스타 서지컬(STAA) 2026년 2분기 실적 발표 컨퍼런스 콜: 중국과 EVO 플러스가 111% 매출 성장 견인

핵심 요약

• 2026년 2분기 매출은 중국 시장의 회복, EVO Plus 채택 확대, 중동을 제외한 미주 및 EMEA(유럽·중동·아프리카) 지역의 두 자릿수 성장세에 힘입어 전년 동기 대비 111% 증가한 9,350만 달러를 기록했다.
• 중국 매출은 5,230만 달러를 기록해 전년 동기 대비 100% 이상, 전 분기 대비 10% 증가했다. 경영진은 이번 성장이 재고 축적이 아닌 실질적 수요를 반영한 결과라고 밝혔다.
• 총마진율은 74.0%에서 74.5%로 개선되었다. 순이익은 810만 달러(희석주당순이익 $0.16)를 기록하며 전년 동기의 1,680만 달러 순손실에서 흑자 전환했다.
• 현금, 현금성 자산 및 매도가능증권은 1분기 말 1억 6,390만 달러에서 1억 8,150만 달러로 증가했다. 스타 수지컬(STAAR Surgical)은 무부채 상태를 유지했다.
• 경영진은 계절성 변화로 인해 3분기 중국 매출이 2분기보다 소폭 감소할 것으로 예상하지만, 2025년 3분기에 인식된 2,590만 달러의 일회성 항목을 제외하면 전년 동기 대비 성장할 것으로 보고 있다.
• 분기 말 기준 EVO Plus는 중국 판매량의 약 3분의 1을 차지했다. 수요가 회사의 초기 예상과 공급 능력을 초과했다.

주요 재무 데이터

총마진율 개선은 스위스 공장 가동 확대 비용 감소, 첨단 제조 경비 절감, 재고충당금 감소, 운임 및 기타 매출원가 비율 하락을 반영한 결과다. 다만 이러한 긍정적 요인은 단위당 제조원가 상승과 미국산 제품에 대한 중국의 관세로 인해 일부 상쇄되었다.

사업 및 경영 실적

중국 및 EVO Plus

중국이 핵심 성장을 견인했다. 경영진은 전 분기 대비 실적 증가 원인을 EVO Plus의 채택 확대 덕분으로 돌렸으며, 유통업체나 병원의 재고 축적 정황은 관찰되지 않았다고 밝혔다.

2분기 말 기준 EVO Plus는 중국 판매 수량의 약 3분의 1을 차지했다. 경영진은 채택 수준이 기대를 뛰어넘었으며 고객들이 상당한 가격 프리미엄을 계속 받아들이고 있다고 밝혔다. 이 제품은 아직 목표로 하는 모든 병원 및 의료 시스템에 등록되지 않은 상태다.

스타 수지컬(STAAR)은 또한 환자들이 렌즈 기반 대안을 찾음에 따라 EVO V4c에 대한 후광 효과가 나타났다고 보고했다. 경영진은 고르지 못한 중국 굴절수술 시장 상황과 레이저 시력교정술 수술 수요 압박에도 불구하고 자사의 시장 점유율이 확대되고 있다고 믿고 있다.

미국 및 기타 지역

미국 매출은 2분기 연속 약 600만 달러를 기록했다. 경영진은 더 많은 안과 의사들이 임상적 신뢰를 얻고 레이저 시력 교정 수술과 함께 EVO를 제안함에 따라 도입이 늘어나고 있다고 밝혔다. 다만 주문 제작 렌즈의 이월 주문(백오더) 발생 및 전체적인 굴절 수술 시장 약세가 전 분기 대비 실적에 영향을 미쳤다.

일본의 판매 수량은 14% 증가했으나 환율 하락 영향으로 보고된 매출 성장률은 2%에 그쳤다. 경영진은 일본 내 수요가 견조하다고 설명했다. 한국은 계절적 비수기에도 불구하고 중요한 시장으로 유지되었으며, 대만은 2025년 출시 이후 전 분기 대비 가파른 성장세를 이어갔다.

EMEA 지역 매출은 중동 지역 분쟁 지속으로 인해 1% 감소했다. 중동을 제외하면 해당 지역 매출은 12% 증가했다.

수익성, 시스템 및 혁신

영업비용에는 마케팅 관련 퇴직금 120만 달러, ERP 컨설팅 비용 170만 달러, ERP 관련 감가상각비 110만 달러가 포함되었다. 현재 ERP 플랫폼이 본격 가동 중이며, 경영진은 2분기 중 매출에 미친 영향은 미미하다고 밝혔다.

스타 수지컬은 차세대 제품의 최초 인체 대상 임상시험(first-in-human study)을 준비하고 있으며 최고기술책임자(CTO)를 영입할 계획이다. 구체적인 제품 및 일정은 공개되지 않았으나, 경영진은 단일 EVO ICL 제품군을 넘어 더욱 광범위한 안과 플랫폼을 구축하겠다는 의지를 밝혔다.

경영진 전망

경영진은 공식적인 매출 가이던스 대신 다음과 같은 계획 고려 사항을 제시했다.

• 2025년 3분기 매출액 9,470만 달러에는 2024년 주문에 따른 2,590만 달러가 포함되어 있다. 이 항목을 제외하면 비교 기준이 되는 실적은 6,880만 달러다.
• 회사는 해당 조정된 비교 기저를 기준으로 2026년 3분기 매출 성장을 계획하고 있다.
• 1분기와 2분기가 계절적 성수기로 자리잡으면서 3분기 중국 매출은 전 분기 대비 소폭 하락할 것으로 예상된다.
• 4분기 중국 매출은 앞선 3개 분기에 비해 계절적으로 약세를 보일 것으로 예상되지만, 경영진은 전년 동기 대비 성장을 계획하고 있다. 2025년 4분기 연결 매출액은 5,780만 달러였다.
• 회사는 2026년 하반기 상당한 수준의 잉여현금흐름(FCF)이 발생하고 연말 현금 잔액이 2억 달러를 크게 상회할 것으로 기대하고 있다.
• 스타 수지컬은 2026년 지출 목표치인 2억 2,500만 달러를 준수하기 위해 지속적인 관리를 기울이고 있으나, 목표 대상 투자가 늘어날 경우 지출이 다소 증가할 수 있다.
• ERP 컨설팅 비용은 4분기부터 크게 감소할 것으로 예상되며, 2분기에 발생한 마케팅 퇴직금 비용은 재발하지 않을 것으로 예상된다.

리스크 및 관전 포인트

• 중국의 굴절수술 시장은 여전히 불균형한 상태를 보이고 있으며, 경영진은 Q&A 세션에서 실질적인 시장 성장률이 보합에서 5% 안팎의 한 자릿수 중반대 수준이라고 설명했다.
• 군 입대 검진 관련 수술 및 여름철 수요가 1분기와 2분기로 앞당겨짐에 따라 3분기에는 전 분기 대비 불리한 계절적 영향이 발생한다.
• EVO Plus 수요가 공급 전망치를 초과했다. 경영진은 계절적 완화 요소에 힘입어 3분기 말까지 공급이 수요를 대체로 충족할 수 있을 것으로 예상한다.
• 중국으로 출하되는 모든 제품이 스위스에서 생산될 때까지 중국 관세가 총마진율에 압박을 가할 것이며, 경영진은 2026년 말까지 스위스 생산 전환이 완료될 것으로 기대하고 있다.
• 일본의 판매 수량 두 자릿수 성장에도 불구하고 환율 변동으로 인해 보고된 성장률은 감소했다.
• 주문 제작 생산 요건으로 인해 미국을 포함한 공급망 병목 현상과 백오더가 발생했다.
• 현지 경쟁, 거시경제적 요인 및 환율 제약으로 인해 인도는 보다 장기적이고 복잡한 시장 기회가 되고 있다.

애널리스트 Q&A 하이라이트

중국 비교 실적 및 계절성: 경영진은 시장 컨센서스 전망치에 대한 언급이나 구체적인 3분기 매출 범위 제시를 사양했다. 투자자들은 2025년 3분기 비교 실적에서 2,590만 달러의 일회성 항목을 제외해야 하며, 3분기 중국 매출이 2분기보다 소폭 하락할 것으로 예상해야 한다고 재차 강조했다.

EVO Plus 가격 및 제품 구성: 분기 말 기준 EVO Plus는 중국 판매 수량의 3분의 1 수준에 도달했으며 높은 가격 프리미엄을 유지했다. 경영진은 이것이 분기 말 기준 비율(exit rate)일 뿐 전체 분기나 연간 평균 제품 구성비(mix)는 아니라고 강조했다.

중국 내 경쟁 상황: 스타 수지컬(STAAR)은 현지 경쟁업체들의 렌즈가 자사의 독자적인 콜라머(Collamer) 소재 대신 아크릴을 사용하고 있다고 밝혔다. 경영진은 경쟁이 점차 심화되고 있음을 인정하면서도, 32년간 입증된 콜라머 소재의 안전성과 유효성 기록이 안과 의사들의 신뢰를 이끄는 핵심 요소라고 판단하고 있다.

미국 성장 전략: 회사는 거점 병원을 지속적으로 확대하는 동시에 임상적 신뢰를 확보한 안과 의사들을 대상으로 한 시장 침투율을 높이는 데 우선순위를 두고 있다. 상업적 초점에는 병원 경영 효율성, 환자의 치료 접근성, 그리고 수술을 포기하거나 레이저 수술을 받았을 수도 있는 잠재 환자의 전환 유도가 포함된다.

제품 파이프라인: 경영진은 굴절 수술 및 모양체구(sulcus) 고정형 렌즈가 여전히 핵심 분야라고 밝혔다. 이전에 논의된 잠재적 개발 영역에는 초점심도 확장(EDOF) 및 노안 교정이 포함되지만, 구체적인 신제품을 발표하지는 않았다.

실적 발표 컨퍼런스 콜 전문

전체 실적 발표 컨퍼런스 콜 녹취록

경영진 발표

Operator

Welcome to the STAAR Surgical second quarter 2026 results conference call and webcast. [Operator Instructions] Please note this event is being recorded. I would now like to turn the conference over to Connie Johnson, Director of Investor Relations.

Connie Johnson

Thank you, operator. Good afternoon and thank you for joining us. On the call today are Warren Foust, President and Chief Executive Officer of STAAR Surgical, and Deborah Andrews, Executive Vice President and Chief Financial Officer of STAAR Surgical. Earlier today, we reported our second quarter 2026 results via a press release in Form 8-K. We posted our results, release, and shareholder letter to our investor website at investors.staar.com. Today's call is scheduled for 1 hour and will include Q&A for publishing analysts. Webcast participants can also send questions for today's Q&A session to ir@staar.com.

Before we get started, I want to remind you that during today's discussion, we will be making forward-looking statements. Forward-looking statements are subject to risks and uncertainties that may cause actual results to differ materially from those expressed or implied by such forward-looking statements. I encourage you to read the disclosures in today's release, as well as on our filings with the SEC. Except as required by law, STAAR assumes no obligation to update these forward-looking statements to reflect future events or actual outcomes.

In addition, during today's discussion, we will reference certain non-GAAP financial measures including adjusted EBITDA and constant currency sales. Please refer to today's release for definitions and reconciliations of non-GAAP metrics. For brevity, unless otherwise specified, all comparisons on today's call will be on a year-over-year basis versus the relevant period.

Finally, a quick reminder. We intend to use our website as a means of disclosing material non-public information and for complying with our disclosure obligations under Regulation FD.

Such disclosures will be included on our website in the investor relations section. Accordingly, investors should monitor our investor website in addition to following our press releases, SEC filings, and public conference calls and webcasts. And with that, I would like to turn the presentation over to our President and CEO, Warren Foust.

Warren Foust

Good afternoon, everyone, and thank you for joining us. Six months ago, Deborah and I stepped into our roles as interim co-CEOs. Looking back now, I am struck by how much we accomplished together. We navigated uncertainty and challenges and leaned into significant opportunities. And today, we are proud to report the strongest first half revenue performance in STAAR's history. That includes the launch of EVO Plus in China, which fueled market share gains and drove both year-over-year and sequential growth in the region, back-to-back record quarters in the U.S., and a return to profitability and free cash flow generation across the business. These results reflect the focus, resilience, and execution of teams across the company, and that is a milestone worth celebrating.

Through it all, it's been a tremendous experience, one that I'm grateful for. As we move forward, I'm proud to do so as President and Chief Executive Officer. I thank the Board for their confidence and each of you for your continued support. I want to take a moment to recognize and thank Deborah Andrews. Over the past 6 months, Deborah has been an extraordinary partner, steady, wise, and tireless in her commitment to STAAR. Her clarity and focus on financial discipline, culture, and strategy have profoundly benefited this company. I'm thrilled that she continues as Chief Financial Officer and is doing so now as an Executive Vice President. I could not ask for a better partner as we lead our company forward.

Now, let's talk about the quarter, which was a strong one. Our shareholder letter published today covers our second quarter results, regional performance, ERP implementation, and long-term priorities in detail. Rather than repeat all of that here, I want to focus on the 3 priorities that we laid out nearly 6 months ago.

Revenue growth, profit expansion, and innovation acceleration. In the second quarter, we advanced all 3, and I'd like to walk you through where we stand. Starting with revenue growth, the second quarter was a strong revenue quarter. Net sales were $93.5 million, up 111% year over year. We delivered sequential growth in China, double-digit growth in the Americas, and double-digit growth in EMEA, excluding the Middle East.

Deborah will take you through the details a little later, but the headline is clear. This business is performing. One important item I want to flag for your modeling. Our third quarter of 2025 results included the recognition of $25.9 million related to the 2024 order. On a consolidated basis, third quarter 2025 net sales were $94.7 million.

Excluding that item, though, the comparable total base is $68.8 million. That revenue from the 2024 order will not repeat, and we encourage you to use the adjusted base when evaluating third quarter 2026 year-over-year results. Fourth quarter comparisons are unaffected. Fourth quarter 2025 net sales were $57.8 million.

Now on China, I'm proud of our market share gains and of our expanding EVO Plus launch. China remains critical to our success in an area where we have a compelling opportunity ahead. In the quarter, China grew sequentially supported by increased adoption of EVO Plus, and importantly, we saw no evidence of inventory build at distributors or hospitals reinforcing that our growth is being driven by demand.

The broader refractive market remains uneven. Recent industry commentary reinforces the view that procedures remain pressured in parts of China and APAC. Against that backdrop, STAAR's performance supports our belief that EVO is gaining market share. We're definitely getting a lift from the EVO Plus rollout, but more than that, we're seeing patients and surgeons really leaning into the benefits of lens-based surgery.

People like that EVO is reversible and doesn't require removing corneal tissue, and that's a big differentiator as laser-based procedures continue to struggle in many markets around the world. We also want to provide more clarity on China's seasonality. As discussed in our shareholder letter, the quarterly pattern in China has evolved. The first and second quarters are emerging as our strongest revenue quarters, supported by Chinese New Year, a shift forward of military recruitment-related procedures, and summer demand.

While the third quarter revenue is expected to be moderately lower than the second quarter due to shifts in seasonality, excluding the 1-time order of $25.9 million booked in the third quarter of 2025, we expect year-over-year growth. As is typical, the fourth quarter will remain seasonally softer than the first 3 quarters, but we are still planning for year-over-year growth. Outside China, we continue to see strong revenue contributions in key markets such as Japan and Korea, as well as double-digit growth in the U.S., the Americas broadly, and excluding the Middle East and EMEA as well. We also see compelling long-term opportunities in many other markets around the globe.

In the Americas, growth was led by another greater than $6 million quarter in the U.S., our second consecutive quarter at that level. The U.S. market remains underpenetrated, and we continue to see opportunity to grow EVO sales and continue to take market share as practices look for differentiated, lens-based refractive alternatives to laser vision correction as demand for laser procedures continues to decline.

In APAC outside of China, Japan remains an important market where EVO has strong category awareness, is a strong market leader, and has sustainable long-term potential. We continue to see solid underlying demand in Japan, bolstered by direct-to-consumer awareness initiatives launched in November of 2025. Unit volume rose 14%, though currency headwinds damaged the market and reported sales growth, which came in at 2%.

Across the broader region, market dynamics vary, and we are being disciplined about where we invest. In EMEA, excluding the Middle East, the region grew double digits, reflecting solid underlying demand across much of the region. Across all regions, our approach is consistent. Invest where we see the clearest returns and support surgeons and patients through service, training, and education. While we continue driving the global shift from laser-based to lens-based refractive surgery, we are also working to increase our product availability in order to satisfy the accelerating global demand that has outpaced our supply chain projections.

The second area is profit expansion. In the second quarter, we demonstrated meaningful progress in expanding profitability. We grew gross profit and net income compared with both the prior year quarter and the first quarter. These improvements resulted in significant cash flow generation, increasing cash from $163.9 million at the end of the first quarter to $181.5 million at the end of the second quarter.

This progress reflects the strength of our business model and the financial discipline that Deborah and the team had brought to the organization. The result is a company with strong gross margins, a strong balance sheet, no debt, an increasing cash balance, and the flexibility to invest in the business where it matters, commercial execution, customer support, product availability, innovation, and the systems that help us scale.

Our ERP implementation demanded significant energy and focus across the organization in the quarter. And our teams delivered. We continued to sell EVO lenses. We provided support for our customers and achieved strong results. The ERP system is now live and we are actively optimizing the system in the third quarter. This is not just an operational upgrade.

It is a foundational investment that improves visibility across our business and positions us to scale more effectively and efficiently as we grow. With the ERP system in place, we are also beginning to build towards artificial intelligence enabled capabilities that will improve how we operate over time.

The third area, innovation acceleration, is the one that I am most excited about. EVO is a genuinely differentiated product built on our proprietary Collamer material. It is a lens-based procedure that preserves the cornea, is removable by a surgeon, and addresses a broad range of myopia and astigmatism. While our progress is significant and exciting, accelerating, our global share of the refractive market remains far below what we believe is possible. That gap is our opportunity. Capturing it requires moving beyond a single product mindset.

EVO, powered by Collamer, is our foundation, but we have the opportunity to build a broader platform and a more diversified product organization supported by a disciplined innovation roadmap, structured product development, clear milestones, and a stronger execution accountability.

Our R&D team, including our advanced research group, is working hard against these objectives and is actively preparing for first-in-human studies on our next-generation product. To further support our efforts, we will soon be hiring a chief technology officer to drive STAAR's innovation agenda. I have personally led this search with the support from trusted advisors and our board. And I'll say this, this process has only deepened my conviction about STAAR's long-term potential.

I'm excited to share more in the coming weeks. This is the next chapter of STAAR, Grounded and Differentiated Technology, Disciplined Execution and Sustainable Long-Term Value Creation.

With that, I'll turn the call over to Deborah to walk through the financials in more detail.

Deborah Andrews

Thank you, Warren. I'll provide a brief financial summary and then we'll move to Q&A. Second quarter net sales were $93.5 million compared to $44.3 million in the prior year quarter, which, as a reminder, was impacted by minimal China shipments while distributors worked through excess inventory.

Excluding China, net sales were $41.2 million, up 6% year over year. Regionally, the quarter was generally consistent with the preliminary net sales update we provided in July. APAC net sales increased 189% year-over-year. Excluding China, net sales were up 7% year-over-year. China net sales increased 100 plus percent and grew 10% sequentially to $52.3 million.

In Japan, unit volume rose 14%, though currency headwinds dampened reported sales growth, which came in at 2%. The Americas grew 12% year-over-year, and the U.S. delivered another approximately $6 million quarter. EMEA has declined 1%, resulting from the continued conflicts in the Middle East.

Excluding the Middle East, EMEA also grew 12% year over year. Gross margin was 74.5% compared to 74% in the prior year quarter. The improvement reflected lower Switzerland ramp-up costs, reduced advanced manufacturing expenses, inventory provisions and lower freight and other costs of sales as a percentage of sales, partially offset by higher per unit manufacturing costs related to lower production volumes in 2025.

Gross margin was also negatively impacted by China tariffs on U.S. manufactured product. Margins will continue to be impacted by tariffs until 100% of products shipped to China are manufactured in Switzerland, which should happen by the end of 2026. Total operating expenses were $59.6 million compared to $62.8 million in the prior year quarter. Excluding $5.2 million in restructuring and merger related costs from the prior year period, operating expenses increased approximately 3.7% year over year. Included within operating expenses were $1.2 million in marketing severance and $1.7 million in ERP consulting. We don't expect the severance to repeat and expect the ERP consulting expense to decline significantly beginning in the fourth quarter.

Depreciation expense related to ERP systems was $1.1 million. We continue to manage toward our 2026 spending target of $225 million, though we may choose to make targeted investments that could result in marginally higher spending should the opportunity arise.

Net income was $8.1 million, or $0.16 per diluted share, compared to a net loss of $16.8 million, or $0.34 per diluted share, in the prior year quarter. Adjusted EBITDA was $20 million, or $0.39 per diluted share, compared to an adjusted EBITDA loss of $14.8 million or $0.30 per diluted share in the prior year quarter.

We ended the quarter with $181.5 million in cash, cash equivalents, and investments available for sale, up from $163.9 million at the end of the first quarter, and we continue to have no debt. The company currently expects to generate significant free cash flow in the second half of the year, ending 2026 with well over $200 million in cash.

Overall, the second quarter reflected meaningful improvement in profitability, cash generation, and operating leverage. Our focus remains on maintaining financial discipline, advancing new product development, and investing selectively in the opportunities with the clearest return potential. With that, I'll turn it back to Warren.

Warren Foust

Thank you, Deborah. Stepping back, the second quarter was a strong quarter that rounded out the best first half-year revenue performance in STAAR history. This is yet another step forward for STAAR. We grew revenue, expanded gross margins, generated net income, and built cash. And we have much to be proud of, growing EVO Plus adoption in China, back-to-back record quarters in the U.S., a successful ERP implementation, and early progress in organizing our product pipeline with an eye toward the mid- and long-term future.

Our strategy is clear, our team is focused and performing, and our long-term opportunity remains as compelling as ever. With more than 4 million lenses sold, 85 countries served, and 32 years of proven Collamer safety and efficacy in a world that is becoming more myopic every year. Now, our focus is to build on this momentum. Revenue growth, expanding profitability, and advancing innovation.

Deborah and I are aligned with our board and management team as we focused on long-term value creation through clear priorities and operating discipline. Thank you for your continued support. With that, operator, we are now ready to take questions.

Operator

[Operator Instructions] The first question will come from John Young with Canaccord. Please go ahead.

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John Young

I want to touch on Q3 and just maybe understand how you're going to level set investors, just given the comps and the one-timers that he called out. So using that adjusted number of $68.8 million that was in the press release and that he spoke about, you know, consensus currently sits at $80.9 million going into this print, so about 17.5% year-over-year growth from that figure you provided.

Are you comfortable with the consensus number today? And what's a good way to think of the Q3 growth algorithm? If you're not comfortable about that number, how should we think about growth overall for the quarter?

Warren Foust

Yes, hey John, great question. Nice to hear from you, and I'll make some comments and then invite Deborah to join. Look, we don't comment on consensus numbers generally. What I would say is we tried to give a little bit of a bridge to how you think about Q3 and Q4. We wanted to be clear that you needed to take the 2024 order out of each quarter so that you could have an appropriate base. We intend to grow off of that number. In fact, we're planning to grow on Q4 as well. That's what we would say as far as how to think about it.

I think the primary driver of the success so far, clearly China has come back for us. We recognize that the market is somewhat muted. You hear that in some of the commentary about other companies that are reporting, but we believe we have a nice advantage with EVO Plus launching in that market. We're clearly taking share relative to our competitors. And then we're still putting up a nice performance around the rest of the world, even in the face of some external challenges.

John Young

Okay, great. And then maybe just as a quick follow-up then, any of this color on where EVO Plus is today as a share of China volume versus your initial expectations at launch? And then maybe how could we think about the price versus unit benefit in Q3 to China?

Warren Foust

You bet. Yes, it's a good one. Look, we're excited about what's happened with EVO Plus. Candidly, it's outstripped our supply capabilities based on the demand. It's higher than what we anticipated it would be. Certainly, we saw that in the first quarter, and second quarter was no different. So, even in other markets around the world, we're now working to try and sort through scaling up supply to be able to reach the demand.

And so that speaks to EVO Plus has done better in China than expected. As far as the percent penetration of it, look, by the time we exited the quarter, it's probably close to a third of the units. And so we feel that's pretty strong, and it beats what we expected when we started. So, you know, how you think about it going forward from a price standpoint, we're still taking a considerable premium.

Our customers and seemingly their patients have not balked at that premium. And so we expect that to continue at least into the near term. And then we'll see what next year brings.

Operator

The next question will come from Tom Stephan with Stifel. Please go ahead.

Thomas Stephan

I want to start off with China and sort of thinking more intermediate to long term. Comp's weird this year when the street looks at numbers, but you're seeing obviously underlying volume growth. obviously have a good sense on price and mix. So not asking for guidance or anything, Warren, but if we think out to 2027 on a full year basis, and that obviously strips out any quarter to quarter seasonality questions, like as we sit here today, what do you view as the general range of call it normalized year-over-year China growth for STAAR, and then I'll have a follow-up.

Warren Foust

Yes, thanks, Tom. Appreciate the comments. And look, I love that you said you're thinking intermediate to long term. That's what we want. We're focused on building the long term, not just from the revenue standpoint, but the infrastructure investments that we're making in the organization, the preparations we're making behind the scenes from a portfolio standpoint. We are intending to operate this business into the long term. So thanks for that mindset.

You said it, look, aside from the nuance of us taking out the $25.9 million from the Q3 base, now we're going to be back to what we call clean quarters. We had clean quarters already this year, and you've seen growth better than market in China, and you've seen us continue to deliver in markets elsewhere around the world. And so I have no reason to believe that's going to change in China.

Our thinking is that as that market, which we think is probably mid to single digits right now from a refractive market standpoint, pulled down a little bit by lasers that are struggling, but it's offset by improvements that are happening, largely because of price with EVO Plus and then V4c halo effect that's happening when patients go in looking for V5 and either don't get it because it's slightly higher price from a premium standpoint, or it's not even available because we're trying to satisfy that demand.

So we think that feels like a tailwind as we go into next year, but not really ready to comment on exactly what that means for the quarters. I'll just finish by saying we did try and give some more guidance, not formal guidance, but some guidance around what the shape of the quarters look like in China.

Clearly Q1 and Q2 have now moved in the last couple of years to be seasonally our highest quarters. Q3 is still strong, but it's typically going to be less than what Q1 and Q2 are, and Q4 will be a softer quarter from a total revenue standpoint. But again, we're planning growth in both of those quarters, notwithstanding the $25.9 million that we've talked about extensively. I hope that makes sense.

Thomas Stephan

Makes sense. Appreciate that. And I'll maybe shift a little near term. I wanted to start off long term to set this up a little better, but I'll take a stab at kind of the 3Q, 4Q cadence and focus on China here. Warren, if I got this right, I think you mentioned 3Q China revenues moderately lower than 2Q. Hopefully I heard that right.

Wondering if we can put a finer point on that. And I'll ask it in the context of 3Q24 and 3Q23. China dollar declines were $10 to $15 million, roughly speaking. Warren or Deborah, is that reasonable for 3Q26 China, particularly as EVO Plus Mix, I think, continues to provide a continued sequential headwind. And as we try to contemplate, it sounds like pretty resilient ICL, China summer high season trend.

So is that down $10 to $15 million that you've seen in the past a good anchor point?

Warren Foust

Yes, that's a good one. Look, I'll start and then invite Deborah. I think it's important to remember two things. The seasonal shift has happened that I described. So Q1 and Q2, we expect to be stronger. That's borrowing partially from Q3. So it's hard for us to say, gosh, this is exactly what we think is going to happen in Q3 because one, because of that dynamic, and then two, because of what we said around having to pull some of that 2024 order out of Q3. But we still expect the underlying, I think the important piece, the underlying demand in China, it's stable.

It's not amazing. It's not as high as it was back in periods of hypergrowth, but we're taking advantage of it disproportionately because of the acceleration of share capture in our view. So I think that's how I would be thinking about it. It's hard for us to put a number on that, which is sort of stating the obvious why we have it.

Operator

The next question will come from Anthony Petrone with Mizuho Americas. Please go ahead.

Anthony Petrone

Congrats, everyone, on the new roles and look forward to working with everyone moving forward. Maybe I'll pivot to the U.S. and then come back to China. Just maybe an update on active sites and the strategy. So where are we in terms of total active sites in the U.S.? And I know that there was sort of a go deeper penetration strategy, but also there was a push to open up new sites. Maybe where are we on active sites and a recap and a refresh on the strategy between deeper penetration at the EVO live sites versus going after new accounts. And then I'll have a follow-up on China.

Warren Foust

Yes, thanks Anthony. Good to hear from you. Look, what we're seeing in the U.S. is a bit of what we're seeing around the world. Remember that only got the approval for EVO in '22. Commercial launch kind of happened in 2023 as we built up the team. And what you're seeing now is we've got hundreds and hundreds and hundreds of active sites. We're going deeper where we know we can make the biggest difference. We're focused on 2 key things.

And it's a U.S. discussion, but it's also the one that is relevant outside of the U.S. And that is, once we get customers clinically confident, when they use EVO, and those patients come back and they see them in the clinic, or they see the optometrist, these are happy people. And so what we're seeing is the surgeons get more confident clinically and then they look for how do I make this work for me economically and that varies by whether they operate in their practice or whether they go down the street in their car to a multi-specialty ASC where they have to pay anywhere from $900 to $1,800 an eye to operate on them. That's a more challenging situation to where we have in-office suites where the doctor can go right down the hall and operate in his or her own practice. So you can see where there's opportunity sets within each one of those scenarios.

We've stratified those customers. Our team is actively and aggressively going after clinically confident customers with an economic message that says, you've got revenue that's walking out of your practice because they're high diopter and someone's trying to sell them LASIK, which is declining year over year, and now again quarter over quarter. And so that's a little bit of an almost dated discussion because what's happening now is patients are asking for EVO because they're hearing more about it.

Younger patients and younger doctors recognize the value of a removable, reversible technology, and so they're more excited. So more of those surgeons in the U.S. are offering EVO as one of their refractive surgery options. And so you're seeing the adoption, you're seeing less walkout revenue, and you're seeing more of the practices that we're targeting narrow the delta for the patient from a pricing standpoint. So they make it more accessible to them, and that's what we're seeing drive the adoption in the U.S. It's still on smaller volume that we want, but we're proud of another $6 million quarter and looking forward to continued growth.

Anthony Petrone

Very helpful. And China, you know, EVO Plus, just a reminder, what percent of the market does the larger lens size open up in China? And then just looking at the consignment numbers, they're up pretty substantially year over year in the queue. I was wondering how much of the China consignment sales were linked to EVO Plus.

Warren Foust

I'll let Deborah comment on the consignment sales. I'll just say as far as opening up the opportunity, look, the way we see market demand is it's unlimited. And that's not just China, that's on a global basis. The amount of refractive error on this planet is untreated and it's massive. And so we're on a journey after it. Obviously we're constrained by some things. We're constrained by total patient in the refractive market coming in and seeking consultation.

And then as it pertains to EVO Plus in China, we're constrained a bit by inventory as we've been struggling to build enough to meet the demand in Q1 and then in Q2. I think we're getting our hands around that now, particularly as we get into the latter parts of Q3 and into Q4, we'll see some of the demand slow down just because of the dynamics of the seasonality.

So that'll actually help us from a supply standpoint. But you're seeing, you know, There's no additional number of patients that EVO Plus opens up because EVO Plus can be used for any number of patients that EVO could be used for. It becomes a premium positioning at the account level and whether the patient has the economics to support themselves on it.

Deborah Andrews

I guess, this is Deborah. From a consignment standpoint, actually our consignments in China are way down. And that's why you're seeing increased tariff costs on the gross margin side. Because if you recall, we shipped those consignments before the increased tariffs were put into effect last year, early last year. And so now that those lenses have been used, we're shipping U.S. product into China increasingly and they are subject to tariffs. But the overall numbers are way down in China in consignments.

Operator

The next question will come from Simran Kaur with Wells Fargo. Please go ahead.

Gursimran Kaur

Warren, you know, you framed the China share gains as coming primarily from laser-based procedures. Can you just help us understand the mechanism behind that? Are you seeing more patients opt for ICL up front, or is the bigger driver surgeons expanding into ICL and converting procedures within their practices?

And as domestic competition develops in the China refractive market over the next few years, how durable do you believe those share gains are?

Warren Foust

Yes, hey, Simran. Thanks for the question. Look, I think starting with the competition, we're thrilled to have competition. It's just more of an admonition that the future's lens-based from a refractive surgery standpoint. You're seeing laser volumes around the world face headwinds. And is that what's happening in China? It's hard to say getting into the share discussion. We believe a little bit of all of it's happening. Patients are coming in asking for EVO Plus. Oftentimes, they're getting EVO Plus if they have the economics to do it and we're able to supply it.

And then even when they're not and if they're a candidate for V4c, we're seeing a bit of a halo effect that's happening from that standpoint. So despite the otherwise sort of modest market growth in refractive in China, we believe we're getting a bigger share of it because we're getting dollar share with EVO Plus and we're getting some unit share probably with EVO Plus and with EVO that's inviting that competition.

And so, we respect it. We see it outside of China. We see it inside of China. It's not made such an impact so far. Remember, these are acrylic lenses. The advantages of STAAR for 32 years and beyond now is our material.

The EVO and EVO Plus powered by Collamer message is very real and the trust that our surgeons have for a device that they've had implanted for 30 plus years gives them great confidence, and I think it makes it more challenging for these other devices that are not made out of Collamer to compete in those markets. It doesn't mean that we have any disrespect for them, it just means they've got an uphill battle.

Gursimran Kaur

Got it, very helpful. And for my follow-up, you know, ex-China, I can certainly appreciate on a year-over-year basis every region grew, but if I look at the growth rates across APAC in particular, it looks like it's decelerated pretty significantly. So maybe just to help us understand what's going on in the region, And more broadly, should we think about ex-China as sort of a mid-single-digit grower going forward, or is there opportunity to re-accelerate the growth rate there?

Warren Foust

You know, we have strong contributions from our largest markets in the region in APAC, Japan and Korea. Japan grew substantially from a unit standpoint but faced tremendous headwinds from a currency experience from an exchange standpoint. So I think it's 13% or 14% growth even in units, and then what we faced after currency was just 2% growth.

So it's modest from that perspective, but the underlying market activity is strong. And we don't have any reason to think that that's going to change. Korea is a bit of the low season for Korea. Korea's also, it's a smaller market relative to Japan, but it's a really important one for us, and it's onewcastlemax where we have great sales execution, great customer relationships, and so we believe in the long-term viability of that market as well.

India is really, really a long-term play for us. That's a complicated market. It's complicated relative to local competition. It's complicated relative to macroeconomic factors that they're facing. Obviously, there's currency issues associated with being able to access U.S.-made and Swiss-made products in India.

So that's a long term process for us, but it's still a really important market. So as far as the heart of your question of what should we expect as far as growth rate, can't say, but what I would say is we don't have any reason to believe that the viability of EVO in those markets is going to be under any siege.

Deborah Andrews

No, I just wanted to add that plus we're seeing really strong growth in Taiwan, which we just launched last year. And that market is really doing very, very well. Sequentially, every quarter, it's increased significantly. So nice market there.

Warren Foust

It's a fun market to think about because we just got the approval for EVO Plus. It's adjacent to China, obviously. So from a patient population standpoint, they have access and visibility to seeing the social media and the happiness with EVO. And its the one that we're going to start servicing and it's filled with lasers and opportunity.

Operator

The next question will come from Ryan Zimmerman with BTIG. Please go ahead.

Ryan Zimmerman

You know, the first question, I want to go back to the pricing and volume dynamics in China for a minute here. You know, Warren, I was struck by your comments about a third of the lenses in China are EVO Plus. And, you know, let's assume that, you know, there's a 30%, 40% price premium on that product. I mean, that would suggest, I think, that you're getting about, call it 10 points of growth on those lenses.

But if you back that out and all else being equal, if the China market's mid-single digits, is it and again, I can appreciate that you're taking share in the market, but wouldn't that suggest that the volume, the units are declining in China?

Warren Foust

Well, you got to start with this exit share in July. So we don't have, it's not a third of the units of EVO Plus for the full year. And so, remember, we're building as we go. We're not even launched with EVO Plus and all of the hospitals or the systems that we're going to ultimately get launched and listed into.

So the math becomes a little bit challenging from that perspective. But again, I'll just double down on revenue in China now is being driven by 2 things. It's being driven by return of our EVO V4c, somewhat of a halo effect, and it's being driven by adoption, both units and price, with EVO.

And so, How much that's ultimately going to go from a third exit to the full year, we'll see. It remains to be seen, and we have to be able to supply it as well.

Ryan Zimmerman

Okay, that's very helpful and that, you know, buttons that up. The other question I had was just U.S. And, again, I can appreciate, you know, that this is still building, but if you go back to the launch of EVO in the U.S., I mean, we have seen sequential growth from 1Q to 2Q every quarter since EVO launched.

I appreciate that, you know, it's holding steady at $6 million, but it did decline sequentially a little bit in the U.S. in 2Q. And that may just be, you know, based on small numbers and so forth. But I wanted to at least, you know, get your perspective on that because it is still early days, you know, given the opportunity in the U.S.

Warren Foust

That's a good one. Look, I think the long-term value of the U.S. market is massive. I think access that we have is going to create a channel for us to do all sorts of things. And this is a long-term discussion, not a quarter-to-quarter one. But just as a practical matter, even though we do better than the laser market, there's often an inverse relationship between how the laser market declines and we grow, but we're not taking every one of those points of their decline clearly.

And so when the overall refractive market shrinks or grows, we benefit from that or we suffer a bit from that. So in Q2, sequentially versus Q1, you saw the laser, the total refractive market go down, driven by lasers because they have the predominant share, And so we suffered a bit from that.

So that explains, I think, some of the sequential, we grew but the decline versus our first quarter performance, which was like 22%. There's probably some timing in there also. And then the other thing I'll say candidly, the U.S. makes up 5%, maybe 7% of the share here. When we're on backorder or supply constraint in our largest market, China, or in other markets as a result, as we try and satisfy by building product, we have to build MTOs, made-to-order products for Torics.

And when we do that, those are built in smaller units, smaller volume of units, and therefore it gums up our supply chain. And when that happens, guess what? The U.S. goes on back order for MTOs. And so that's going to explain some of it too. I suspect if you channel check, you'll find some unhappy customers, unfortunately, in the U.S. that are trying to get product from us, which we are cranking out now to try and get caught up.

Operator

The next question will come from David Saxon with Needham and Co. Please go ahead.

David Saxon

Maybe just on the, I'll start on the ERP, any way to quantify the impact of the second quarter earnings, I'm sorry, orders or revenue, and does that all get recouped in the third quarter or does that take longer or is it just lost sales at this point?

Deborah Andrews

No, no, we don't think the impact was material, there was any material impact overall on our revenue numbers. You know, as far as the P&L is concerned, the impact was mainly on expenses as we work to stabilize the system overall and upgrade or update the system.

But on the revenue side, could there have been some lost sales, I guess, on the MTO side of it, the made-to-order lens side of it? It could have been. But that's mainly driven not by the ERP system. It's driven by the strong demand in the first half of the year, especially in China.

Warren Foust

Hey, David, we referenced it in the pre-release, and then we referenced it in the shareholder letter. Honestly, it's more of an acknowledgment of how hard our teams work because despite the internal exhaustion that it created, we were still shipping products, still booking orders, still servicing our customers, still delivering the revenue for the quarter, which delivered our profit.

So I think the ERP system has been a big lift. We'll continue to tune it as we go, but from a revenue impact, I think it was negligible.

Deborah Andrews

Yes, I mean, I would just say, understand that we've actually exceeded our plans, operating plans for both the first and second quarter of this year. That I will say. we're pleased overall.

David Saxon

Okay. That's helpful. Thanks for that. And then maybe I'll try a third quarter question. So obviously appreciate the seasonality commentary. So, I mean, looking at third quarter, you know, round numbers, sounds like you'll land somewhere in the $70 to $90 million range. I guess sitting here halfway through the quarter or thereabouts, how would you characterize the sequential trend you're seeing? Like how steep or gradual is that trend line looking at this point?

Warren Foust

Look, I won't comment on the specifics there. I would just say from a trend line standpoint, I don't think a lot has changed. We've seen some commentary out there around the high season for China, remembering we believe there's kind of 2 high seasons that happened back to back in Q1 and Q2 now because of the pull forward of the military procedures as well as the Chinese New Year. And then in the second quarter, you get a bit of the, to get some of the summer high season, which fades off during Q3.

If you listen to what's happening in China, it's sort of flat to mid-single digit sort of growth for the market. And as you've heard us say, at least in the quarter, we've done better than that. So I all those dynamics hold as we go forward and then you just have to back out the $25.9 million from last quarter to get your Q3 and think about a little bit of growth there.

Same for Q4. Q4 was unaffected by that order, but we think we're planning at least to grow in Q4.

Operator

The next question will come from Mason Carrico with Stephens. Please go ahead.

Harrison Parsons

This is Harrison on for Mason. Just wanted to ask on ASPs, blended ASPs under pressure from Toric/sphere mix and the diopter curve dynamics. After exiting Q2 at 30% of China volume, is the EVO Plus premium now large enough to offset these headwinds at the consolidated level in the back half of the year?

Warren Foust

Look, it's a good question. I'd have to give a lot of thought to that to try and come up with the best answer. I would just say, clearly, we're going to continue to get ASP to the level that we can get it tailwind from EVO Plus. But honestly, price is a function of well at least in Europe, a country like Germany where we have the highest price in Europe, we're facing competition, we're going to have some ASP slippage there, but it's not massive.

We've held price in most markets around the world partially because the adoption of Toric continues, and so Toric's a little bit higher priced, the higher mix of Toric we have, the better pricing we have, so I'm less concerned about pricing and I'm more concerned and focused on continuing to take share, which we believe we have line of sight to keep doing. So rather than say we're going to overcome price erosion with price in China on EVO Plus, I'd rather say we're focused on taking share on global markets and we think we can do that.

You mentioned diopter, and outside of China, if you look at our percentage of units that we sell, if you look at above minus 8 and you look at below minus 8, we've moved ourselves down outside of China a couple of percentage points at least down from minus 8 into the minus 6 to minus 8 range. And so we believe that we are continuing to move ourselves down the diopter curve. And any time we're doing that, that gives us an opportunity to take share where lasers may have been treating that patient before. And so that's going to be our focus rather than the ASP component.

Harrison Parsons

Great. Thank you. That all makes sense. And then, sorry if I already missed on the call, but when do you expect to have enough EVO Plus inventory to fully supply the demand you were seeing right now in the China region?

Warren Foust

You know, I think we're there or thereabouts now. Remembering that we're going to start to see the summer part of the high season tail off, which gives us a chance to catch our breath and start to build units. So I think by the end of the third quarter, roughly, we should be in place where we can supply as much EVO Plus as necessary.

Now our focus is to build V4c. Remember, every unit of V4c that we build in Switzerland for China gives us the benefit of not having to pay the tariffs. And so our focus is supplying EVO Plus, but a side card of we want to make sure we supply as much V4c out of China as possible. And we're hoping by the end of the year we're going to be able to accomplish that.

Operator

The next question will come from Adam Maeder with Piper Sandler. Please go ahead.

Adam Maeder

Congrats on the appointments. I'll keep it to one multipart question. In the press release, you talked about moving beyond a single product line company into kind of, I think, a true platform was the phrase you used. Could you just expand on that comment? Are you thinking about moving beyond the refractive market? Or is it more a focus of kind of having a broader offering within refractive?

And I'm assuming everything kind of starts and stops with your polymer-based technology. Is that the right way to think about it? And just any comments around potential time lines, whether it's years or medium, long term would be helpful.

Warren Foust

Thanks Adam. I love the question. Look, we're excited to run this business for the long term. The thinking here now has really evolved to we want to establish the infrastructure and the capabilities for this to be a long-term investment for folks, but a long-term successful company in ophthalmology.

And so from a pipeline standpoint, we've got great engineers, and great clinical, medical, regulatory talents in this organization that have been working in the background for years now on a variety of things. And so we're looking forward to bringing those things together in what will be a more cohesive, a more easy-to-understand portfolio. And we'll talk about that in future releases. We're not ready to talk about it today.

You heard us say we're going to hire a chief technology officer. I'm excited about that. I'm excited to be able to start talking about first in human testing that we will be doing very soon, as early as even the first part of next year, if we can't even do it sooner. And that's on next generation products. We said before we're focused on things, of course, that are going to be very, very important. the material capabilities that we have are unique.

And that's how Collamer has differentiated us for many years. So we want to use those same capabilities, whether it's Collamer or whether it's something else, for us to be able to accelerate and become beyond just an EVO ICL company.

Refractive is our wheelhouse. In the sulcus is our wheelhouse, where the surgeons place the EVO ICL. So I think all of those represent opportunities. You've heard us talk in the past about extended depth of focus or presbyopia correction, being able to take advantage of a patient's natural ability to accommodate, but be able to give them some extra help with a lens-based technology, that's an option amongst many other options. So we'll talk about those in a more formal way as we go, but there's a lot of excitement here about our future.

Adam Maeder

I'll stay tuned. Thank you.

Operator

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