LENSAR - Q2 2024
August 8, 2024
Transcript
Operator (participant)
Good morning, and thank you for your participation. At this time, all participants are in a listen-only mode. Later, we will conduct a question-and-answer session. As a reminder, this conference call will be recorded. I would now like to turn the call over to Cameron Radinick of Burns McClellan. Mr. Radinick, please go ahead.
Cameron Radinovic (VP for Investor Relations)
Thank you, operator. Good morning, and welcome to the LENSAR Second Quarter 2024 Financial Results Conference Call. Earlier this morning, the company issued a press release providing an overview of its financial results for the quarter ended June 30, 2024. This press release is available on the investor relations section of the company's website at www.lensar.com. Joining me on the call today is Nick Curtis, Chief Executive Officer of LENSAR, who will review the company's recent business and operational progress. Following his comments, Tom Staab, Chief Financial Officer of LENSAR, will provide an overview of the company's financial highlights before turning the call back over to the operator to facilitate answering any questions you may have. Today's conference call will contain forward-looking statements, including those statements regarding future results on audited and forward-looking financial information, as well as the company's future performance and/or achievements.
These statements are subject to known and unknown risks and uncertainties, which may cause the company's actual results, performance, or achievements to be materially different from any future results or performance expressed or implied in this presentation. You should not place undue reliance on these forward-looking statements. For additional information, including a detailed discussion of the company's risk factors, please refer to the company's documents filed with the Securities and Exchange Commission, which can be accessed on the website. In addition, this conference call contains time-sensitive information that is accurate only as of the date of this live broadcast, August 8, 2024. LENSAR undertakes no obligation to revise or update any forward-looking statements to reflect events or circumstances after the date of this live conference call. With that, it is my pleasure to turn the call over to Nick Curtis. Nick?
Nick Curtis (CEO)
Thank you, Cam, and good morning to everyone. I appreciate you joining us, and I'm excited to update you on an unprecedented second quarter for LENSAR. Starting from an ALLY system placement standpoint, the second quarter was a record period for LENSAR. We placed 17 new ALLY systems, a remarkable 30%, increase over a strong second quarter of 2023. From a historical perspective, the second and fourth quarters are typically our strongest in terms of revenue. In each of these quarters in 2023, we achieved $12 million in revenue, which we exceeded with the $12.6 million in Q2 2024, an increase of 5%. Remember, however, this is without clearance to sell Allies outside the U.S.
With this past performance in mind, and given the newly received EU and Taiwan clearances, we're excited about the system as well as procedure market share growth possibilities for the remainder of the year. In addition to the 17 placed ALLY systems, we converted six previously installed systems on usage agreements to sold systems, as well as ended the quarter with a backlog of an additional 17 ALLY systems. We expect these to be placed in the second half of 2024. The conversion of placed rental systems to sold systems demonstrates significant customer satisfaction with ALLY and provides further validation of ALLY's capabilities versus competitive systems in the marketplace. Demand for LENSAR's ALLY systems is strong and growing, despite some weakness and uncertainty in the overall economy, with interest rates remaining high.
In the face of these macroeconomic headwinds, LENSAR has proven resilient in our ability to meaningfully expand our footprint in refractive laser cataract surgery. In addition to our record number of placements, procedure volume also had impressive growth, with a 19%, increase over Q2 2023, and first half 2024 procedure volumes up 22%, over the first six months of 2023. Furthermore, we saw a 16%, increase in our installed base with 80 ALLY's in the field and 330 LENSAR systems installed worldwide. I'm really proud of this impressive progress. Another important performance metric is our penetration into new practices. In the second quarter, 88%, of our ALLY placements were with new customers, and more than 80% of the U.S. systems placed in the first half of the year were with first-time LENSAR users.
This is another clear example of surgeons growing choice to use ALLY over competitive systems and directly impacts the growth trajectory of our recurring revenue and procedures going forward. Given ALLY clearance in the E.U. and Taiwan, we can begin to replace older competitive devices and attract new practices to LENSAR from those regions where there is already significant interest in ALLY, and begin executing our OUS commercial strategy to further increase our worldwide installed base. I have a great deal of confidence that these efforts will prove successful as they have thus far in the U.S. With the majority of our U.S. conversions thus far have been surgeons new to LENSAR, upgrading to ALLY is a better option than an aging, suboptimal, however, still usable laser. We're approaching a significant industry-wide replacement cycle as competitive systems currently in use are nearing end of life.
These systems are based on decade-plus-old technology, and while still functional, they're clearly inefficient... and lack features capable of delivering improved outcomes for patients. Given the slow pace of innovation from the largest eye care companies competing in our space, rapid servicing and system reliability are beginning to create challenges. And as we have shared on previous calls, this reality is creating a perfect commercial opportunity for LENSAR. Adoption and placement of an ALLY system into a surgeon's practice or an ASC, can result in meaningful revenue and EBITDA growth, thanks to its ability to significantly increase efficiency and patient throughput, as well as enhance outcomes. Because of these factors, we believe it is a matter of when, not if, they adopt our technology. And we're beginning to see a substantive acceleration in the rate of ALLY conversions.
The current economic conditions I mentioned earlier, make it more challenging for surgeons and facilities to invest in upgrading their capital equipment. However, the speed and efficiency of ALLY, which is being discussed in an increasing number of peer-to-peer communications, surgeon-initiated studies, and case studies discussed during this quarter's medical meetings, demonstrate the financial benefit of adopting our system, helping to overcome the economic challenges surgeons face. Additionally, penetration into important channels such as the private equity groups, combined with the overall age of competitive systems in the market, will continue to provide significant catalysts for ALLY adoption. Accordingly, we expect to see new customers and overall market share growth continue quarter over quarter as this perfect storm plays out.
As we continue placing new systems with new users, and these surgeons become more familiar with the ALLY experience and the associated advantages of working with LENSAR, we're confident that procedure volumes and recurring revenues will increase in parallel. We had an exceptional quarter, as evidenced by the continued revenue and placement growth in the U.S., and receiving CE Mark approval for ALLY, a major strategic milestone, which we announced yesterday, that sets the stage for commercial expansion into the European market. This important regulatory approval for ALLY further reinforces our belief LENSAR is paving the way to revolutionize advanced laser cataract surgery. The E.U. clearance is a critical step toward our objective of expanding ALLY's reach on a global scale. There are a number of European surgeons eager to take their capabilities to the next level with ALLY.
We have a solid network of distributors ready to deploy, and LENSAR is poised to replicate its U.S. success story in key markets elsewhere in the world. To that end, we have been training our E.U. field service and clinical application support partners, and we have already initiated shipments to Europe, and the first ALLY was installed in a surgeon's facility this week. I look forward to updating you on all the progress of the European launch next quarter. I'd also like to report we recently received TFDA approval to make ALLY commercially available in Taiwan and Hong Kong. Like Europe, we've been working closely with our Southeast Asian distributor to support an efficient launch. I'm pleased to share that we have also shipped our first systems to Taiwan, with users having already performed the first ALLY cases and have additional OUS regulatory approvals on the horizon.
We continued to actively evangelize ALLY within the medical community, with a strong LENSAR presence at both the AECOS Europe Symposium in Prague and the DOC meeting in Nuremberg. We conducted a number of ALLY demos and interacted with European thought leaders, highlighting ALLY's key differentiators and unique ability to address the shortcomings of first-generation systems. This actively dovetailed perfectly into the EU commercial launch on the heels of our fortuitous regulatory clearance. With our growing installed base, encouraging utilization trends, and an expanding international footprint, we're well positioned to further increase our market share, both in the U.S. and the rest of the world as we move forward. I'm proud of what the LENSAR team has accomplished to date, and it's incredibly gratifying to share some of the details on how far we've come since receiving FDA clearance of ALLY just two years ago.
Gaining over four procedural market share points in the U.S. since launching ALLY is an incredibly positive milestone, but it's just the start. We continue to believe that ALLY is a transformative technology with the potential to positively impact the future of the laser cataract market. We're starting to see this play out, but view this as a marathon, not a sprint. Now that we can market and sell ALLY outside the U.S., with additional markets potentially available to us in the coming months, I expect that the positive momentum for LENSAR will begin building at a quicker pace. Now, let me turn the call over to Tom to cover our financial highlights for the quarter. Tom?
Tom Staab (CFO)
Thank you, Nick. Just a few brief remarks from me on our strong second quarter performance. Revenue was $12.6 million in the second quarter of 2024, compared to $12 million in the second quarter of 2023, reflecting a 5% increase. This growth was generated from an increase in procedure volume. To echo Nick's earlier comments, US procedure volume increased 16%, over the second quarter of 2023, and on a worldwide basis, we saw an increase of 19%.
Given the timing of placements in the second quarter and ramp-up time for sites and surgeons to reach an optimal utilization rate, we expect to see more robust procedure volume culminating in recurring revenue in the third and fourth quarters of 2024, when these recently installed systems begin to achieve a typical monthly run rate. In addition, we are extremely excited to have recently received EU and Taiwan regulatory clearances that allow us to sell ALLY outside the United States. We are now able to increase ALLY's global footprint. Selling ALLY systems in these operating regions is extremely important and enables us to increase our market share, total and recurring revenue, as well as positively impact our cash flow. We have been anxiously awaiting these clearances as they are significant catalysts for our future success.
Gross margin for the quarter was $6.8 million, representing a gross margin of 54%, compared to $6.8 million and 56%, gross margin realized in the second quarter of 2023. Our gross margin was strong this quarter, although we anticipate a slight decrease in our future gross margin percentage as we see a higher concentration of ALLY sales and anticipate a higher concentration of revenue outside the United States in future quarters. For the year, we continue to expect a gross margin percentage of approximately 50%. Total operating expenses for the second quarter of 2024 were $12.1 million, and compared to $9.6 million in the second quarter of 2023. The increase in operating expenses was primarily attributable to a one-time impairment charge on intangible assets of $3.7 million.
If you exclude this impairment charge, our total operating expenses were $8.4 million, which is largely a function of decreased general and administrative expenses, somewhat offset by increased selling and marketing expenses as we focus on growing our commercial organization and market share in the United States. The $3.7 million charge relates to a strategic decision to terminate our collaboration with Oertli, associated with the integration of their phacoemulsification system into ALLY. Although we remain committed to combining ALLY and phaco capabilities, and will continue to maintain a robust portfolio of IP related to this integration, we have decided to discontinue activities with Oertli. The discontinuation of the collaboration eliminates any contractual and any other potential limitations on LENSAR collaborating with other phaco manufacturers in the future.
Net loss for the quarter was $9 million, or a $0.79 loss per common share, compared to an $8.8 million loss and an $0.81 loss per common share in the second quarter of 2023. However, as discussed previously, included in the net loss was the one-time impairment charge of $3.7 million and a charge associated with our outstanding warrants, which occurred in both second quarters relating to an increase in our stock price. To evaluate our results and operations more intuitively, let us look at our adjusted EBITDA results. The second quarter is generally a strong quarter for us, and you see we achieved breakeven, having a positive adjusted EBITDA of $30,000, after narrowly missing breakeven in the second quarter of last year with a negative $188,000.
Looking forward, we expect to see operating breakeven quarters with some consistency starting as soon as the fourth quarter of this year. If you exclude the warrant and impairment items from our net loss for the second quarter, our loss was $1.4 million in 2024, as compared to $2.8 million in 2023, or one half of what it was for the second quarter a year ago. As of June 30, 2024, we had cash and cash equivalents of $15.4 million, as compared to $24.6 million at December 31, 2023. Cash used in the second quarter was $3.7 million and was largely dedicated to increases in inventory and our leased fleet of U.S. systems.
These uses of cash are a function of building inventory to supply ALLY systems to the EU and Taiwan, for which shipments have begun, as well as expanding our fleet of ALLY systems in the United States. Now, I'd like to turn the call over to the operator, and we look forward to your questions. Marjorie?
Operator (participant)
Thank you, sir. At this time, if you would like to ask a question, please press the star one on your telephone keypad. You may remove yourself from the queue at any time by pressing star two. Once again, that is star one to ask a question. While we wait for those questions to come in, we will next go to Frank Takkinen from Lake Street Capital Markets. Please go ahead.
Frank Takkinen (Analyst)
Great. Thanks for taking the questions. Congrats on all of the progress. I was hoping to start with one on the mix of sales versus placements in the quarter. Obviously, a really impressive placement quarter. Nick, can you maybe talk a little bit more about the mix of how much of those were actual upfront sales versus placements, and then how the prospects look to shift those into a full purchase, or do they stay as placements and just develop a big recurring revenue stream?
Nick Curtis (CEO)
Yeah. Hey, hi, Frank. I appreciate the questions. Thank you. So of the 17 on the installs, 10 of those were sold and 7 of those were leases, if you will. So about 59%, of the systems were actually sold systems of the 17, and then, of course, we converted the additional 6 systems that had been placed previously.
Frank Takkinen (Analyst)
... Got it. That makes sense. And then maybe shifting over to manufacturing capacity. Clearly, you're scaling well, and I think I asked about this last quarter, too, but do you still feel confident you're able to produce the amount of ALLY systems required to keep up with demand now that you're entering a couple new geographies?
Nick Curtis (CEO)
I do, actually. You know, we had anticipated these approvals, and so, you know, as Tom had made some remark of, you know, in his comments here, we, you know, we had been buying inventory and building inventory. There's some lead time to receiving some of the critical parts, such as the laser aspect and certain other components of, you know, computer-wise and whatnot, and chips. So we've been, you know, we've been placing orders, and we had been receiving items in anticipation of this. So, you know, manufacturing is actively building systems now as we speak, and we feel good that we're gonna be able to deal with our backlog. By the way, that was US backlog that I was talking about going into the quarter.
You know, we'll see as we move forward in this quarter, as we start to get more orders from outside U.S. But we feel comfortable that we've ordered enough parts, and we're actively building, and you know, people are pretty fired up around here.
Frank Takkinen (Analyst)
Nice. And maybe just the last one, help us with back half expectations. Heard the comment Q2, Q4, typically the strongest, but maybe if you can help us think about how we should be thinking about our, our models for Q2 and Q4, and, bridging to the, the expectation for 20%, growth for this year.
Nick Curtis (CEO)
Yeah. So typically, you know, as we said, Q2, Q4 would be the best quarters. I certainly expect, based on the continued interest in getting approvals outside US and sort of early indication of demand for systems to be shipping OUS, that we'll have a reasonable quarter this quarter, in the third quarter, which typically, you know, just globally, cataract surgery volumes are the lowest, overall, cataract surgery volumes are the lowest in Q3 as compared to all four, you know, the other three quarters over the course of the year, because of extensive European vacation schedules, you know, people, you know, generally traveling more, doing less. And then the fourth quarter typically is the strongest from a procedure number perspective, overall cataract procedures.
So I expect that to follow suit with LenSx, but even more so for us, because we've got a large number of systems that installed at the end of the first quarter and certainly into second quarter, with a big backlog moving into third quarter. We'll have a reasonable third quarter, and then I expect fourth quarter that between the meetings that we've got, the shipments that are going OUS in this quarter and in fourth quarter, that we're really gonna finish the year really strong going into the first quarter. So I would expect that both on a procedure level as well as on an overall capital level and numbers of systems, you're gonna see some really strong performance here as we get into the fourth quarter.
Tom Staab (CFO)
Frank, maybe just a little bit of color. So in my remarks, I had mentioned that we expect the procedure volume to increase in the third and fourth quarter. If you look at the third quarter and the 17 placements, and you split the quarter right in the middle, the vast majority of those placements were actually installed in the latter half of the quarter. And so what that means is, you know, you got to ramp up those systems, and they should kick in significance in the third quarter, but really, all of them will be hopefully operating at an optimal level in the fourth quarter. The other thing to consider is with the 2 clearances, we just started shipping systems, and obviously, it's, you know, at least one third of the quarter is done.
So, it'll take us a while to, you know, to get that. But those procedures from an ex-US perspective should kick in in the fourth quarter. So we really do expect the fourth quarter to be very, very strong for us, just because of those catalysts.
Frank Takkinen (Analyst)
Got it. That's helpful. Thanks. Congrats on all the progress.
Operator (participant)
Thank you. Next, we're gonna go to Ryan Zimmerman with BTIG.
Ryan Zimmerman (Equity Research Analyst)
Hey, guys. Good morning, and
Nick Curtis (CEO)
Good morning.
Ryan Zimmerman (Equity Research Analyst)
Congrats on all the approvals. It's exciting to see. Wanna ask about your OUS strategy a little bit, Nick. So, just talk to us kind of how you're thinking about approaching the market. I mean, obviously, you have distributors there, but, you know, is there something, you know, beyond just attendance at clinical meetings? Are you putting any resources in these markets? Just help us understand kind of how you're thinking about approaching that.
Nick Curtis (CEO)
Yeah. Thanks, Ryan. Appreciate the question. So, you know, it's interesting. We didn't have the luxury 12 years ago when we were introducing the first gen of being able to sort of control the launch, if you will. You know, we kinda had to go global and introduce the product everywhere 12 years ago, because we were sort of the last company, and we were the smallest independent moving into the marketplace. Things are a lot different right now. We're the leader in the technology moving into the marketplace now, with a significantly enhanced new product. And Europe has been pretty polarized in terms of people's belief or lack thereof in the femtosecond laser market space for cataract surgery....
It's been polarized there because when these technologies launched, there was a high expectation for efficiencies, outcome, and performance. Quite frankly, the first-generation systems went into the marketplace, and they didn't necessarily perform like that to start. Now that we've had the benefit of a ramp-up in the U.S., there's been a significant amount of cross-pollination between, you know, European physicians and physicians outside the U.S., you know, hearing about ALLY. We've certainly got a much better handle on ALLY now and understand very well how it works, and we've already put very substantive, you know, kind of continuous improvement and upgrades into the system. So we expect that when we get these first systems installed, there's a couple different areas.
You know, I talked about, you know, channels in the U.S. from a private equity perspective. Well, those same channels exist outside U.S., and we've begun in the EU at least, and we've begun to penetrate into one of the larger... Two of the larger private equity groups, actually, in with first-gen lasers of LENSAR, and we'll be evolving into the ALLY lasers there. We've also reached out to a group of KOLs that heretofore we haven't necessarily had a relationship with and done business before. And as you know, peer-to-peer is really strong in, you know, for these types of technologies and products. And we're really focused on how we address the shortcomings of the first-gen lasers, as in practice in the EU.
And so we are putting some resources into those areas. We're doing, you know, we're gonna be present there. You know, ESCRS is coming up, and, I'll talk more about some of the activities that we're gonna be doing at the ESCRS, in next quarter's call, because I'll be able to give you an update as to actually how we did. And we're also gonna likely be sending some of our people over to Europe and to Taiwan, Hong Kong, to work with the distributors there in getting a quicker uptake with installs, right? Because they don't have the numbers of employees dedicated to it. Sorry to take up so much time there.
Ryan Zimmerman (Equity Research Analyst)
Right.
Nick Curtis (CEO)
But it's, it's important.
Ryan Zimmerman (Equity Research Analyst)
No.
Nick Curtis (CEO)
You know, it's a multiprong-
Ryan Zimmerman (Equity Research Analyst)
No, no
Nick Curtis (CEO)
... approach here.
Ryan Zimmerman (Equity Research Analyst)
Great, great color, and appreciate that. Now, I wanna ask, I mean, your last quarter, if I recall, you weren't building in the contribution from international revenue. I think I heard you correctly say that the backlog of 17 is all U.S. So just want to understand, are you expecting some revenue in the back half of this year, internationally?
Nick Curtis (CEO)
100%. And in fact, it's interesting because rev rec, Tom touched on it in his remarks. Rev rec in the U.S. takes longer than it does OUS. Because in the U.S., to give rev rec, we have to ship. We have to take the order, we have to site visit, we have to ship, we install, we have to train, and then when we have certified users on the product, we get to rev rec, whether it's a sold system or whether it's a placed system in the U.S. And so there's a time lag there. Rev rec, outside the U.S., with the distributors, works that when it leaves our dock, it becomes the property, if you will, sold system to the distributor. So rev rec occurs faster outside-
Ryan Zimmerman (Equity Research Analyst)
Right
Nick Curtis (CEO)
... U.S. than it does in U.S., number one. However, lower margins, right? Because distributors are, you know, in essence reselling, contracting with the customer. And, the pathway to procedure revenue, once it leaves our dock, is very similar to the U.S. because they still have to install it, they have to train, they have to, you know, get people certified before there's revenue on procedures, which is why there's always a lag between the installs and when you start to see, productive, Tom said, gets to their normal, normal rate, if you will, of procedures. And so, that's sort of the process.
I'm excited because we'll actually see revenue in the third quarter, when typically we might not see as much revenue in the third quarter OUS, because we just, you know, with us just getting the approvals, regardless of vacations, we're shipping some systems, which is good.
Ryan Zimmerman (Equity Research Analyst)
Okay.
Nick Curtis (CEO)
So, so does that make sense?
Tom Staab (CFO)
Ryan, we'll be getting sales outside the United States in the third quarter, but I wouldn't expect a whole lot of procedure-
Nick Curtis (CEO)
Correct
Tom Staab (CFO)
... revenue until the fourth quarter-
Ryan Zimmerman (Equity Research Analyst)
Yeah
Tom Staab (CFO)
... which is why, you know, when I answered Frank's question, not only do you have the timing in the United States of placements in the second quarter that were late in the second quarter, but then you also have the contribution from Europe on procedure volume going into the fourth quarter. So I think the fourth quarter should be a nice quarter for us.
Ryan Zimmerman (Equity Research Analyst)
Oh, very helpful. And then maybe two more questions for me, and then I'll hop back to you. But just, you know, you guys accelerated your growth 16%, against a 13%, comp in the US. Really great to see. What's your read, Nick, on the health of the procedure environment, particularly for cataracts right now, both US and globally? And then the second question, I'll just ask upfront. You know, Tom, as we think about margins, I appreciate the guidance this year. Conceivably, with all the consumable revenue and recurring revenue next year, margins could step up a little more materially. Just help us think about maybe the longer-term margin opportunity for you guys. Thanks for taking the questions today.
Nick Curtis (CEO)
No problem. Tom, you go ahead.
Ryan, I'm sorry, because I was
Ryan Zimmerman (Equity Research Analyst)
Yeah.
Nick Curtis (CEO)
I was tracking on your gross margin. Can you, can you go back?
Ryan Zimmerman (Equity Research Analyst)
Yeah. First question, Nick, was just U.S. accelerated 16%, on a-
Nick Curtis (CEO)
Oh, how do I look at the cataract market overall?
Ryan Zimmerman (Equity Research Analyst)
Yeah, just your read on cataract health procedures.
Nick Curtis (CEO)
So it's interesting because, you know, there is still some pent-up demand from a cataract surgery perspective. You know, the people, you know, this is kind of still a little bit of a hangover from COVID, right? There's patients that, you know, didn't have surgery, that now have surgery. On the other hand, there's some uncertainty in, you know, with interest rates and, you know, talk about the economy and inflation and whatnot. And so I think patients, I think there's some pressure on physicians from a premium surgery perspective.
On the other hand, you know, you also have, you know, the generation of patients that are becoming cataract age patients, that have had and made significant investments in their eyes in, you know, refractive procedures leading up to this. And so, in AECOS, there was an interesting session. Doctors are under pressure in their offices to maintain profitability, which is very difficult to do with present patients and time necessary in the office. On the other hand, with reimbursements under pressure, and, they certainly and incidence of astigmatism, 70%-90%, of patients have visually significant astigmatism.
It's imperative that doctors begin offering alternatives to patients from a surgical perspective that aligns patient need and patient want with really surgeons' needs to be able to offer those services and, and you know, make a profit. So I think I feel pretty comfortable that with the on the astigmatism side, that you'll see a higher management of astigmatism as more routine to cataract surgery. Cataract surgery is refractive surgery, and doctors are relating to that. Private equity groups also have been pretty static, right? They haven't been able to continue to do deals. They made some pretty rich deals in paid premiums for these practices.
So we're seeing the private equity groups, who are on the business side, they were not that interested in looking at these types of things as replacement technologies to the older technologies that are, when they're hearing the efficiencies, you know, they have to improve efficiencies, they have to be able to have better patient throughput. We deliver on that. So while the macroeconomic climate is difficult, this is, you know, this is not an if, it's a when with this, you know, they're having to look at this, and they are giving serious consideration.
So I feel like, like, our volume and just by the nature of the percentage of new customers that are coming to LENSAR, this is gonna, this is, you know, on the macro market, doctors need to do and offer these types of procedures. Patients want them and need them. And regardless, there's enough patients to be able to do this.
Ryan Zimmerman (Equity Research Analyst)
Thank you.
Tom Staab (CFO)
So, Ryan-
Ryan Zimmerman (Equity Research Analyst)
Margin, margin.
Tom Staab (CFO)
In regards to gross margins, obviously, we're predicting that we're around 50%, for this year. And that's, you know, we're seeing a few more sales than what we had originally anticipated. And it goes to Nick's comments about, you know, the difficult macroeconomic market and just being a little harder for capital equipment sales. That, we've been pleasantly surprised that it's ticked up a little more than what we had anticipated. So you take that forward, and the short answer to your question is, if we're at 50%, right now, we could easily go to 53%-55%. And there's a number of factors that we are evaluating there. One is, you know, the floodgates have opened outside the United States.
Right now, we've been captive to growing in the United States, and we've done really well. We will continue to do that next year, but what you're going to see is, now we have the ability to place outside the United States, and that's very important for two reasons. One is, all those placements will be sales, unlike in the United States. But, you know, our margins generally carry an 80%, or our procedures carry an 80%, margin or so. Obviously, our systems carry a much lower percentage, and then outside the United States, even lower than the United States, simply because we have to make sure that our distributors are motivated and compensated appropriately. And so I think that you have benefit in margin associated with more throughput of systems and utilization of overhead.
More sales of systems is going to pull on that margin down a little bit, but as we place systems, the procedures and the recurring revenue associated with that obviously gives a much higher margin. It'll balance it all out, and I would say 53%-55%.
Ryan Zimmerman (Equity Research Analyst)
Thank you, Tom.
Operator (participant)
Thank you. I'd like to turn the call back to our speakers for any closing remarks.
Nick Curtis (CEO)
I appreciate everybody for joining the call today. Thank you, and for your continued interest in LENSAR. We really look forward to updating you as we make further progress in the exciting remainder of 2024 and beyond. Thank you for your attention today, and questions appreciated.
Operator (participant)
This does conclude today's program. Thank you for your participation. You may disconnect at any time.