platform Innovations - **OMNI Edge**: The latest iteration of the OMNI platform, which enhances the volume of viscoelastic delivered during procedures, has received positive feedback from surgeons [17][18] - **Competitive Landscape**: The company believes it is ahead of competitors in technology and usability, which are critical factors for success in the market [20][21] Dry Eye Treatment Insights - **TearCare Development**: The company has developed TearCare to address the root causes of dry eye disease, focusing on meibomian gland dysfunction rather than tear insufficiency [25][28] - **Clinical Trials**: TearCare has completed two randomized controlled trials (RCTs) demonstrating its superiority over standard care, which is crucial for gaining reimbursement [29][50] - **Market Potential**: There are over 19 million diagnosed and an additional 19 million undiagnosed patients with dry eye disease in the U.S., indicating a significant market opportunity [43] Reimbursement Strategy - **Payer Engagement**: The company is actively engaging with payers to secure reimbursement for TearCare, leveraging strong clinical evidence and economic analyses [30][50] - **Future Goals**: The company aims for policy wins by 2025, with ongoing discussions and positive feedback from payers regarding the Sahara RCT [51][55] Conclusion - **Overall Outlook**: Sight Sciences is well-positioned in the interventional glaucoma and dry eye markets, with a strong focus on innovation, clinical evidence, and strategic payer engagement to drive future growth [4][50]

Financial Data and Key Metrics Changes - Total revenue for the second quarter of 2025 was $19,600,000, an 8% decrease compared to the same period in the prior year [19] - Surgical glaucoma revenue was $19,200,000, a decrease of 5%, primarily due to an 11% decrease in account utilization [19] - Dry eye revenue was $300,000, down from $1,100,000 in 2024, attributed to fewer SmartLid sales [19] - Gross margin was 85%, down from 86%, with surgical glaucoma gross margin at 86% compared to 88% [20] - Net loss was $11,900,000 or $0.23 per share, compared to a net loss of $12,300,000 or $0.25 per share in the prior year [21] Business Line Data and Key Metrics Changes - Surgical glaucoma segment showed a sequential growth in ordering accounts, up 6% sequentially and 4% year-over-year [11] - Surgical glaucoma utilization increased by 4% sequentially, contributing to strong quarterly performance [11] - Dry eye segment revenue decreased significantly due to a focus on achieving reimbursed market access for tear care procedures [13][20] Market Data and Key Metrics Changes - The company is experiencing a stable market environment despite headwinds from Medicare coverage restrictions [32] - The demand for minimally invasive glaucoma treatments is expected to grow, representing a significant long-term market opportunity [8] Company Strategy and Development Direction - The company is focused on securing equitable reimbursement for tier care and driving commercial momentum in MIGS through the rollout of OmniEdge [18] - Strategic initiatives include enhancing competitive positioning, investing in commercial resources, and expanding the pseudophakic standalone omni market [10] - The company aims to build on early traction with OmniEdge and improve surgeon education on standalone procedures [12][17] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the ability to drive adoption of the Omni procedure, citing a shift in surgeon mindset towards interventional glaucoma [9] - The company remains optimistic about achieving reimbursement coverage for tier care, despite delays [38][40] - Future growth is anticipated in the surgical glaucoma segment, with expectations of mid-single-digit declines in the near term [25] Other Important Information - The company has not yet received monetary damages from a patent infringement case against Alcon, and ongoing legal proceedings may impact future revenue [23][24] - The company is exploring additional third-party manufacturing locations to enhance production capabilities starting in 2026 [26] Q&A Session Summary Question: What is driving the strength in the surgical glaucoma business? - Management noted stability in the market and effective execution by the sales team, contributing to better-than-expected performance [32][34] Question: When can reimbursement wins for tier care be expected? - Management indicated that while they are working towards reimbursement wins in 2025, the timing is uncertain [38][40] Question: How is the competitive landscape evolving? - Management acknowledged ongoing competition but emphasized their strong performance and market position, particularly with the Omni product line [46][48] Question: What is the outlook for the second half of the year? - Management expects a mid-single-digit decline in surgical glaucoma revenue for Q3, with potential for growth in Q4 as they lap previous restrictions [52][53] Question: What are the obstacles to standalone MIGS adoption? - Management highlighted the need for a prescriptive approach to identify and treat specific patient populations, emphasizing the importance of education and workflow integration [92][96]

Company Mission and Vision - Sight Sciences' mission is to develop transformative technologies that empower eyecare providers to elevate standards of care [5] - The company aims to transform chronic eye disease treatment by reducing patient burden, slowing disease progression, and improving outcomes [9] Glaucoma Market and Technology (OMNI) - The addressable U S glaucoma market is estimated at over $6 billion with over 4 million patients diagnosed [17] - OMNI is a comprehensive MIGS technology designed to treat the full spectrum of primary open-angle glaucoma (POAG) [28] - OMNI has demonstrated consistent efficacy in both combination cataract and standalone clinical trials [32] Dry Eye Disease Market and Technology (TearCare) - The addressable U S dry eye disease market is approximately $3 billion with over 19.4 million patients diagnosed [61] - TearCare is an FDA-cleared interventional therapy designed to treat MGD by restoring gland functionality [76] - Clinical trials (SAHARA RCT) have shown TearCare to be superior to Restasis in tear break-up time improvement [84] Financial Performance and Strategy - The company projects full year 2025 revenue between $72 million and $76 million and adjusted operating expenses between $101 million and $105 million [96] - Strategic initiatives focus on expanding OMNI utilization and TearCare access and adoption [98]

Core Insights - Glaukos Corporation (GKOS) reported a record-breaking first-quarter 2025 performance with revenues of $106.7 million, a 25% year-over-year increase, primarily driven by the adoption of the iDose TR implant [1][8] - The company reaffirmed its full-year revenue guidance of $475-$485 million, indicating confidence in its commercial momentum [1] Near-Term Growth Drivers - The iDose TR launch is gaining traction, with U.S. glaucoma sales increasing by 41% year-over-year, contributing nearly $21 million in the first quarter, reflecting an $85 million annualized run rate [3] - Internationally, Glaukos achieved $29 million in interventional glaucoma sales, a 15% year-over-year increase, supported by the growing acceptance of minimally invasive glaucoma surgery (MIGS) [4] Long-Term Growth Catalysts - Glaukos has a robust R&D pipeline with key programs including Epioxa, iDose Trex, PRESERFLO MicroShunt, and GLK-401, which are expected to broaden the company's addressable market in the next three to five years [5][6] - The company is cultivating standalone use of MIGS devices like iStent infinite, anticipating long-term growth as more surgeons adopt interventional glaucoma practices [7] Challenges and Watchpoints - Reimbursement complexities and LCD restrictions are impacting legacy stent sales, which declined mid-single digits in the first quarter, with expectations of continued pressure through 2025 [8][9] - Sales of Photrexa remain muted due to the Medicaid Drug Rebate Program, with near-term growth in this segment expected to be flat to low-single digits [10] Competitive Landscape - The iDose TR launch positions Glaukos ahead in procedural glaucoma drug delivery, but competition from Alcon, Johnson & Johnson, and Sight Sciences remains significant [11] - Year-to-date, Glaukos shares have declined by 31.7%, underperforming its rivals in the MIGS space, while Alcon and J&J have seen increases [12]

Summary of the Conference Call Company and Industry Overview - The conference call involved **Site Sciences**, focusing on the **surgical glaucoma** and **dry eye** treatment markets, particularly the **minimally invasive glaucoma surgery (MIGS)** segment and the **TearCare** product for dry eye treatment [1][2][18]. Key Points on Surgical Glaucoma - **First Quarter Performance**: Surgical glaucoma revenue was initially guided to decline by 10-15% year-over-year but only decreased by 6%, indicating better-than-expected performance [2][26]. - **MIGS Environment**: The company is navigating a dynamic MIGS environment due to new restrictions limiting the combination of multiple MIGS procedures during cataract surgery, which has led to a decline in claims for these devices [3][4]. - **Product Performance**: Both **Omni** and **Scion** devices are performing slightly better than expected, with Omni's strong clinical efficacy and surgeon preference contributing to its market share [4][10]. - **Market Dynamics**: The transition to a one MIGS world is ongoing, with Omni positioned well due to its comprehensive functionality, allowing it to address multiple points of resistance in the outflow pathway [6][7]. - **Claims Data**: The volume of visits involving multiple MIGS procedures has dropped from 15% to 5%, indicating a significant shift in the market [11][12]. - **Long-term Growth Potential**: The market for MIGS is not fully penetrated, with significant opportunities in the combination cataract segment, as many patients undergoing cataract surgery are not receiving MIGS [18][19]. Key Points on Dry Eye Treatment - **TearCare Opportunity**: The company is focused on pioneering a new category of interventional dry eye treatment, addressing the underlying causes of dry eye disease, particularly obstructed meibomian glands [42][45]. - **Payer Discussions**: Productive conversations with payers are ongoing, with expectations for coverage policies and payment decisions to begin in 2025 [45][46]. - **Market Size**: There are over 19 million diagnosed patients with dry eye disease in the U.S., with a significant portion suffering from moderate to severe conditions, representing a large market opportunity [55][57]. - **Procedure Volume Potential**: The company estimates a potential for 7-8 million patients to undergo one or two procedures annually, depending on reimbursement rates [56][57]. - **Existing Infrastructure**: Site Sciences has a lean but experienced sales team ready to ramp up once reimbursement decisions are made, with over 1,500 trained smart hubs in place [49][50]. Additional Insights - **Competitive Landscape**: The introduction of new competitors, such as the Via 360 device, is acknowledged, but the company remains confident in the Omni product line and its ongoing innovations [31][34]. - **Market Education**: There is a need for continued education among surgeons regarding the importance of MIGS in the treatment paradigm to increase adoption rates [25][24]. - **Long-term Confidence**: The company expresses confidence in the long-term growth of both the MIGS and dry eye markets, emphasizing the importance of addressing unmet patient needs [20][21].

Financial Data and Key Metrics Changes - Total revenue for the first quarter of 2025 was $17.5 million, reflecting a 9% decrease compared to the same period in the prior year [20] - Surgical glaucoma revenue was $17.1 million, a decrease of 6% year-over-year, primarily due to a 10% decline in account utilization [20] - Dry eye revenue was $400,000, down from $1 million in the same period last year, attributed to fewer SmartLids sales following a price increase [21] - Gross margin for the first quarter was 86%, unchanged from the prior year [21] - Net loss for the quarter was $14.2 million, or $0.28 per share, compared to a net loss of $16.3 million, or $0.33 per share, in the first quarter of 2024 [22] Business Line Data and Key Metrics Changes - Surgical glaucoma segment showed a revenue of $17.1 million, with a slight decline in sequential ordering accounts despite new Medicare restrictions [11][20] - Dry eye segment revenue was $400,000, reflecting a focus on market access and new pricing strategies [17][21] Market Data and Key Metrics Changes - The MIGS market is experiencing changes due to new Medicare coverage restrictions, limiting the number of MIGS procedures performed during cataract surgery [10][20] - The company is actively working to establish third-party manufacturing lines outside of China to mitigate tariff impacts [9][25] Company Strategy and Development Direction - The company aims to build commercial momentum in the MIGS market through customer education, equitable reimbursement, and new clinical data [8][16] - Focus on advancing the product pipeline, including the recent launch of the next-generation OmniEdge [13][15] - The long-term strategy includes pioneering interventional procedures for moderate to severe meibomian gland disease (MGD) in the dry eye market [16] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the demand for glaucoma treatment and the ability to adapt to the new MIGS environment [11][20] - The company reaffirmed its revenue guidance for 2025, expecting total revenue of approximately $70 million to $75 million [23][24] - Management is optimistic about the potential for reimbursement coverage decisions for tier care procedures in 2025 [44][68] Other Important Information - The company is awaiting a final ruling on a patent infringement case against Alcon, which could impact future financials [22] - Adjusted operating expenses for 2025 are expected to be between $101 million and $105 million, reflecting a focus on fiscal discipline [26] Q&A Session Summary Question: Trends in surgical glaucoma and share dynamics - Management noted a decline in actual utilization due to new Medicare restrictions but emphasized the continued reliance on the Omni product for its comprehensive efficacy [30][31] Question: Efforts to reverse the stacking component of LCDs and competition - Management acknowledged ongoing efforts to collect clinical data supporting multiple MIGS procedures and discussed competitive dynamics in the MIGS market [34][35][39] Question: Reimbursement mechanics for Omni versus competitors - Management indicated that reimbursement dynamics remain largely unchanged, with the majority of procedures still performed as single MIGS [42] Question: Update on tier care reimbursement - Management confirmed no coverage determinations have been made yet but expressed optimism about ongoing discussions with payers [44][45][68] Question: Scion product performance and revenue contribution - Management stated that Scion is a modest portion of total revenue, primarily serving as a complementary product to Omni [48][49] Question: Tariff impact and mitigation strategies - Management expects minor impacts to gross margin in 2026 as new manufacturing locations are phased in [52][53] Question: Outlook for device intensive qualification - Management refrained from speculating on device intensive qualification but expressed strong conviction that the device should qualify based on procedure costs [57] Question: Revenue cadence and pricing strategy - Management expects sequential revenue growth in the second quarter, with a typical seasonal pattern throughout the year [60][80]

Core Viewpoint - Sight Sciences, Inc. has launched the OMNI Edge Surgical System, enhancing its OMNI product family with advanced features for minimally invasive glaucoma surgery (MIGS) [1][2][5] Product Features - OMNI Edge incorporates TruSync™ technology, which synchronizes viscoelastic delivery with the surgeon's control, allowing for consistent deployment along Schlemm's canal [2][13] - The system features an expanded viscoelastic capacity of 21 µL, nearly double the previous 11 µL capacity of the OMNI Surgical System, while maintaining safety and usability [2][13] - OMNI Edge is designed to treat all three areas of resistance in the aqueous outflow system, making it versatile for various stages of primary open-angle glaucoma (POAG) [2][7] Clinical Insights - Early clinical use of OMNI Edge has been positively received, with enhancements in ergonomics and predictability noted by practitioners [3] - The OMNI procedure has demonstrated safety, effectiveness, and durability in over 300,000 procedures, establishing its leadership in canal-based MIGS [4] Market Position - The introduction of OMNI Edge allows surgeons to choose between OMNI and OMNI Edge technologies, catering to diverse surgical preferences and patient needs [5] - OMNI Edge is currently available only in the United States, indicating a focused market strategy [5] Company Commitment - Sight Sciences emphasizes its dedication to innovation in glaucoma care through ongoing collaboration with the ophthalmic community [4]

Financial Data and Key Metrics Changes - In Q4 2024, total revenue was $19.1 million, reflecting a 2% increase compared to the same period in the prior year [10][36] - Surgical glaucoma revenue for Q4 2024 was $18.8 million, up 9% year-over-year, driven by a 7% increase in ordering accounts and a 6% increase in account utilization [37][16] - Dry eye revenue for Q4 2024 was $0.3 million, a decrease from $1.6 million in the same period last year, primarily due to fewer SmartLid sales [38][36] - Gross margin for Q4 was 87%, an increase from 85% in the prior year, mainly due to an improved surgical glaucoma product mix [39] - The net loss for Q4 was $11.8 million, or $0.23 per share, compared to a net loss of $10.7 million, or $0.22 per share for Q4 2023 [39] Business Line Data and Key Metrics Changes - Surgical glaucoma revenue grew 9% year-over-year, despite headwinds from new Medicare LCDs [16][37] - The number of customers ordering surgical glaucoma products increased by 3% sequentially and 7% year-over-year [38] - The dry eye segment is focused on achieving reimbursed market access, with a significant decline in revenue due to strategic shifts [36][25] Market Data and Key Metrics Changes - The MIGS market has faced challenges due to new Medicare LCDs, impacting the ability to bill for multiple MIGS procedures [17][19] - Despite short-term declines in MIGS utilization, the company anticipates long-term growth driven by increasing patient demand for glaucoma treatment [19][42] - The company estimates over 13 million U.S. patients are diagnosed with Meibomian gland disease, indicating a significant market opportunity for TearCare [25] Company Strategy and Development Direction - The company aims to build commercial momentum in MIGS and establish equitable reimbursement for TearCare, focusing on customer education and engagement [13][34] - Plans for 2025 include launching the next-generation Omni Edge and continuing to develop the Pseudophakic standalone market [21][45] - The company is committed to addressing the unmet needs in glaucoma and dry eye markets through innovative interventional technologies [11][32] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving cash flow break-even without raising additional equity capital [35] - The company expects 2025 to be transformational, anticipating positive coverage decisions for TearCare [14][41] - Management acknowledged the impact of tariffs on gross margins and operational results, while planning to mitigate these costs through various adjustments [44][45] Other Important Information - The company ended Q4 with $120.4 million in cash and cash equivalents and $40 million in debt [40] - The company has not yet received monetary damages from a patent infringement case against Alcon, with the final ruling pending [41] Q&A Session Summary Question: How is market development on the standalone MIGS market going? - Management noted good momentum in capturing broader adoption of interventional mindset in glaucoma care, with ongoing education efforts [48][51] Question: Can you provide updates on TearCare reimbursement claims? - Management reported increasing volume of claims with some early traction from specific payers, but standardization is still lacking [58][61] Question: What are the trends in surgical glaucoma since the new LCDs? - Management indicated that trends are tracking as expected, with good engagement from customers on where OMNI fits into treatment paradigms [66][70] Question: How is the competitive landscape affecting OMNI volumes? - Management expressed confidence in OMNI's strong market position despite new entrants, emphasizing the importance of clinical evidence and usability [115][117]