Sight Sciences Inc (SGHT) 2023 Q3 法說會逐字稿

Ladies and gentlemen, thank you for standing by. Welcome to the Sight Sciences, third quarter 2023 earnings results call. (Operator Instructions) Please be advisor today's conference is being recorded. I would like now to turn the conference over to your speaker today, Trip Taylor, Investor Relations. Please go ahead.

女士們先生們，謝謝你們的支持。歡迎參加 Sight Sciences 2023 年第三季財報電話會議。 （操作員指示）請指導，今天的會議正在錄製。我現在想把會議交給今天的演講者，投資者關係部 Trip Taylor。請繼續。

Thank you for participating in today's call. Presenting today or Sight Sciences, Co-Founder and Chief Executive Officer, Paul Badawi, Chief Financial Officer, Ali Bauerlein and Chief Commercial Officer, Matt Link.

感謝您參加今天的電話會議。今天介紹的是 Sight Sciences 聯合創始人兼執行長 Paul Badawi、財務長 Ali Bauerlein 和首席商務長 Matt Link。

Earlier today, Sight Sciences released financial results for the three months ended September 30, 2023. A copy of the press release is available on the company's website at investors.sightsciences.com.

今天早些時候，Sight Sciences 發布了截至 2023 年 9 月 30 日的三個月財務業績。新聞稿的副本可在該公司網站 Investors.sightsciences.com 上取得。

I'd like to remind everyone that comments made by management today and answers to questions will include forward-looking statements within the meaning of the federal securities laws. Those include statements related to Sight Sciences' anticipated financial performance and operating results, cost savings initiatives, market opportunity, business and product reimbursement strategy, clinical trial results and plans for developing and marketing new products.

我想提醒大家，管理層今天發表的評論和對問題的回答將包括聯邦證券法含義內的前瞻性陳述。其中包括與 Sight Sciences 的預期財務表現和經營業績、成本節約計劃、市場機會、業務和產品報銷策略、臨床試驗結果以及開發和行銷新產品的計劃相關的聲明。

Forward-looking statements are based on estimates and assumptions as of today are neither promises nor guarantees and are subject to risks and uncertainties that may cause actual results to differ materially from those expressed or implied by these statements.

前瞻性陳述是基於截至目前的估計和假設，既不是承諾也不是保證，並且存在風險和不確定性，可能導致實際結果與這些陳述明示或暗示的結果有重大差異。

A description of some of the risks and uncertainties that could cause actual results to differ materially from those indicated by the forward-looking statements on this call can be found in the Risk Factors section of the company's public filings with the Securities and Exchange Commission. The Company undertakes no obligation to publicly update or revise any forward-looking statements, except as required by law.

有關可能導致實際結果與本次電話會議中前瞻性陳述所表明的結果存在重大差異的一些風險和不確定性的描述，可以在該公司向美國證券交易委員會提交的公開文件的風險因素部分中找到。除法律要求外，本公司不承擔公開更新或修改任何前瞻性聲明的義務。

On this call, management may refer to financial measures that were not prepared in accordance with generally accepted accounting principles in the United States, including adjusted operating expenses because we believe these non-GAAP financial measures are important indicators of operating performance because they exclude items that are unrelated to and may not be indicative of its core operating results since the company's earnings release for a reconciliation of these non-GAAP financial measures to the most directly comparable GAAP measures.

在這次電話會議上，管理階層可能會提及未依照美國公認會計原則編製的財務指標，包括調整後的營運費用，因為我們認為這些非公認會計準則財務指標是營運績效的重要指標，因為它們排除了以下項目：自公司發布收益報告以來，這些非公認會計原則財務指標與最直接可比較的公認會計原則指標之間的調節與其核心經營績效無關，也可能不代表其核心經營績效。

I will now turn the call over to Paul.

我現在將把電話轉給保羅。

Thanks, Trip, Sight Sciences is, mission is to elevate the standard of care for glaucoma and dry eye patients by providing doctors with market-leading interventional technologies focused on the preservation of site and improving the quality of life for all patients, we are confident that we are redefining the glaucoma and dry eye treatment paradigms.

謝謝，Trip，Sight Sciences 的使命是透過為醫生提供市場領先的介入技術來提高青光眼和乾眼患者的護理標準，專注於保護部位並提高所有患者的生活質量，我們有信心我們正在重新定義青光眼和乾眼症的治療範例。

To continue these efforts currently, our main focus is on establishing maintaining and enhancing market access to our innovative technologies and clinically effective procedures to ensure the best treatment options are available to all patients based on the clinical efficacy profile of our products, coupled with demonstrated integration into routine clinical practice, we strongly believe our surgical glaucoma product should continue to have broad reimbursed access.

目前，為了繼續這些努力，我們的主要重點是建立維持和增強我們的創新技術和臨床有效程序的市場准入，以確保根據我們產品的臨床療效概況以及經過驗證的整合，為所有患者提供最佳的治療選擇在常規臨床實踐中，我們堅信我們的青光眼手術產品應該繼續獲得廣泛的報銷。

Turning to discuss where we stand with market access in our surgical glaucoma segment, we were extremely disappointed with the final LCD that was published by WPS on October 26, that identified certain procedures as investigational in patients over the age of 18 for glaucoma management, including canaloplasty in combination with trabeculotomy ab interno, to the procedural description WPS associated with OMNI.

談到我們在青光眼手術領域的市場准入方面，我們對 WPS 於 10 月 26 日發布的最終 LCD 感到非常失望，該最終 LCD 確定某些程序對 18 歲以上患者進行青光眼治療的研究，包括管道成形術與內部小梁切開術結合，符合與OMNI 相關的WPS 程序描述。

We strongly disagree with the LCDs coverage limitations with respect to these procedures and we are pursuing all remediation possibilities to maintain Medicare coverage in the states administered by WPS. We do not have any further updates at this time about the draft LCDs published by the other formats in June. If these proposed LCDs are implemented as currently drafted, many non-implantable mixed technologies would be considered investigational and non-covered for Medicare beneficiaries in the states administered by these MACs.

我們強烈不同意 LCD 在這些程序方面的承保範圍限制，並且我們正在尋求一切補救措施，以維持 WPS 管理的各州的 Medicare 承保範圍。目前我們還沒有關於 6 月其他格式發布的 LCD 草案的任何進一步更新。如果這些建議的 LCD 按目前起草的方式實施，許多非植入式混合技術將被視為研究性技術，並且不屬於這些 MAC 管理的州的 Medicare 受益人的承保範圍。

We believe coverage for OMNI is supported by a significant body of peer-reviewed clinical evidence, demonstrating consistent safety and efficacy, a broad FDA-cleared indication for use for IOP lowering in adults with POAG, primary open-angle glaucoma and broad adoption by ophthalmic surgeons. We strongly disagree with the LCD and are working tirelessly to prevent loss of coverage for canaloplasty in combination with trabeculotomy ab interno.

我們相信OMNI 的覆蓋範圍得到了大量同行評審臨床證據的支持，證明了一致的安全性和有效性，FDA 批准了廣泛的用於降低POAG、原發性開角型青光眼成人眼壓的適應症，並被眼科廣泛採用外科醫生。我們強烈不同意 LCD，並正在不懈地努力，以防止與內小梁切開術相結合的管道成形術的覆蓋範圍喪失。

With regard to our SION Technology used for goniotomy procedures, we are seeking further clarity as to whether it falls within the coverage limitations of WPS' final LCD as well as the other draft LCD, GEMINI 2 a prospective multi-center study to obtain 36-month follow-up for patients treated in the original 12-months. GEMINI study has been completed and favorable results demonstrate sustained IOP and medication reduction at 36-months for OMNI.

關於我們用於前房角切開術的SION 技術，我們正在尋求進一步明確它是否屬於WPS 最終LCD 以及其他LCD 草案GEMINI 2 的覆蓋範圍限制，GEMINI 2 是一項前瞻性多中心研究，旨在獲得36-對原來接受治療的患者進行12個月的追蹤。 GEMINI 研究已經完成，良好的結果表明 OMNI 在 36 個月內持續降低眼壓和藥物治療。

These results have been submitted for peer-review publication, and we expect they will be published in the coming months, which will add further long-term evidence of the safety and effectiveness for OMNI that we believe should meet WPS coverage requirements. They'll be deemed medically necessary and reasonable. Our position is that WPS should pause implementation of its final LCD and the other format should institute a temporary hold on publishing additional future effective makes LCDs to allow for full consideration of multiple missing studies pending studies for GEMINI 2 and IRIS Registry data as well as resolution of what we believe are material substantive and procedural flaws in the WPS LCD and LCD process.

這些結果已提交同行評審發布，我們預計它們將在未來幾個月內發布，這將為 OMNI 的安全性和有效性提供進一步的長期證據，我們認為這些證據應滿足 WPS 覆蓋範圍要求。它們將被認為在醫學上是必要且合理的。我們的立場是，WPS 應暫停實施其最終 LCD，而其他格式應暫時停止發布其他未來有效的 LCD，以便充分考慮多項缺失的研究，待對 GEMINI 2 和 IRIS 註冊數據和解決方案進行研究我們認為WPS LCD 和LCD 製程存在重大實質和程序缺陷。

As a result of the uncertainty in the reimbursement environment we are also actively taking steps to protect our cash reserves and reduce our operating expenses while driving enhanced focus on our key strategic priorities.

由於報銷環境的不確定性，我們也積極採取措施保護我們的現金儲備並減少營運費用，同時更加關注我們的關鍵策略優先事項。

Separately, as part of our long-term market access strategy back in May of this year, we applied to CMS to establish new procedure codes and assign them to new technology, ambulatory payment classifications or new technology, APCs for the unique multimodal and comprehensive interventional procedures enabled by our OMNI technology, which we call TCOR for trabecular cannula killer outflow restoration new technology, APC designation is provided by CMS to establish payment for facilities like hospitals and ASCs for procedures that are not fully and appropriately reported with existing codes.

另外，作為我們今年5 月長期市場准入策略的一部分，我們向CMS 申請建立新的程序代碼，並將其分配給新技術、流動支付分類或新技術、APC，用於獨特的多模式和綜合介入治療我們將 OMNI 技術稱為 TCOR，用於小梁插管殺手流出恢復新技術，APC 指定由 CMS 提供，用於為醫院和 ASC 等設施支付現有代碼未完全正確報告的程序。

We believe the TCOR procedure falls squarely into this category in our applications. We requested that CMS create three new C-codes to describe the standalone TCOR procedure and the TCOR procedure. One performed in conjunction with routine or complex, cataract surgery.

我們相信 TCOR 程式在我們的應用中完全屬於這一類。我們要求 CMS 建立三個新的 C 程式碼來描述獨立 TCOR 流程和 TCOR 流程。一種與常規或複雜的白內障手術結合進行。

We also requested that CMS assigned the standalone TCOR procedure and combination cataract TCOR procedures to new technology APCs, consistent with the cost data and invoices provided to CMS associated with furnishing these procedures, we are awaiting feedback from CMS on our requests to establish new C- codes as part of the new technology APC designation process. CMS issued these determinations on a rolling quarterly basis.

我們還要求 CMS 將獨立 TCOR 程序和組合白內障 TCOR 程序分配給新技術 APC，與向 CMS 提供的與提供這些程序相關的成本數據和發票一致，我們正在等待 CMS 關於我們建立新 C-的請求的反饋代碼作為新技術APC 指定過程的一部分。 CMS 按季度滾動發布這些決定。

In summary, we believe WPS should pause implementation and revise its final LCD. The other format should stay their publication and revised future effective mix LCDs and CMS should create new C-codes to describe TCOR. While we do not control the timing or ultimate outcomes, we believe the evidence clearly and convincingly supports continued fair access to our OMNI technology for patients and providers.

總之，我們認為 WPS 應該暫停實施並修改其最終 LCD。其他格式應保留其出版物，並修訂未來的有效組合 LCD 和 CMS 應創建新的 C 代碼來描述 TCOR。雖然我們無法控制時間或最終結果，但我們相信證據清楚且令人信服地支持患者和提供者繼續公平地使用我們的 OMNI 技術。

On other fronts in one of the more exciting clinical developments for OMNI this year, we collaborated with Verona Health to leverage the AAOS, IRIS Registry to better understand the clinical value proposition of mixed technologies in real world settings on a very large scale.

在 OMNI 今年更令人興奮的臨床開發之一的其他方面，我們與 Verona Health 合作，利用 AAOS、IRIS 註冊來更好地了解混合技術在現實世界環境中大規模的臨床價值主張。

We believe this represents the most comprehensive mixed data set ever assembled. Verona Health compiled data from over 100,000 glaucoma patient eyes to evaluate long-term two year post-surgical outcomes for the three most commonly used FDA approved or cleared makes devices in the United States as well as cataract surgery alone.

我們相信這代表了有史以來最全面的混合數據集。 Verona Health 收集了超過 100,000 名青光眼患者眼睛的數據，以評估美國 FDA 批准或批准的三種最常用製造設備以及白內障手術的術後兩年的長期結果。

9,000 of these eyes were treated with either OMNI, Hydrus Microstent or iStent Inject combined with cataract surgeries. The remaining eyes received cataract surgery alone. The complete details of the study have been submitted and under peer-review by a top tier journal at the two year endpoint and in the full OMNI cohort of 428 patients and 541 eyes treated specifically with OMNI technology, the TCOR procedure delivered clinically and statistically significant improvements in mean IOP and medication reduction.

其中 9,000 隻眼睛接受了 OMNI、Hydrus Microstent 或 iStent Inject 合併白內障手術的治療。其餘眼睛僅接受白內障手術。研究的完整細節已提交，並由頂級期刊在兩年終點進行同行評審，在由428 名患者和541 隻眼睛專門接受OMNI 技術治療的完整OMNI 隊列中，TCOR 手術具有臨床和統計學顯著性平均眼壓的改善和藥物治療的減少。

Moving to the larger cohort of all patients in the study receiving any of the MAC interventions at the two year endpoint, the TCOR procedure with OMNI technology delivered the numerically greatest IOP and medication reductions compared to Hydrus, iStent inject and cataract surgery alone.

轉向在兩年終點接受任何MAC 幹預的研究中所有患者的更大隊列，與單獨的Hydrus、iStent 注射和白內障手術相比，採用OMNI 技術的TCOR 手術在數值上實現了最大的眼壓和藥物減少。

This study corroborates existing peer-reviewed literature and supports our thesis that technologies that enable comprehensive interventional procedures by targeting the underlying causes of disease in a minimally invasive manner can deliver highly compelling, long-term safety and efficacy outcomes for patients.

這項研究證實了現有的同行評審文獻，並支持我們的論點，即透過以微創方式針對疾病的根本原因來實現全面介入手術的技術可以為患者提供高度引人注目的長期安全性和有效性結果。

This analysis developed from the independent Iris data is extremely valuable and we think it can help inform surgeon decision making when considering treatment options for their glaucoma patients going forward. We expect to continue our work with Verona Health to explore additional datasets, deleverage the IRIS Registry to further validate the clinical efficacy of our technologies.

這項根據獨立 Iris 數據開發的分析非常有價值，我們認為它可以幫助外科醫生在考慮青光眼患者未來的治療方案時做出決策。我們希望繼續與 Verona Health 合作，探索更多資料集，降低 IRIS 註冊的槓桿率，以進一步驗證我們技術的臨床功效。

Turning now to our dry eye business, our TearCare technology can provide safe and effective procedural intervention for millions of patients suffering from meibomian gland disease. The traction generated by our controlled commercial launch in a cash pay environment is evidence of not only the technologies market fit with our eye care provider customers, but also the consumer demand for interventional dry eye procedures, which address the root underlying cause of evaporative dry eye disease with extensive clinical experience and feedback from the market. We believe this demand would accelerate with appropriate insurance reimbursement.

現在轉向我們的乾眼業務，我們的 TearCare 技術可以為數百萬患有瞼板腺疾病的患者提供安全有效的程序幹預。我們在現金支付環境中受控商業發布所產生的吸引力不僅證明了技術市場適合我們的眼科護理提供者客戶，而且證明了消費者對介入性乾眼手術的需求，該手術解決了蒸發乾眼症的根本原因具有豐富的臨床經驗和市場回饋的疾病。我們相信，透過適當的保險報銷，這種需求將會加速。

On our last call, we reviewed the top-line success of our SAHARA RCT six-month results were presented last month at the American Academy of Optometry annual meeting, and we also held an investor event last Friday at the American Academy of Ophthalmology meeting to review these results in more detail.

在我們的最後一次電話會議上，我們回顧了上個月在美國驗光學會年會上公佈的SAHARA RCT 六個月結果的主要成功，我們還在上週五的美國眼科學會會議上舉辦了投資者活動更詳細地查看這些結果。

The SAHARA trial achieved its primary objective six-month endpoint, demonstrating the superiority of interventional islet procedures enabled by TearCare over Restasis prescription eyedrops and the improvement of tear breakup time or IBUT. At all measured time points, one week, one month, three-months and six-months key, but is a key measure of aqueous retention, gear stability and the tear film is ability to protect the ocular surface.

SAHARA 試驗實現了其主要目標 6 個月終點，證明了 TearCare 實現的介入性胰島手術相對於 Restasis 處方滴眼劑的優越性以及淚液破裂時間或 IBUT 的改善。在所有測量的時間點上，一周、一個月、三個月和六個月是關鍵，但關鍵是衡量水瀦留、齒輪穩定性和淚膜保護眼表的能力。

Patients receiving care treatments exhibited statistically significant improvements in TI, but from baseline that increased from a 1.5 second improvement from baseline at one week to a 2.5 second, improvement from baseline at six-months. TearCare and Restasis also delivered comparable clinically and statistically significant improvements at every time point, measured in patient reported outcomes measured by Ocular Surface Disease Index or OSDI scores, the trial's primary subjective endpoint.

接受護理治療的患者在 TI 方面表現出統計上顯著的改善，但與基線相比，從一周時的 1.5 秒改善增加到 6 個月時的 2.5 秒改善。 TearCare 和 Restasis 也在每個時間點提供了可比較的臨床和統計顯著改善，透過眼表疾病指數或 OSDI 評分（試驗的主要主觀終點）衡量患者報告的結果。

We believe the combination of clinical outcomes from this groundbreaking RCT and a rigorous budget impact model that demonstrates the compelling comparative health economic value of TearCare will together serve as the foundational building blocks to achieve fair market access for TearCare.

我們相信，這項突破性隨機對照試驗的臨床結果與嚴格的預算影響模型相結合，證明了 TearCare 具有令人信服的相對健康經濟價值，將共同成為 TearCare 實現公平市場准入的基礎。

We plan to begin payer discussions in early 2024 upon publication of the six-months SAHARA clinical data and completion of our budget impact model. Although the reimbursement process requires considerable time, effort, and investment. We are confident the results of our efforts can improve the lives of the millions of dry eye sufferers, who lack access to effective MGD treatment.

我們計劃在 2024 年初發布六個月的 SAHARA 臨床數據並完成我們的預算影響模型後開始付款人討論。儘管報銷過程需要大量的時間、精力和投資。我們相信，我們的努力成果能夠改善數百萬缺乏有效 MGD 治療的乾眼症患者的生活。

We are happy to be leading the way for this important clinical cause and societal need. Our highest priorities for TearCare are market access, execution, payer education and existing account support. As a result, we have scaled down dry eye commercial resources by approximately 50% to focus more on market access execution and the publication of additional clinical data from SAHARA, such as the one year crossover data that we expect will further enhance our market access initiatives as we await market access wins, we expect dry eye sales in 2024 to be modest as we focus instead on building long-term value through market access and payer education throughout the year.

我們很高興能夠為這項重要的臨床事業和社會需求發揮領導作用。我們對 TearCare 的最高優先事項是市場准入、執行、付款人教育和現有帳戶支援。因此，我們將乾眼商業資源縮減了約 50%，以更多地關注市場准入執行和來自 SAHARA 的其他臨床數據的發布，例如我們預計將進一步加強我們的市場准入計劃的一年交叉數據在等待市場准入勝利的過程中，我們預計2024 年乾眼症銷售額將不大，因為我們將重點放在全年透過市場准入和付款人教育來建立長期價值。

In summary, at Sight Sciences, we create and commercialize interventional technologies and procedures that comprehensively address the underlying causes of eye disease. We have produced substantial body of clinical evidence that demonstrates the clinical value of both our interventional TCOR glaucoma procedure with OMNI technology and interventional dry eye procedures with TearCare technologies.

總之，在 Sight Sciences，我們創造並商業化介入技術和程序，全面解決眼部疾病的根本原因。我們已經提供了大量的臨床證據，證明了我們採用 OMNI 技術的介入性 TCOR 青光眼手術和採用 TearCare 技術的介入性乾眼手術的臨床價值。

Both procedures have demonstrated substantial potential to improve treatment paradigms and elevate the standards of care as we work to maintain and achieve fair market access for both technologies, we are poised to positively impact millions of patients� lives while driving more profitable growth.

這兩種手術都顯示出改善治療模式和提高護理標準的巨大潛力，隨著我們努力維護和實現這兩種技術的公平市場准入，我們準備好對數百萬患者的生活產生積極影響，同時推動利潤更高的成長。

I will now turn the call over to Ali to discuss our financials.

我現在將把電話轉給阿里，討論我們的財務狀況。

Thanks, Paul. Before I go into the third quarter financial results, I wanted to provide additional commentary on our cost reduction initiatives. As we announced in mid-October, we implemented a targeted plan intended to reduce operating expenses, improve cost efficiencies, better align our operating structure for long-term profitable growth and further extend our cash runway.

謝謝，保羅。在介紹第三季財務業績之前，我想對我們的成本削減計劃提供更多評論。正如我們在10 月中旬宣布的那樣，我們實施了一項有針對性的計劃，旨在減少營運費用，提高成本效率，更好地調整我們的營運結構以實現長期盈利增長，並進一步擴大我們的現金跑道。

We reduced our headcount by approximately 10% or 25 employees. Specifically, we reduced our commercial infrastructure and operating expenses within our dry eye business segment, including approximately half of our dry eye sales and marketing employees as we shift our commercial focus to market access, payer education and higher utilization within existing account.

我們減少了約 10% 的員工人數，即 25 名員工。具體來說，我們減少了乾眼業務部門的商業基礎設施和營運費用，包括約一半的乾眼銷售和行銷員工，因為我們將商業重點轉向市場准入、付款人教育和現有帳戶內的更高利用率。

And secondly, we eliminated certain positions in the surgical well from a commercial support infrastructure deemed nonessential to continued surgical glaucoma account penetration and revenue growth. In addition, we reduced our operating expenses principally by implementing measures to limit marketing costs, primarily for TearCare limiting general administrative costs and delaying replacement hires for certain roles.

其次，我們從商業支援基礎設施中取消了手術井中的某些職位，這些基礎設施被認為對於持續的青光眼手術帳戶滲透和收入成長不是必需的。此外，我們主要透過實施限制行銷成本的措施來減少營運費用，主要是針對 TearCare 限制一般管理成本和推遲某些職位的替代招聘。

We estimate the workforce reductions alone will yield savings of approximately $7.9 million on an annualized basis. We also estimate that the other cost savings measures should yield SG&A savings of an additional $5 million on an annualized basis, our total annualized savings of approximately $13 million, with such savings primarily being realized starting in 2024.

我們估計，僅裁員一項就可以每年節​​省約 790 萬美元。我們也估計，其他成本節約措施應能每年額外節省 SG&A 500 萬美元，我們的年化總節省約為 1,300 萬美元，此類節省主要從 2024 年開始實現。

Lastly, given the additional reimbursement uncertainty in our industry, we are evaluating other cost reduction opportunities to extend our cash runway as we have more material information to share, we will provide an update.

最後，考慮到我們行業額外的報銷不確定性，我們正在評估其他降低成本的機會，以擴大我們的現金跑道，因為我們有更多重要資訊要分享，我們將提供最新資訊。

Moving back to the third quarter total revenue for the third quarter was $20 million, representing 7% growth compared to the third quarter of 2022 and at the top end of the guidance range we provided mid-September surgical glaucoma revenues for the third quarter were $18.4 million, up 8% versus the comparable period.

回到第三季度，第三季度的總收入為2000 萬美元，與2022 年第三季度相比增長7%，在我們提供的9 月中旬青光眼手術收入指導範圍的上限中，第三季度的青光眼手術收入為18.4 美元萬元，較去年同期成長8%。

Over 1,100 customers ordered surgical glaucoma products in the third quarter, up 16% compared to the third quarter of 2022, but down 2% from the record second quarter of 2023. Utilization of ordering accounts was relatively flat in the third quarter compared to the same period in the prior year, but down sequentially by approximately 10%.

第三季有超過1,100 名客戶訂購了青光眼手術產品，與2022 年第三季相比成長了16%，但與2023 年第二季創紀錄的水平相比下降了2%。與去年同期相比，第三季的訂購帳戶利用率相對持平與去年同期相比，但環比下降了約 10%。

While our customer retention remained strong, we believe we experienced lower utilization from ordering accounts and lower new account additions than expected, primarily as a result of the uncertainty resulting from the proposed LCDs and more pronounced summer seasonality.

雖然我們的客戶保留率仍然很高，但我們相信，我們的訂購帳戶利用率較低，新帳戶添加量低於預期，這主要是由於擬議的LCD 和更明顯的夏季季節性造成的不確定性。

Well, this impact was higher in the areas covered by the five MACs, we saw an impact to utilization and ordering accounts across all geographic regions. Our dry eye revenues for the third quarter were $1.6 million, down 1% compared to the third quarter of 2022 and down 24% compared to the record second quarter of 2023.

嗯，這種影響在五個 MAC 覆蓋的區域中更大，我們看到了對所有地理區域的利用率和訂購帳戶的影響。我們第三季的乾眼收入為 160 萬美元，比 2022 年第三季下降 1%，比創紀錄的 2023 年第二季下降 24%。

We believe the decline was primarily due to the evolution of our commercial strategy, which emphasizes driving higher utilization within existing accounts as we focus on market access and more pronounced seasonality patterns.

我們認為，這一下降主要是由於我們商業策略的演變，該策略強調提高現有帳戶的利用率，因為我們專注於市場准入和更明顯的季節性模式。

For the third quarter of 2023, we had 318 active dry eye customers, over 40% increase versus the third quarter of 2022. Additionally, we sold 5,090 dry eye treatments lives in the quarter and 8% increases versus the comparable period.

2023 年第三季度，我們擁有318 名活躍乾眼客戶，與2022 年第三季度相比增長了40% 以上。此外，我們在本季度銷售了5,090 個乾眼治療產品，與可比同期相比增長了8%。

Well, both of our core operating metrics for dry eye improved compared to the same period in the prior year. Our total revenue was down 1%, primarily due to fewer new customers added in the period, which led to lower Smart Hub revenue.

嗯，我們乾眼的兩個核心營運指標與去年同期相比都有所改善。我們的總收入下降了 1%，主要是由於該期間新增客戶減少，導致 Smart Hub 收入下降。

Gross margin for the third quarter was 86.6% compared to 84.3% in the same period in the prior year. Our continued strong gross margin was due to improvement in both surgical glaucoma gross margin and dry eye gross margin, surgical glaucoma gross margin improved primarily due to manufacturing efficiencies generated because of higher production volumes, partially offset by lower average selling price due to product mix.

第三季毛利率為86.6%，去年同期毛利率為84.3%。我們持續強勁的毛利率是由於手術青光眼毛利率和乾眼毛利率的改善，手術青光眼毛利率的改善主要是由於產量增加而產生的製造效率，部分被產品組合導致的平均售價降低所抵消。

Dry eye gross margin improved primarily due to lower manufacturing costs and increase of higher gross margin, smart lid versus Smart Hub and higher average selling price of Smart Hub. Total operating expenses for the third quarter were $30.7 million, a decrease of 18% compared to $37.6 million in the third quarter of 2022.

乾眼毛利率的改善主要是由於製造成本的降低和毛利率的提高、智慧蓋與智慧集線器相比以及智慧集線器的平均售價較高。第三季總營運費用為 3,070 萬美元，較 2022 年第三季的 3,760 萬美元下降 18%。

Adjusted operating expenses were $26.8 million for the third quarter, down from $33.3 million in the same period in the prior year and well below expectations of our average quarterly target of $30.5 million. The decrease in operating expenses in the comparable periods was primarily driven by $3.6 million, lower personnel-related expenses, including lower incentive based commission expense of $1.9 million, mostly due to lower than expected revenue and $0.9 million of restructuring costs incurred in the third quarter of 2022 that did not repeat this quarter.

第三季調整後營運費用為 2,680 萬美元，低於去年同期的 3,330 萬美元，遠低於我們 3,050 萬美元的平均季度目標預期。同期營運費用減少主要是由於人事相關費用減少 360 萬美元，其中包括基於激勵的佣金費用減少 190 萬美元，這主要是由於收入低於預期以及第三季度發生的 90 萬美元重組成本2022 年的情況在本季沒有重複。

In addition, we incurred $1.2 million lower clinical trial costs in the third quarter compared to the same period in the prior year R&D expenses were $4.2 million compared to $6.1 million in the third quarter of 2022. SG&A expenses were $26.5 million compared to $31.5 million in the comparable period in the prior year.

此外，與去年同期相比，我們第三季的臨床試驗成本減少了120 萬美元。研發費用為420 萬美元，而2022 年第三季為610 萬美元。SG&A 費用為2,650 萬美元，而2022年第三季為3,150 萬美元。上年可比期間。

Our loss from operations for the third quarter was $13.4 million compared to a loss of $21.8 million in the third quarter of 2022. Our net loss was $13 million or $0.27 per share in the quarter compared to a net loss of $22.2 million or $0.46 per share for the third quarter of 2022.

我們第三季的營運虧損為1,340 萬美元，而2022 年第三季的虧損為2,180 萬美元。本季的淨虧損為1,300 萬美元，即每股0.27 美元，而本季的淨虧損為2,220 萬美元，即每股0.46 美元2022 年第三季。

We ended the quarter with $144.5 million of cash and cash equivalents and $35 million of long-term debt. Excluding debt discounts and amortized debt issuance costs, we used $10 million of cash in the quarter, representing continued operational discipline and a sequential improvement from $12.8 million cash used in the second quarter of 2023.

截至本季末，我們的現金和現金等價物為 1.445 億美元，長期債務為 3,500 萬美元。不包括債務折扣和攤銷債務發行成本，我們在本季度使用了 1000 萬美元現金，這表明我們持續遵守營運紀律，並且比 2023 年第二季度使用的 1,280 萬美元現金有所改善。

Moving the guidance, we are withdrawing our full year 2023 revenue and adjusted operating expense guidance due to the uncertainty caused by the final LCD published by WPS' and the proposed LCDs issued by four other MACs to the lower sales volume. We expect gross margin in the fourth quarter of 2023 to decrease sequentially as overhead cost per unit increase versus the prior period.

由於 WPS 發布的最終 LCD 和其他四家 MAC 發布的擬議 LCD 導致銷售下降，造成不確定性，我們將撤回 2023 年全年收入和調整後的營運費用指引。我們預計 2023 年第四季的毛利率將環比下降，因為每單位管理成本較上一期增加。

However, we still expect gross margin in the fourth quarter of 2023 to increase compared to the same period in the prior year. We expect to record a cash restructuring charge of approximately $1.3 million in the fourth quarter of 2023, related to our reduction in force, consisting primarily of onetime employee severance and benefits contribution costs, which will be excluded from adjusted operating expenses.

不過，我們仍預期 2023 年第四季的毛利率將較上年同期有所成長。我們預計在2023 年第四季將記錄約130 萬美元的現金重組費用，與我們的裁員有關，主要包括一次性員工遣散費和福利繳款成本，這些費用將不包括在調整後的營運費用中。

We plan to continue to be prudent in our spend and identify additional cost reduction opportunities to extend our cash runway now I'll turn it back to Paul for closing remarks.

我們計劃繼續謹慎支出，並尋找額外的成本削減機會來擴大我們的現金跑道，現在我將把它轉回給保羅做結束語。

Thanks, Ali. Our main priorities are maintaining reimbursement for OMNI and SION creating new coding that specifically defines the comprehensive interventional procedure delivered by our OMNI technology, creating a pathway for TearCare reimbursement, optimizing our cost structure and protecting our cash reserves, all while maintaining long-term investments in core research and development projects for the surgical glaucoma and dry eye market.

謝謝，阿里。我們的主要優先事項是維持OMNI 和SION 的報銷，創建新的編碼，專門定義我們的OMNI 技術提供的綜合介入程序，創建TearCare 報銷途徑，優化我們的成本結構並保護我們的現金儲備，同時保持長期投資參與手術青光眼和乾眼市場的核心研發項目。

Before we open the call for Q&A, I want to introduce Matt Link, our new Chief Commercial Officer. Matt is a highly talented MedTech leader with a track record of success, scaling a high growth public medical device company, predictably quarter-after-quarter, when Matt joined NuVasive, a disruptive orthopedics company to transform spine surgery that had similar revenue to Sight Science today, Matt methodically and persistently help lead and scale NuVasive's business over a decade to over $1 billion in revenue, we believe is market development experience with procedurally focused less-invasive solutions utilizing disruptive technology that transform spine surgery is exactly analogous to the procedural transformation of glaucoma and dry eye disease we have undertaken.

在我們開始問答之前，我想先介紹一下我們新任首席商務官馬特·林克(Matt Link)。馬特(Matt) 是一位才華橫溢的醫療技術領導者，擁有成功的記錄，當馬特(Matt) 加入NuVasive 時，他成功地擴大了一家高成長的公共醫療設備公司的規模，這是一家顛覆性的骨科公司，旨在改變脊椎外科手術，該公司的收入與Sight Science 類似今天，Matt 有條不紊、堅持不懈地幫助領導NuVasive 的業務，並將其規模擴大到超過10 億美元的收入，我們相信，利用顛覆性技術改變脊椎手術的程序性微創解決方案的市場開發經驗與手術的程序轉型完全相似。青光眼和乾眼症我們都承擔過。

He has already made a significant impact on our commercial strategy and execution rigor. His leadership will be crucial as we enter our next phase of growth. Matt will now join us for Q&A. Operator, please open the line for questions.

他已經對我們的商業策略和執行嚴謹性產生了重大影響。當我們進入下一階段的成長時，他的領導力將至關重要。馬特現在將加入我們進行問答。接線員，請開通提問線。

Thank you. (Operator Instructions) The first question comes from Margaret Kaczor with William Blair. Your line is open.

謝謝。 （操作員說明）第一個問題來自 Margaret Kaczor 和 William Blair。您的線路已開通。

Hey, good afternoon. Guys. Thanks for taking the questions, maybe just to start, you know, at this point I imagine you've had and at least the few, if not many discussions with your customers on the WPS' update. So just curious if you can give us any sense from a distribution of discussion so far, how many people have indicated they're willing to at least keep using OMNI for patients outside of Medicare? Or are they indicating kind of the other way around where maybe unfortunately, they'll have to pull back on use until there's a more firm reimbursement update?

嘿，下午好。夥計們。感謝您提出問題，也許只是開始，您知道，此時我想您已經與您的客戶就 WPS 更新進行了幾次討論（如果不是很多的話）。因此，我想知道您是否可以從迄今為止的討論分佈中給我們任何啟發，有多少人表示他們願意至少繼續為 Medicare 之外的患者使用 OMNI？或者他們是否表明了另一種方式，也許不幸的是，他們將不得不取消使用，直到有更確定的報銷更新？

Yeah, I can start with that, Margaret and Paul and Matt can join in as needed here. But I think this is a very dynamic environment that we're in. And at this point, most of the industry is still trying to understand what is in that LCD, what does it mean what are the nuances of coverage.

是的，我可以從這裡開始，瑪格麗特、保羅和馬特可以根據需要加入。但我認為我們所處的環境非常活躍。此時，大多數行業仍在試圖了解 LCD 中的內容，這意味著什麼，覆蓋範圍的細微差別是什麼。

So that is really what we're seeing from surgeons at this point is, first of all, seeking to understand. And then second of all, significant disappointment of the lack of coverage for canaloplasty. So it does seem to be the most prominent factors that we're hearing at this point. But it is very early since the LCDs have been published and there is a lot of work being done to train change course here from many parties.

因此，我們現在從外科醫生那裡看到的確實是，首先，尋求理解。其次，對管道成形術的覆蓋範圍缺乏感到非常失望。因此，這似乎確實是我們目前聽到的最突出的因素。但自從液晶顯示器發布以來，現在還為時過早，許多各方正在做大量工作來培訓改變方向。

Yeah, Margaret, we were just completed the American Academy of Ophthalmology annual meeting and I can just say that there was there's so much support from the surgical community. They're passionate, committed. Our OMNI customers, who now for years have relied on OMNI to take care of their glaucoma patients. \

是的，瑪格麗特，我們剛結束了美國眼科學會年會，我只能說外科界給了我們這麼多的支持。他們充滿激情、忠誠。我們的 OMNI 客戶多年來一直依賴 OMNI 來照顧他們的青光眼患者。 \

There is tremendous support from our surgeon community from our societies, state society's, national societies, and we're all rallying behind this to get it to the right place and address these LCDs that would ultimately if they go into effect on takeaway treatment options for glaucoma providers.

我們的外科醫生界從我們的協會、國家協會、國家協會獲得了巨大的支持，我們都在背後團結起來，將其帶到正確的地方並解決這些液晶顯示器問題，如果它們對外賣治療方案生效，最終將解決這些問題。青光眼提供者。

Taking care of glaucoma patients. Again, this is the leading cause of irreversible blindness. So we do need to get this right.

照顧青光眼患者。這又是導致不可逆失明的主要原因。所以我們確實需要把這件事做好。

Okay. That's helpful. And you have a follow-up to that. I'm curious if you guys had any discussions with commercial payers either OMNI proposed MAC rules that funnel that WPS rule at this point and to give us a sense now as maybe they would at least hold potential reimbursement changes should they tried to copy what WPS had said that and maybe just kind of a similar question, have the societies kind of banded together and said "hey, here's our game plan, here's how we can respond more strongly". Thank you.

好的。這很有幫助。您對此有後續行動。我很好奇你們是否與商業付款人進行了任何討論，或者OMNI 提議的MAC 規則在這一點上融合了WPS 規則，並讓我們現在有了一個認識，因為如果他們試圖複製WPS 的內容，他們至少會保留潛在的報銷變更曾經說過，也許只是類似的問題，讓社團聯合起來說「嘿，這是我們的遊戲計劃，這是我們如何做出更強烈的反應」。謝謝。

Yeah. So Margaret, since the proposals, there has not been any change in commercial payers, Cigna around the same time as the proposals, Cigna was doing a diligence on our clinical evidence and did arrive at our coverage a positive coverage determination. So that's one example in the interim over the past several months since we've been in this LCD. process, there hasn't been any change on the commercial side.

是的。因此，瑪格麗特，自提案以來，商業付款人沒有任何變化，Cigna 大約在提案提出的同時，Cigna 正在對我們的臨床證據進行盡職調查，並確實對我們的承保範圍做出了積極的承保決定。這是我們使用 LCD 以來幾個月來的一個臨時例子。流程上，商業方面沒有任何改變。

Commercial payers will regularly go through their annual cycle to review coverage different payers. Summer, some have positive coverage for procedures performed with OMNI, some are silent on it, and none of those policies has changed as far as we know during this period. So far, so good on the commercial front.

商業付款人將定期進行年度週期，以審查不同付款人的承保範圍。在夏季，有些人對 OMNI 執行的手術進行了正面報道，有些人對此保持沉默，據我們所知，在此期間這些政策都沒有改變。到目前為止，商業方面進展順利。

Great. Thank you, guys. Appreciate it.

偉大的。感謝你們。欣賞它。

Thanks.

謝謝。

(Operator Instructions) Yes, the next question comes from Kallum Titchmarsh with Morgan Stanley. Your line is open.

（操作員說明）是的，下一個問題來自摩根士丹利的卡勒姆·蒂奇馬什（Kallum Titchmarsh）。您的線路已開通。

Thanks, guys. I just wondered I know you touched on it briefly. If you could spend some time talking about the steps, you're taking to remediate the current ruling with WPS and just maybe discuss the time lines on any appeals or similar processes here? And then, I'll have one follow-up. Thanks.

多謝你們。我只是想知道我知道你簡短地提到過它。如果您可以花一些時間討論這些步驟，您正在採取措施糾正 WPS 的當前裁決，並可能在此討論任何上訴或類似流程的時間表？然後，我將進行一項後續行動。謝謝。

Yeah, Kallum, it's a collective effort as you can imagine a number of different parties involved a number of different activities. We're working. We're communicating with the MACs directly with WPS with the other four MACs we're working communicating with CMS or communicating with national. Our national societies are communicating with state societies, as you can imagine, with our very strong OMNI surgeon customer base. We're also working with one of our Medical Device Associations, Medical Device Manufacturers Association, MDMA.

是的，卡勒姆，這是一項集體努力，因為你可以想像許多不同的團體參與了許多不同的活動。我們正在工作。我們正在透過 WPS 直接與 MAC 進行通信，而我們正在與 CMS 進行通信或與國家通信的其他四個 MAC 進行通信。正如您可以想像的那樣，我們的國家協會正在與國家協會進行交流，我們擁有非常強大的 OMNI 外科醫生客戶群。我們也與我們的醫療器材協會之一、醫療器材製造商協會 (MDMA) 合作。

So, all stakeholders are aligned here. We feel like we've got tremendous support. We'll be making our arguments to WPS to the other MACs as we've been doing, we're going to continue to do that. And we're very encouraged by how much support from all of those groups I just mentioned and how aligned. We seem to be to get this to the right conclusion.

因此，所有利益相關者都在這裡保持一致。我們感覺我們得到了巨大的支持。我們將像我們一直在做的那樣，向其他 MAC 提出 WPS 的論點，我們將繼續這樣做。我們對我剛才提到的所有這些團體的支持和協調程度感到非常鼓舞。我們似乎要得出正確的結論。

Okay. Great. And then maybe if you could just provide some color around the reorganized commercial teams. What's changed here aside from the reduced headcount and how you're thinking about the commercial teams in those regions with anticipated OMNI coverage removal. Because I know the focus of the cuts so far have been skewed towards the drive business. Thanks a lot.

好的。偉大的。然後也許你可以為重組後的商業團隊提供一些色彩。除了人員數量減少以及您對預期 OMNI 覆蓋範圍刪除的這些地區的商業團隊的看法之外，這裡還發生了哪些變化。因為我知道迄今為止裁員的重點都偏向驅動器業務。多謝。

Yes, this is Matt. Thanks for the question, though. So as Paul covered in the now in the prepared remarks, the reorg was really about restructuring the business in allowing us to be in a place for sustained growth moving forward, thinking less about infrastructure, really more focused on capacity and capability.

是的，這是馬特。不過還是謝謝你的提問。因此，正如保羅在準備好的發言中所提到的那樣，重組實際上是為了重組業務，使我們能夠保持持續增長，減少對基礎設施的考慮，並真正更多地關注產能和能力。

And as independent of the final LCD with WPS and the posted LCD, we have two businesses that are at very different stages. And so focusing on the growth potential of the surgical outcome of business. But as you heard in the ocular surface and TearCare business, really looking at the environment, focusing on market access, but really working with our existing customers to understand and how best to support their efforts towards increasing utilization in the use of the TearCare products.

獨立於 WPS 的最終 LCD 和發布的 LCD，我們有兩項處於截然不同階段的業務。因此，重點關注業務手術結果的成長潛力。但正如您在眼表和TearCare 業務中聽到的那樣，真正著眼於環境，專注於市場准入，但真正與我們現有的客戶合作，了解並最好地支持他們為提高TearCare 產品的利用率而做出的努力。

As we have stated in response to a couple of the different questions, obviously, with the LCD posted by WPS and the other spending, we'll need to continue to re-evaluate how to optimize our structure to respond to the current environment.

正如我們在回答幾個不同問題時所說的那樣，顯然，隨著 WPS 公佈的 LCD 和其他支出，我們需要繼續重新評估如何優化我們的結構以應對當前的環境。

But again, as Paul just covered, we're very encouraged despite the circumstances that there's a universal and overwhelming support from all the he covered off from our individual providers, the academy, other National society, State societies and other surgical and trade organizations that recognize that at least in the case of WPS, they've arrived at what we see and believed to be as a foundationally incorrect decision and so we're focused on working with those other constituents in collaboration to arrive at the right outcome and then turn back to our business and really focus on the scale and growth opportunities we see in front of us.

但是，正如保羅剛才提到的，儘管我們的個人提供者、學院、其他國家協會、國家協會以及其他外科和貿易組織給予了他所涵蓋的所有人普遍和壓倒性的支持，但我們仍然感到非常鼓舞。認識到至少就 WPS 而言，他們做出了我們認為並認為是根本上錯誤的決定，因此我們專注於與其他三方合作，以達成正確的結果，然後轉向回到我們的業務，真正關注我們面前的規模和成長機會。

Very clear. Thanks very much.

非常清楚。非常感謝。

(Operator Instructions) The next question comes from Tom Stephan with Stifel. Your line is open.

（操作員說明）下一個問題來自 Stifel 的 Tom Stephan。您的線路已開通。

Great thanks for the questions. Maybe I'll start with OMNI coverage and really good to see the GEMINI, 36- month data. I think, Paul, you said should be coming in the next couple of months, but can you elaborate a bit on what the LCD reconsideration process entails. And maybe how long that might take once you submit that GEMINI data to at WPS and I guess maybe the others.

非常感謝您的提問。也許我會從 OMNI 覆蓋範圍開始，很高興看到 GEMINI 的 36 個月數據。 Paul，我想您說過應該在接下來的幾個月內完成，但是您能否詳細說明一下 LCD 重新考慮過程需要哪些內容。一旦您將 GEMINI 資料提交給 WPS，可能需要多長時間，我想也許還有其他資料。

Yes, sure, Tom, happy to take that question. So first and foremost, we're focused on trying to reverse course before the LCD is implemented and also and working with other formats to not have those additional LCDs move into a final status until they can consider the information from both GEMINI and the IRIS Registry as well as other missing studies is a on what we deem it as substantial and procedural flaws in the process.

是的，當然，湯姆，很高興回答這個問題。因此，首先也是最重要的，我們專注於在實施 LCD 之前嘗試扭轉方向，並與其他格式合作，以免這些額外的 LCD 進入最終狀態，直到他們可以考慮來自 GEMINI 和 IRIS 註冊表的資訊以及其他缺失的研究是我們認為過程中存在實質和程序缺陷的研究。

But if we do have to go through reconsideration and you cannot submit a reconsideration until an LCD is effective. So after December 24, we could submit a reconsideration request and with new evidence. So we would have to have new information that the MAC had not already considered, and we would submit that through a reconsideration process.

但如果我們確實需要進行複議，並且在 LCD 生效之前您無法提交複議。因此，12 月 24 日之後，我們可以提交複議請求並提供新的證據。因此，我們必須獲得 MAC 尚未考慮的新信息，並且我們將透過重新考慮流程提交該資訊。

That process can vary quite significantly in length based on both complexity as well as MAC availability and other priorities, but that process could take multi-months and in in range. So it certainly is a long process which we believe would be. A significant issue for patient access during that period, which is why we are so focused on trying to prevent implementation of that LCD, in the interim period.

根據複雜性以及 MAC 可用性和其他優先級，該過程的長度可能會有很大差異，但該過程可能需要幾個月的時間，並且在一定範圍內。因此，我們相信這肯定是一個漫長的過程。在此期間，患者就診是一個重大問題，這就是為什麼我們如此專注於試圖阻止在過渡期間實施該 LCD。

Got it. That makes sense. That's helpful. And then, Ali, I'll stick with you just on the balance sheet, if you can be helpful, maybe you could provide a bit more detail just on the construct of the runway you believe the business has. I know you guys obviously pulled the OpEx guidance this year, but maybe if you can just give us a general framework, what the burn maybe looks like in the near to intermediate term? Thanks

知道了。這就說得通了。這很有幫助。然後，阿里，我會繼續關注資產負債表，如果您能提供幫助，也許您可以提供有關您認為企業擁有的跑道構造的更多細節。我知道你們今年顯然取消了營運支出指導，但也許如果你們能給我們一個總體框架，那麼近期到中期的燒錢可能會是什麼樣子？謝謝

Sure. So Tom, as we said, we're first of all pulling guidance. So we're not going to provide any specific guidance either for 2023 or 2024 as you can imagine, this is a very dynamic situation that we're in and there are many variations and flavors of what could happen in terms of coverage for OMNI and SION and how that may play out with WPS and the other MACs.

當然。所以湯姆，正如我們所說，我們首先要拉動指導。因此，正如您所想像的那樣，我們不會為2023 年或2024 年提供任何具體指導，這是我們所處的一個非常動態的情況，就OMNI 的覆蓋範圍而言，可能會發生許多變化和風格. SION 以及它如何與 WPS 和其他 MAC 一起發揮作用。

So we are running a variety of scenarios and then focused on what our infrastructure needs to look like in each of those scenarios. But first and foremost, the priority of the upcoming week, it's really on what can we do to tie in reverse course here with WPS and potentially and we have resolved the issue with the other four MCAS in terms of our balance sheet, as you see we do have significant cash resources right now with -- and with our cash balances.

因此，我們正在運行各種場景，然後專注於我們的基礎設施在每個場景中需要是什麼樣子。但首先也是最重要的是，下週的優先事項實際上是我們能做些什麼來與WPS 結合起來，並且有可能我們已經解決了與其他四個MCAS 在資產負債表方面的問題，如您所請參閱我們現在確實擁有大量現金資源以及我們的現金餘額。

And we've done a good job of managing cash with only $10 million of burn in the third quarter, we would expect to continue to be very focused on where we're spending money in the interim, waiting for these solutions to resolve themselves, and then we can set appropriate infrastructure.

我們在現金管理方面做得很好，第三季僅消耗了 1000 萬美元，我們預計在此期間將繼續非常關注我們的資金支出，等待這些解決方案自行解決，然後我們可以設置適當的基礎設施。

But in terms of absolute dollars or scenarios, frankly, it's just there's just so many different variations of outcomes here and that we're working through internally. We can't provide that today which is why we withdrew guidance.

但坦白說，就絕對美元或情境而言，結果有很多不同的變化，我們正在內部解決這些問題。我們今天無法提供這一點，這就是我們撤回指導的原因。

Very clear. Thanks.

非常清楚。謝謝。

(Operator Instructions) Our next question comes from Matthew O�Brien with Piper Sandler. Your line is open.

（操作員說明）我們的下一個問題來自 Matthew O�Brien 和 Piper Sandler。您的線路已開通。

Hi this is Samantha on for Matt. Thanks for taking our question. I guess and then on the restructuring here, I guess them imagine that some of that would be then the mix sales force. And I guess does that and prior suggest that you are not expecting a quick reversal of the final LCD?

大家好，我是為馬特代言的薩曼莎。感謝您提出我們的問題。我想，關於這裡的重組，我想他們想像其中一些將是混合銷售團隊。我想這和之前的內容是否表明您不希望最終的 LCD 快速反轉？

Yeah. Just to start, while a portion of the restructuring was associated with our surgical glaucoma business, that was really focused on management infrastructure on the commercial side, not on and the sales rep capacity. So there was some small combining of regions, but really the focus of that reduction in force on surgical glaucoma was not yes, for the carrying reps, but more management infrastructure that we think really allowed us to be more efficient and effective in our overall structure.

是的。首先，雖然重組的一部分與我們的青光眼手術業務有關，但實際上重點是商業方面的管理基礎設施，而不是銷售代表的能力。因此，對地區進行了一些小的合併，但實際上，對於攜帶代表來說，減少青光眼手術力量的重點並不是“是”，而是更多的管理基礎設施，我們認為這些基礎設施確實使我們的整體結構更加高效和有效。 。

So it did not imply anything about our likelihood of success or feelings about the surgical glaucoma business. All of this was done in advance of any decision by WPS this was done in the middle of October.

因此，這並不意味著我們成功的可能性或對青光眼手術業務的感受。所有這些都是在 WPS 於 10 月中旬做出決定之前完成的。

Just to follow up on Ali's comments, as it was actually quite the opposite. It was moving the structure of flattening the structure in a way that we thought it would allow us to enhance our responsiveness to the opportunities in front of us.

只是為了跟進阿里的評論，因為實際上恰恰相反。它正在以一種我們認為能夠增強我們對眼前機會的反應能力的方式來扁平化結構。

Further, our engagement with our customers who value the technology, OMNI in the procedures we support it was really all about our ability to both sustain and drive more consistent, predictable growth in the future. So we believe infrastructure we can scale into the future. We obviously understand we need to deal with the matters in front of us, but the moves were all about our ability to support and sustain growth moving forward.

此外，我們與重視該技術的客戶的互動，以及我們支援該技術的 OMNI 程序，實際上都是為了我們維持和推動未來更加一致、可預測的成長的能力。因此，我們相信我們的基礎設施可以擴展到未來。我們顯然知道我們需要處理擺在我們面前的問題，但這些舉措都是為了我們支持和維持未來成長的能力。

And just to add on to that when we were here recruiting, Matt is his background scaling a business of a similar size to site and scaling it into the hundreds of millions and beyond to over $1 billion in revenue. He sees experienced all the different stages of growth that we're going to be going through now and into the future. And I think I think a lot of what we're doing is very familiar to him and it and kind of in his mind, the best-in-class way of operating our business at today's scale.

補充一點，當我們在這裡招募時，馬特的背景是擴大與網站規模相似的業務，並將其擴大到數億甚至超過 10 億美元的收入。他看到了我們現在和未來將要經歷的所有不同的成長階段。我想我認為我們正在做的很多事情對他來說非常熟悉，並且在他看來，這是以當今規模運營我們業務的最佳方式。

Perfect. Thank you for all of that. And I guess last question from us, could you give any more detail on timing of future WPS interactions or with them any of the other formats as well?

完美的。謝謝你所做的一切。我想我們的最後一個問題是，您能否提供有關未來 WPS 互動的時間表或與任何其他格式互動的更多詳細資訊？

Yeah, at a high level, we are communicating with the MAC I really think it wouldn't be appropriate for us to comment on the specific conversations or upcoming timing. Obviously, the time line that we're trying to address all of this is before the December 24, implementation. So the next six-weeks is really the critical time frame for us before it moves into the more formal reconsideration process.

是的，在高層，我們正在與 MAC 進行溝通，我真的認為我們不適合對具體對話或即將到來的時間發表評論。顯然，我們試圖解決所有這些問題的時間線是在 12 月 24 日實施之前。因此，接下來的六週對我們來說確實是進入更正式的重新考慮過程之前的關鍵時間框架。

So that is really the timing that we would expect to be working with both WPS as well as the rest of the MAC as well as all of the key societies and CMS to trying to address that. But in terms of specific communication, at this point, we're just working through those plans with the MAC directly.

因此，我們確實希望在此時與 WPS 以及 MAC 的其他成員以及所有主要協會和 CMS 合作，試圖解決這個問題。但就具體溝通而言，目前我們只是直接與 MAC 制定這些計畫。

Okay. Thank you so much.

好的。太感謝了。

I show no further questions at this time. I would now like to turn the call back to Paul for closing remarks.

我目前沒有提出任何進一步的問題。現在我想把電話轉回給保羅，讓他發表結束語。

Thank you. We just like to thank, I thank everybody for your time listening into this call and thank you for your support. Have a great day.

謝謝。我們只想感謝大家，感謝大家花時間收聽本次電話會議，並感謝你們的支持。祝你有美好的一天。

This concludes today's conference call. Thank you for participating. You may now disconnect.

今天的電話會議到此結束。感謝您的參與。您現在可以斷開連線。