Synergeyes Contact Lenses for the Treatment of Keratoconus and Irregular Corneas
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SynergEyes Family of Hybrid Contact Lenses
The SynergEyes family of hybrid contact lenses are a popular keratoconus treatment option for patients experiencing decreased vision due to mild to moderate keratoconus.
Hybrid Contact Lenses – The First Comfortable Keratoconus Lens
Before hybrid contact lenses, patients with keratoconus often had to wear small diameter gas permeable lenses in order to achieve good vision. In spite of the better vision, patients often could not tolerate the poor comfort associated with gas permeable contact lenses. Hybrid contact lenses were an attempt to solve this problem and were patented in 1977. Hybrid contacts gave patients a more comfortable alternative to gas permeable lenses without sacrificing vision.
Piggyback Contact Lenses – The Precursor to Hybrid Contact Lenses
Keratoconus specialists used piggyback lenses to treat patients with keratoconus before hybrid contacts were available. Piggyback lenses gave patients the benefit of good vision from a gas permeable lens while still providing good comfort. Fitting a gas permeable lens on top of a soft contact lens is called a piggyback lens. This combination gave pretty good comfort and vision. Piggyback lenses are rarely used now since hybrid lenses and scleral contact lenses both provide better vision, comfort, and ocular health.
SynergEyes Hybrid Contact Lenses
The early generations of hybrid contact lenses were plagued with durability problems due to the difficulty in bonding the soft skirt to the gas permeable lens in the center. The first few generations of hybrid contact lenses were known to tear easily at this junction. The original SynergEyes contact lens, which gained FDA approval in 2005, was the first hybrid lens to significantly improve the durability problem. While the SynergEyes lenses are not nearly as durable as scleral contacts, gas permeable lenses or even soft contacts tearing is not nearly the problem it used to be. The original SynergEyes lenses are available in a few variations.
- A for astigmatism
- KC for keratoconus,1
- PS for post-surgical (to treat patients after LASIK, PRK or corneal transplant)
- MF multifocal lens for presbyopia
A significant drawback to the original SynergEyes lens is its thick, low oxygen permeable skirt, because of this the Ultrahealth hybrid contact lens was developed. If the cornea does not get enough oxygen it will grow blood vessels to make up the deficit. The lack of oxygenation to the cornea is called hypoxia. These blood vessels tend to grow into the peripheral cornea (limbus). The limbus is where the cornea meets the white part of the eye (sclera). These limbal blood vessels are called neovascularization.
SynergEyes UltraHealth Hybrid Lens for Keratoconus
The UltraHealth hybrid contact lens is the newest version of the SynergEyes keratoconus family. It differs from the original SynergEyes hybrid lens by adding a high oxygen permeable (SiHy) soft lens skirt in addition to an ultra-high oxygen central gas permeable lens. Thus improving on one of the disadvantages of the original SynergEyes design. Because of this, when a hybrid contact lens is indicated, most keratoconus specialists tend to choose the Ultrahealth hybrid contact lens over the original SynergEyes lenses. Keratoconus patients tend to have high contact lens wearing times, therefore high oxygen permeability is especially important.
SynergEyes UltraHealth FC Hybrid Contact Lens for Post Refractive Surgery
The Ultrahealth FC uses all of the same high oxygen permeable technology as the Ultrahealth hybrid contact lens for keratoconus. The FC lens, however, is designed to treat patients that require a lens after eye surgery. Patients that have had eye surgery often require a post-surgical contact lens to achieve their best visual acuity. Some eye surgeries that may be treated with the SynergEyesUltraHealth FC hybrid contact lens are;
- corneal transplants
- corneal collagen cross linking
- radial keratotomy
Duette Hybrid Contact Lenses
While not used in the treatment of keratoconus, the SynergEyes Duette hybrid contact lenses rely on the same high oxygen permeable technology found in the Ultrahealth hybrid lenses. The Duette hybrid lenses lack the extra steep center found in the SynergEyes UltraHealth keratoconus hybrid lens designs. The Duette hybrid contact lenses were designed to give patients that find a gas permeable lens uncomfortable; however, they need the vision only found with a gas permeable lens. SynergEyes Duette hybrid contact lenses are available for high astigmatism, high refractive error, and presbyopia.
When are Hybrid Contact Lenses not The Best Option?
Hybrid contact lenses are not as customizable as other contact lens options such as scleral lenses. While a hybrid contact lens typically gives a patient reasonably good comfort, the vision and fit of the lens may not be optimal for patients with advanced keratoconus or highly irregular corneas. Because of this they may not be the best keratoconus treatment option for patients with moderate or severe keratoconus. Patients wearing a well fit scleral lens will almost always experience better comfort and vision than they had with a hybrid lens. Scleral contact lenses have the advantage of being highly customizable thus making it easier for the doctor to fine-tune both the vision and the comfort.
Who is a Good Candidate for a SynergEyes Hybrid Contact Lens
Patients with mild to moderate keratoconus are the best candidates for hybrid contact lenses.2,3 Hybrid contact lenses are not as customizable as scleral contact lenses or gas permeable contacts. Nonetheless, they are often used for patients needing medically necessary contact lenses.
How Do I Learn More?
There are many keratoconus treatment options available. Dr. Driscoll specializes in treating patients with all types of corneal problems requiring complicated contact lens designs. During your consultation, he will discuss with you all of the options available. His goal is to help you achieve your best vision.
If you would like to schedule your free consultation with Dr. Driscoll you can do so at either our Colleyville or Keller/Southlake location. Please call us at 817.416.0333 or you can do schedule it online here.
About Dr. Richard Driscoll
Dr. Driscoll is a therapeutic optometrist and keratoconus specialist at Total Eye Care in Colleyville, Texas. A 1988 Graduate of the Illinois College, Dr. Driscoll has been treating patients with keratoconus for over 30 years. Following Dr. Driscoll’s Graduation from the Illinois College of Optometry, he joined the residency program at the Tuscaloosa VA Medical Center in Tuscaloosa, Alabama.
Dr. Driscoll likes to write. He wrote An Eye Doctor Answers: Explanations To Hundreds Of The Most Common Questions Patients Wish They Had Asked, available on Amazon.com, and The Patient’s Guide to Keratoconus.
1Abdalla YF, Elsahn AF, Hammersmith KM, Cohen EJ. SynergEyes lenses for keratoconus. Cornea. 2010 Jan;29(1):5-8. [PubMed]
2Carracedo G, González-Méijome JM, Lopes-Ferreira D, Carballo J, Batres L. Clinical performance of a new hybrid contact lens for keratoconus. Eye Contact Lens. 2014 Jan;40(1):2-6. [PubMed]
3Mohammadpour M, Heidari Z, Hashemic H. Updates on Managements for Keratoconus. J Curr Ophthalmol. 2018 Jun; 30(2): 110–124. [PubMed]