Institutional ticker directory tracking stock mentions, long/short ideas, and high-conviction pitches extracted from quarterly hedge fund letters.
| Ticker | Company | Sector | Industry | Pitches | Stance |
|---|---|---|---|---|---|
| Fund / Manager | Thesis Excerpt | Stance | Period / Date | Action |
|---|---|---|---|---|
Rodrigo Benedetti Rodrigo | “Rxsight (RXST) This company sells intraocular lenses (IOLs). When you get eye surgery to fix your vision, normally you get your cornea sliced to adjust your dioptres and compensate for the crystalline deformation. When it comes to IOLs (widely used in cataracts as slicing the cornea won't help) they get your natural lens out and put in a new artificial one. You won't believe me, but cataracts were being treated in the early antiquity. Back then, the only solution was to push the crystalline down into the eye, basically getting rid of the cloudy lens and allowing some kind of vision (the lens is there for a reason, a lot myopia is the normal outcome, and many times, zero vision). Of course, the intervention was only considered when the cataract was very very advanced, basically making those people as good as blind. Anyhow, come modernity, we now replace the lens. Thanks innovation, we have plenty to choose from as the replacement: Conventional (monofocal IOL): Our natural lens is partly the tool that allows us to focus so we can see things that are 1 meter away as well as things that are 20 meters away, despite the light having a different angle. With monofocal IOL, that ability is “lost” and you rely on glasses to adjust to short and long term ranges. These lenses don't correct presbyopia or astigmatism. These are the cheaper ones. Multifocal IOLs: These are more advanced lenses implanted during cataract or refractive surgery that provide vision at multiple distances, reducing or eliminating the need for glasses. Your ability to “focus” is still lost, but the lenses use concentric rings or segmented zones with different focal powers to allow the brain to adapt and select the appropriate focus depending on the visual task. While many patients achieve good spectacle independence, some may experience halos, glare, or reduced contrast sensitivity, especially at night. Astigmatism-Correcting or Toric Intraocular Lenses (IOLs): Toric IOLs are specially designed to correct pre-existing corneal astigmatism. Unlike standard monofocal lenses, toric IOLs have different optical powers in different meridians of the lens to neutralize the uneven curvature of the cornea. They must be precisely aligned during surgery to be effective. By correcting astigmatism at the time of lens implantation, they often reduce or eliminate the need for glasses or contact lenses for distance vision. Patients would still require glasses unless combined with multifocal technology. The last two, fix different problems, multifocal IOLs allow for a reduced or nil use of glasses, but sometimes create halos and need replacement (yes another surgery) and the Toric lenses fix an existing vision problem, these technologies can be combined. That gets us to what we can call the “premium IOL” market, of which RxSight has 10% share with their solution, the Light Adjustable Lens (LAL), from the 10K: RxSight's LAL system enables precise, non-invasive post-surgical customization of the intraocular lens (IOL) using UV light. The LAL is made from a proprietary silicone polymer containing photo-reactive macromers that can be reshaped after implantation. Following cataract surgery, a doctor uses the Light Delivery Device (LDD) to project UV light patterns that adjust lens shape and power in-office, based on the patient's visual preferences. This iterative process allows up to three adjustments for optimal vision without additional surgery. The LAL offers superior accuracy in correcting refractive errors, including astigmatism, with minimal glare or halos—common drawbacks of multifocal IOLs. For surgeons, it reduces reliance on preoperative measurements and enhances practice profitability. For patients, it delivers customized, high-quality visual outcomes with broad distance coverage and high satisfaction. Clinical studies show LALs outperform conventional IOLs in uncorrected vision, making RxSight a disruptive solution in premium cataract care. The LALs offer two advantages over other premium IOLs. First, you don't rely on a previous measurement of a vision problem to correct it, you can adjust post implantation and most importantly, can adjust further if the vision problem evolves without a new surgery, basically buying insurance in case your vision changes. Second, the halo effect and glare typical of the multifocal IOLs is less prevalent. The LALs work as a plain monofocal, it has no rings that split light and cause halos. What makes it special is the silicone matrix that can be reshaped with the LDD weeks after the eye has healed. Adjustments with the LDD replace the “extra focal points” of multifocals: instead of sending part of the light to near, the lens refocuses all of the light where the patient wants it. Some patients still need glasses for long night drives or really small print. All that text wall just to justify the belief that they have a premium product, that it is probably the best option in the market, but the extra cost might not be worth it for everyone. What I mean is that this product is worth something. Maybe the final penetration rate is today's 10%, maybe it goes up to 20% or higher. I don't know, but the uniqueness of the product is there. This is the enterprise value of the company: This is the EV/S: And these are some financial metrics: We can see someone got excited in 2024 and the company raised $110mm at $53 per share in may 2024. The company has almost $230mm in cash for a $530mm market cap. I know that the savvy readers are pointing at that Q1 revenue drop and asking, what's going on. Let me tell you, it's not only that Q1 revenues dropped, a metric that shows the health of the product, which is LALs installed per LDD machine dropped YoY (I like to think of that metric as the LFL for retail companies, it's good to grow opening new stores, but the sales per store going down is a sign of trouble. Thank god RXST fixed costs don't depend on the number of LDDs around though). I want to turn you off a bit more, showing you how the company approached the missed Q1 guidance. 25th of February they reaffirm guidance, then just after the end of the quarter they pull this: How bad was March that they had to cut guidance by 15%? Why did that decel in March happen? Those are the questions the thesis boils down to. The company says that the macro uncertainty made their clients pull out of the market, as well as launches by two competitors of premium IOLs (not LALs) that went aggressively to market in a non economical way that, according to management, is not sustainable. This was said during the Q1 CC: Two for me. First, Shelley, I just want to make sure I heard you right. I think you said second quarter will be below the low end of the range. Does that mean we're looking at something less than $38 million in sales in 2Q? Shelley Thunen (CFO) Oh, I didn't get that specific at all. I didn't give guidance on the second quarter. What I did say is that as we go through the year, I would expect second quarter to not be the type of quarter we've typically seen with a big uptick and that most of the growth on the LAL side will happen in the second half. What Ron did say is that we saw encouraging signs as we exited April in terms of volume getting better. And so, I'm just being cautionary on the second quarter, just given the macroeconomics and some market turmoil and giving us time for consumers to not necessarily -- they haven't been harmed, but people tend to stand still until they know how something is going to affect them. So we think more of that will happen in the second half and also that trialing will start to abate in the third quarter. The company has been to several Conferences after the Q1 earnings call and they don't sound upbeat about Q2. In fact, they are pointing out at the second half and are “hopeful”. This company is however barely burning cash (the losses are mostly SBC) and they do have a premium product with 10% of the high end IOL market while trading at less than 2 times revenues. My bet is that this company is not going away, that growth might pick up (if fact, macro has gotten quite better since April), that the shareholders have stopped liquidating their holdings and the stock might go up again. The bear case is that Q2 is bad, they guide down the year and you start wondering whether the 2023 and 2024 growth was due to some other reason than the goodness of the product. Then the time to reevaluate will come and probably sell. Despite that, I own shares and I think at this valuation the risk reward is good. I am also short puts 12.5 strikes that I think given the cash pile makes them a nice bet. I have found that puts are not efficiently priced when companies have a big to huge percentage of the market cap in cash and no debt. BSD Analysis: RxSight is disrupting cataract treatment with a technology that allows post-surgery vision customization, which is exactly the kind of “quality-of-life” innovation patients will pay for. The story is compelling because it improves outcomes and reduces the guesswork that exists in traditional lens selection. Adoption is still scaling, and the biggest driver is surgeon workflow integration and patient awareness—once clinicians are comfortable, utilization can rise quickly. The bear case is that reimbursement, competition, or adoption friction slows the ramp, which would hit valuation hard. The bull case is that RxSight becomes a category standard in premium cataract procedures, expanding the installed base and driving recurring revenue from consumables. Execution risk is real, but the clinical value proposition is intuitive. If uptake continues, operating leverage can be substantial.” | BULL | Q2 2025 Jun 30, 2025 | View Pitch |
Each excerpt above is the manager's commentary on this ticker specifically. The full letter has the rest of their portfolio thinking, risk discussion, and broader institutional context.
