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Posts Tagged ‘hybrid contact lenses’

Christian’s Keratoconus Story – “ClearKone Changed the Way I See Life”

Thursday, June 23rd, 2011

My vision challenges began in junior high school when I started to wear glasses. Although my vision was fine at that time, things started to change when I entered high school. I began to notice that I wasn’t able to read the chalkboard. Even though I sat in the front row, I found it difficult and frustrating to read the teachers’ notes. I went back to my optometrist, who gave me another pair of glasses with a stronger prescription. Unfortunately, the new glasses only helped for a period of time. By the time I was in my junior year, my vision was a problem again. The new glasses no longer corrected my vision. I decided it was time to see a new optometrist. 

In my senior year of high school my new optometrist, Dr. Barry Leonard, diagnosed me with keratoconus. While I was glad to have found out the cause of my vision problems and learn that contact lenses could improve my eyesight, I could never have imagined the contradictions that came with contact lens wear. My doctor fit me in RGP lenses, which did improve my vision, but the lenses were so uncomfortable. My eyes were often irritated, so I would try to function without wearing the lenses. Unfortunately, my vision was so poor without them that I could not drive, see faces of friends at a distance, or read a book with small font. Keratoconus was truly affecting my daily activities!

Dr. Leonard then recommended that I try the ClearKone lens from SynergEyes. He explained that the rigid center would give me the visual acuity I needed, while the soft skirt would keep my eyes comfortable throughout the day. It sounded like a great option! As we began the fitting process, it was difficult for my lids to open wide enough for the lenses to be inserted. My eyes were so sensitive that my lids would close whenever the lens got near my eye. Thankfully, Dr. Leonard was very patient with me, and after many attempts, was able to insert the lenses.

Once I began wearing the lenses, I was amazed. My vision was clear and crisp, and the lenses were so comfortable that I could wear them all day long without irritation. It really was the best of both worlds!

I have now been wearing the lenses for several months, and my life has changed in so many ways. I can distinguish faces from a distance and see their expressions, which is so wonderful! I am also able to drive, use the computer, and read books with small font. I feel like I now have a normal life without the frustrations of poor vision. ClearKone lenses have truly changed the way I see life!

Melanie’s Keratoconus Story – “Life Inside an Impressionist Painting”

Tuesday, December 21st, 2010


ClearKone Sharing Vision Grant Recipient

Melanie's Keratoconus Story

I live inside an impressionist painting, where colors smear across the canvas and ghost images hover around any large object I can actually identify. At night, my world is ablaze with eight-pointed stars that spring from every source of light – headlights, streetlamps, neon signs and even candles on the altar at church. When I try to focus on your face, I see a double image of your features; your eyes and nose and mouth run together like melting wax. Like a blind person, I focus on your voice, your height and weight, and the way you move. I miss seeing you smile and roll your eyes and grimace – all the nuances that nurture communication. Because I can’t see you clearly, I often misunderstand. I’m a writer and graphic designer, but I can’t read the words on the monitor as I type them. I can’t read a letter or take legible notes when I talk on the phone. The more I enlarge the letters on my monitor, the more they smear. I squint. I turn my head, and try to capture a pinpoint of light that will fall on my retina at just the right angle and reflect a clear impression of what’s before me.


I’ve lived for 39 years as a classic myope, “seeing” new places and people and experiences through my enormous collection of novels, reference and business books, textbooks, biographies, and books on art, psychology and spirituality. At one time, I could take out my contact lenses before I went to bed, put on a pair of bottle-bottom glasses, and settle under my down comforter to read myself to sleep. Since having RK surgery some 17 years ago, however, there’s not a lens in the world that can filter light through my damaged corneas and hit the sweet spot on my retinas. If I want to read these days, I must wear both contact lenses and reading glasses, and maintain a powerful squint.

Now I’m locked into a smeared world filled with beautiful works of art and brilliant literature, as well as the simple pleasures and necessities of sight – the daily newspaper, the buttons in the elevator, the menu at the meat-and-three, the birthday card from a friend, the calorie count on a carton of yogurt. I can’t see any of them clearly enough to use them. Bursts of light are excruciating for my damaged corneas. Sometimes it’s seemed easier just to stay in bed in despair and sleep the days away.

To adequately explain why ClearKone® lenses made such a difference in my life, I have to explain the impact of my RK surgery. I started wearing glasses when I was eight and contacts when I was 12. I could always read without correction, but the glasses and/or contacts were critical if I needed to see anything beyond my books. When RK surgery came to the forefront in the early 1990s, I jumped on the bandwagon and had one major procedure and one “touch-up” performed on each eye by one of the city’s most prominent ophthalmologists. For a few weeks, I lived the miracle of 20/10 vision. I could see the lighted display on my clock in the middle of the night. I no longer had to baby expensive contact lenses or endure the pain of getting debris caught under them. I could move from reading to driving to computer work seamlessly, ride freely in a convertible without worrying about dirt flying into my eyes or my contacts drying out, swim and see at the same time, and best of all – my vision was better than it had ever been in my whole life!

My 20/10 days lasted for about a month, and then the unthinkable happened. My vision began to deteriorate, both at near vision and at a distance. My new crystal-clear world slipped away from me day by day, and I began what would be a 17-year quest to regain my sight. My doctors tried every contact lens available. While I could see fairly well with gas permeable lenses, they were pure misery to wear, rubbing against my RK incisions and forcing me to take them in and out, over and over, every day. My vision fluctuated so much in the course of a day that no prescription glasses ever gave me clear vision at any distance. With menopause, my dry eyes dried out even more. I had my tear ducts cauterized. I tried wearing nothing but glasses for months in hopes that my vision would stabilize and adapt to the glasses, but it didn’t work I moved to another city and new optometrists tried to help me. We tried various soft lenses, but they only draped themselves over my flat cornea and many incisions and did little to help me see, although they were more comfortable than gas perms. My optometrist tried piggy-backing a gas perm lens over a soft lens, but the lenses wouldn’t center. I spent endless hours on the internet and phone, talking with specialists throughout the country, trying to find the one doctor who might have a rare and unpublicized solution for failed RK procedures.

Finally, with the dawning of the new century, the first hybrid lenses came on the market, and after weeks and weeks of fittings and trial and error, for the first time, I had decent vision and decent comfort with monovision Soft Perm lenses. I still couldn’t be corrected with glasses, so I was heavily dependent on my contacts to read, drive, and work. Because my RK incisions were so prone to irritation, the hybrid lenses would periodically cause one or more of the incisions to open up. That was agony, both because of the pain and because I would be unable to wear the lens (and thus become visually disabled) until the incision healed enough for me to tolerate it again. This year I developed yet another problem with my hybrid lenses. Almost as soon as I’d insert them, they would cloud over with a thick, gluey substance. I spent more time taking them out and cleaning them than I spent actually wearing them!

Having moved back to Birmingham, I went back to UAB Eye Care and met Dr. Adam Gordon, who told me about ClearKone® hybrid contact lenses. From the first moment I felt that lens on my eye, I knew it was the answer I’d been searching for. Because the lens floated on a layer of fluid above my RK incisions, they were incredibly comfortable, and my visual acuity was better than it had been since my one-month bout of 20/10 vision 17 years earlier.

SynergEyes Grants Life Changing Gift for Holidays: Ability to Distinguish Family Faces Keratoconus Patients Granted New Hybrid Contact Lens Technology

Tuesday, December 21st, 2010

Carlsbad, CA (December 20, 2010) – This holiday season patients are receiving the life-changing gift of clear and comfortable vision thanks to the Sharing Vision Grant Program sponsored by SynergEyes, Inc. This program was created to bring the new technologically advanced ClearKone® hybrid contact lens to keratoconus patients who may otherwise not have access.  Keratoconus is a degenerative eye disease that occurs 1 in 1,000 people causing substantially distorted vision and in many cases changes how they live their lives. Patients can apply for the program on at www.TreatKeratoconus.com.

Cassidy Randle was a successful college student looking to go to nursing school, after graduation. Just as any young girl, she wanted to get rid of her glasses and therefore underwent refractive eye surgery in 2003. Initially her vision was okay and then it started deteriorating. In no time she was almost blind in her left eye and had poor vision in the right eye.  She had seen many cornea specialists and tried many type of lenses, but unfortunately, none of the lenses gave her the comfort or the vision back. It came to a point that she was unable to drive a car and her hopes of nursing school were fading.  “I began to worry and think to myself: ‘How will I be able to focus in school if I am unable to see?’” Cassidy said.  And her worries were more personal as well. “The worst feeling imaginable is being unable to distinguish my family’s faces and see their expressions.”

After Dr. Gupta at the University of Texas Medial Branch (UTMB) Eye Center volunteered her time and provided a free fitting for Cassidy in ClearKone® lenses, provided free by SynergEyes, Inc., Cassidy is now able to see again. “When I tried on the lenses for the first time I knew the difference in my vision was going to be life-changing,” said Cassidy.  Thanks to the Sharing Vision Grant Program and Dr. Gupta, Cassidy can see her father’s face again and she can pursue her dream of becoming a nurse.

Currently, over 15 patients are enrolled in the program; receiving free lenses from SynergEyes and free fitting from participating eye care practitioners. One of these patients is Melanie LeMay who is working with Dr. Adam Gordon to achieve clear vision for the first time in 17 years. “I can’t think of a better Christmas gift than a pair of ClearKone® lenses!” said Melanie. “These lenses will be life changing for me and for others as well.”


The ClearKone® hybrid contact lens is the only hybrid lens of its kind for keratoconus and is having a significant impact on thousands of patients.   Available for less than a year, this new technology offers both clear vision and comfort for patients who would otherwise have to compromise their vision.  SynergEyes is the only company that makes a hybrid lens which has a “hard” center for the clear vision, and a soft outer skirt that provides comfort.

About SynergEyes®:

SynergEyes®, Inc. was founded in 2001 with a recognized need for a hybrid contact lens that combined the superior visual acuity of a rigid gas permeable lens with the comfort of a soft contact lens. The patented SynergEyes® hybrid technology with FDA market clearance is providing comfortable clear vision through the services of more than 5000 eye care practitioners throughout the United States, Canada, Puerto Rico and the United Kingdom.

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Contact Lens Options for Keratoconus

Monday, October 18th, 2010

Author:  Dr. Anderson, OD, FAAO

Keratoconus is a bilateral, progressive corneal thinning disorder which manifests as irregular, asymmetric astigmatism. Symptoms include blurred, subacute distorted vision which is usually more pronounced in one eye than the other. Refraction is often difficult and patients may not be adequately corrected with spectacles. Contact lenses are the best form of visual correction in most cases of clinically significant keratoconus. There are many different types of contact lenses available for keratoconus. Depending on the degree of clinical significance, lifestyle and ocular health, the optimal contact lens can be determined for each patient. This article describes the different design options currently available, along with the goals to keep in mind when fitting these patients.

Soft Toric Lenses

Many times, patients in the early stages of keratoconus do well with soft lenses. A satisfactory baseline refraction, which will most likely have a moderate amount of cylinder, is necessary in order to determine the soft lens prescription, which will most likely be toric. Occasionally, a spherical equivalent will produce good visual results. Patients with forme fruste keratoconus may also do well with soft toric lenses since adequate spectacle refraction is often possible.

Rigid Gas Permeable (RGP) Lenses

RGPs are the most commonly prescribed lenses for keratoconus. Traditionally, these lenses were fit with small diameters, three-point touch and variable edge lifts to improve comfort. However, this type of fit often results in a low-riding lens, decentered inferiorly over the pupil which induces aberration. More recent RGP designs for keratoconus have incorporated aspheric or biaspheric optics to decrease aberration, along with larger diameters to improve centration.

Piggyback Systems

Keratoconus patients who are currently fit with RGP lenses oftentimes experience discomfort and decreased wearing time as their condition progresses. The cone steepens and the apex thins to the point of inflammation, abrasion and irritation from RGP bearing. A simple way to halt this cascade of events is to place a soft lens beneath the RGP. Using a low minus power will flatten and protect the corneal surface as well as improve the comfort and wearing time. High Dk soft and RGP materials work well to maintain corneal integrity by decreasing the incidence of neovascularization.

Hybrid Lenses

These lenses consist of an RGP center with a soft skirt edge. They combine the benefits of rigid lens optics, including better lens centration and decreased aberrations, along with the comfort of a soft lens. The results are improved vision and increased wearing time. This is especially beneficial in keratoconus patients whose cone apex is very steep, thin and decentered. Traditional small diameter RGP lenses tend to decenter downward over the apex, inducing bothersome aberrations over the pupil. SynergEyes is currently the only manufacturer of hybrid lenses in the U.S. The designs available for keratoconus include the SynergEyes A, KC and ClearKone. Patients with mild to moderate keratoconus may fit into the A lens which has a spherical RGP center. The KC lens has an aspheric RGP center and is reserved for more advanced cones. ClearKone consists of a reverse geometry RGP center which is fit upon elevation or sagittal depth rather than base curve. This allows for clearance, centration and stabilized vision over a decentered cone. Because it achieves clearance by vault, ClearKone offers lower powers and reduced aberrations as compared to lenses fit according to base curve.

Scleral/Semiscleral Lenses

Rigid gas permeable lenses with diameters of 13mm or greater fall into this category. The benefits of these large diameter RGPs in keratoconus are a large,well-centered optic zone, minimal movement with blink, stabilized vision and improved comfort. Fitting these lenses requires a great deal of skill, which is acquired from experience. The dynamics are quite different from corneal lenses. The parameters of the larger periphery determine the patient’s ability to wear the lens comfortably and must be fit independently of the central base curve. The ultimate goal in fitting any keratoconus patient with contact lenses is good vision and comfort. This is relatively easy to achieve in early cones and becomes more difficult as corneal thinning and steepening progress. Determining the best lens to fit in order to achieve these goals is as much of an art as it is a science. For example, a patient who has worn small diameter RGPs unsuccessfully may do better in a hybrid or semi-scleral design. Regardless of lens design, finding the best lens begins with careful measurement of corneal curvature and diagnostic lens fitting.

Keratoconus Treatment Options

Friday, September 3rd, 2010

By Dr. Brandon Ayres, MD

Keratoconus causes progressive thinning and distortion of the cornea that affects approximately 1 in every 2000 people.  It tends to affect younger people sometimes starting in the early teen years and progresses most rapidly through the fourth decade.  As the dystrophy progresses the cornea takes on an irregular cone like shape and may develop scar tissue.  The changes in the cornea seen in keratoconus lead to “irregular astigmatism.”  Irregular astigmatism means that light is not able to focus on the retina even with the use of glasses or traditional soft contact lenses.

The primary treatment options fall into two categories:  contact lenses and surgery.  This article outlines both options.

Glasses and Contact Lenses

In the very early stages of keratoconus patients may notice a change in their prescription glasses or contact lenses.  Often times what is seen is an increase in astigmatism.  If the keratoconus progresses only minimally, all that will be needed is modification of the glasses prescription or possibly a soft contact lens that also corrects for astigmatism.

Keratoconus Contact Lenses

Once patients with keratoconus are dissatisfied with there vision with traditional glasses or soft contact lenses a special keratoconus contact lens may be necessary.  Most commonly this contact lens will be either a hybrid or rigid gas permeable (RGP) contact lenses.  It is important to understand that contact lenses may allow excellent vision, but do not actually treat or stop the progression of the underlying dystrophy.

A rigid gas permeable contact lens is able hold it’s spherical shape vaulting over the irregular cone shape of the irregular cornea.  This gives a new smooth surface to refract light, restoring good vision.  The use of an RGP is an excellent, non surgical, technique to restore vision in keatoconus,  but the fitting of the lens can be quite challenging.  Each patient with keratoconus has a uniquely shaped cornea and the shape may change over time.  Many different designs of RGP’s are available for patients with keratoconus and patience is needed to get the right fit.  Most people with keratoconus are able to be successfully fit with RGP’s, however, some have persistent foreign body sensation or difficulty with the lenses falling out of the eye.

Hybrid contact lenses work on a similar principal as RGP’s.  This style of contact lens has a rigid gas permeable center that is fused to a soft contact lens “skirt” and therefore a hybrid of hard and soft contact lenses.  By fusing the two styles of contact lenses the visual benefit of a RGP is combined with the comfort of a soft lens.  As with the traditional RGP, these lenses must be specially fitted to ensure function, comfort, and safety.

Surgical Options

Collagen Crosslinking (CXL)

Collagen crosslinking is a technique that is currently under FDA trial here in the United States, but widely available outside the country.  Collagen crosslinking is a technique where vitamin B2 (also known as riboflavin) in liquid form is placed on the cornea.  The cornea is then exposed to ultravioled light (UV-A).  The combination of vitamin B2 and UV light increases the “linkages” in the corneal collagen.  This has been shown in laboratory studies to “stiffen” the cornea.  The goal of collagen crosslinking is to prevent progression of the keratoconus, not to reverse or cure it.

INTACS® Corneal Inserts

INTACS corneal inserts are small inserts that are placed in the cornea.  These inserts help “flatten” the central cone of the cornea in patients with keratoconus.  Once surgically implanted in the cornea the inserts are almost invisible and they cannot be felt.  INTACS have been shown to help with improvement in corrected and uncorrected vision.  INTACS can also be helpful in improving contact lens tolerance by reducing the conical shape of corneal in patients with keratoconus.  Recent studies have shown continued improvement in patients having INTACS placed over the course of 1 year and there is some suggestion that they may help stabilize the cornea.

Corneal Surgery

Approximately 20% of patients with keratoconus will have progression to the degree where corneal surgery is necessary.  The most common procedure performed is a full thickness corneal transplant also know as a penetrating keratoplasty (PKP).  In this surgery the diseased corneal is removed and replaced by a human donor cornea.  Luckly, transplantation of the cornea is the most successful of all organ transplants with a low rejection rate.  The vast majority of patients will achieve excellent vision after a transplant though it may take 12 to 18 months to achieve.  Many patients will still need the assistance glasses or contact lenses for optimal vision.

A second surgical option for keratoconus is a deep anterior lamellar keratoplasty (DALK).  This procedure is essentially the same as a corneal transplant except that the very thin innermost layer of the patient’s cornea, called the endothelium, is spared.  The surgery will look and heal very similar to a corneal transplant except that there is a lower chance for transplant rejection.  The surgery is technically much more challenging for the surgeon and sometime has to be converted into a full thickness transplant.

Most recently there has been an interest in using a laser to make the incisions for both corneal transplants and DALK surgical procedures.  The laser-guided incisions allow for an exact match of the patient and donor corneas.  The exact fit allows for a stronger wound and possibly faster healing with less residual astigmatism after the surgery.

Recent Hybrid Lens Technology

Saturday, August 28th, 2010

By Rob Davis, O.D., F.A.A.O.

In 2001, Quarter Lambda Technologies (later to become SynergEyes, Inc.) began research and development of a new hybrid contact lens design that ultimately received FDA clearance in 2005. The SynergEyes® hybrid lens differed from the original SoftPerm® design in several key areas. SynergEyes hybrid contact lenses use high oxygen permeable materials and a patented technology called “Hyperbond®” that significantly reduces the separation between the rigid and soft junction of the lens that was common in the SoftPerm® lens. The soft skirt portion incorporates a special surface treatment called ‘HydrolEyes®’ to improve surface wettability and comfort.  In addition, the SynergEyes® lens is available with adjustable soft skirt curves as well as multiple fitting curves allowing for more customized fitting of the lens for virtually any patient in a contact lens practice.

SynergEyes initially developed four hybrid contact lens designs, including the SynergEyes® A lens for patients with astigmatism, the SynergEyes® KC lens for fitting cases of emerging keratoconus and other steep corneas, the SynergEyes® PS lens for fitting post-surgical corneas and other eyes that have flatter corneal surfaces; and the SynergEyes® Multifocal design for patients over 40 who cannot see close up.

In 2010, SynergEyes introduced the ClearKone® design, which fits a much broader range of keratoconus and irregular cornea patients then any other hybrid contact lens products.

The SynergEyes® family of hybrid lenses provides excellent comfort, optimal vision and corneal health. Numerous fitting parameters and the high oxygen permeability of the RGP material eliminates “tight lens syndrome” that can result in edema or swelling of the cornea. The increased amount of tears underneath the lens eliminates friction between the lens and the surface of the cornea giving an added measure of safety and comfort. The improved surface treatment reduces the dryness experienced by other contact lens designs. The improved durability of the rigid/soft junction, base curve availability, and options of skirt radii of the SynergEyes® lens has evolved this technology to the point that it has now entered the mainstream contact lens category for patients with normal corneas as well as irregular corneas.

Read The History of Hybrid Lenses

The History of Hybrid Lens Technology

Thursday, July 1st, 2010

Patient excitement for a contact lens is created when the first lens placed on the eye provides good vision and feels great.  Success in contact lens wear depends upon the patient achieving their vision, comfort and eye health goals. At one time patients could only choose between rigid gas permeable lenses (RGPs) and soft lenses so patients often had to compromise on either vision or comfort. Today there is another technology option available called the hybrid contact lens. A hybrid contact lens combines the superior vision benefits of an RGP lens with the comfort benefits of a soft lens.  Hybrid lenses have come a long way since they were conceived in 1977.  Now in the 4th generation, the hybrid lens category has evolved to offer patients with all types of vision problems an opportunity to experience the benefits a hybrid contact lenses offers.

Hybrid Lenses – How they started.

The quest to develop a contact lenses that provides the opportunity for crisp vision and unparalleled comfort began in 1970 with the experimentation of placing a RGP lens on top of a soft lens known as a “piggyback system”. By using this piggyback combination, comfort was improved over RGP lenses and the quality of vision improved from soft lenses. The added benefits of good centration and increased lens stability on irregular corneas created a lens design used for the more complicated cases. The disadvantage of a “piggyback” system is the inconvenience of managing the four separate lenses. Also, on already compromised eyes the lack of oxygen and the possible adverse events of corneal swelling and blood vessel growth can be an issues with piggybacking lenses and always requires additional doctor follow up visits.  It seems reasonable if we could create a single contact lens with the advantages of both RGP and soft lenses, all the disadvantages of contact lenses would be solved. This was the first step in creating the revolutionary hybrid contact lens.

Two scientists named Erikson and Neogi had the idea that a combination lens with a hard center and soft skirt could be developed.  They patented technology that made this possible and that technology was acquired by a company called Precision Cosmet in 1977. This first “hybrid” design was known as the Saturn® lens. The idea behind this hybrid contact lens concept was to improve the performance and comfort of an RGP contact lens for irregular corneas.

In March of 1982, a pre-market investigation took place and the Saturn® lens was granted approval by the FDA in April of 1984.  With minimal customizable options and low oxygen permeability, the Saturn® lens was relegated to a problem solving lens.  Saturn lenses typically exhibited very little movement, called “tight lens syndrome” resulting in red eyes and problems of night time glare.

In 1986, a company called Sola Barnes-Hind then purchased the hybrid contact lens concept and technology and set forth to redesign the lens to address the performance issues. They named the product SoftPerm®. The SoftPerm® lens, was made out of the same material as the Saturn lens.  It had the advantage of improved comfort and additional parameters to properly fit patients. However, because the lens had low oxygen permeability and issues with the center separating from the soft skirt, the lens was still only used as a lens of last resort. A third redesign in 1989 by Sola Barnes-hind created the new SoftPerm lens but this design also suffered from its low oxygen permeability, and practitioners were still hesitant to accept it as a lens of first choice because of feared complications. Problems associated with lens sticking to the cornea and acute red eye problems further inhibited the use of these lenses.  The SoftPerm lens was discontinued in 2010.

Today, a company called SynergEyes is the only company successfully making hybrid contact lenses.

Read “Current Hybrid Lenses Technology”

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