Restoring functional vision in moderate-advanced keratoconus: quality-of-life outcomes with hybrid contact lenses

To evaluate the clinical, functional, and quality-of-life outcomes of next-generation SynergEyes UltraHealth® hybrid contact lenses (HCLs) in patients with moderate to advanced keratoconus or irregular astigmatism who failed to achieve adequate visual rehabilitation with conventional optical correction methods.

This retrospective study included 31 patients diagnosed with keratoconus or irregular astigmatism who were intolerant of, or inadequately corrected with, silicone hydrogel soft lenses, or rigid gas-permeable (RGP) lenses. During follow-up, 3 patients (6 eyes) discontinued HCL use due to intolerance, leaving 53 eyes of 28 patients for analysis. All patients were fitted with SynergEyes UltraHealth® HCLs. Best corrected visual acuity (BCVA) with RGP lenses or soft lenses and HCL-corrected visual acuity (HCVA) were recorded at baseline and at 6 months. Kmax, central corneal thickness, and apex values were recorded using Pentacam®. Vision-related quality of life was assessed using the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25).

The mean Kmax was 58.5 ± 6.3 D, indicating predominantly moderate-to-advanced keratoconus. HCVA improved significantly from 0.42 ± 0.22 logMAR to 0.13 ± 0.11 logMAR (p = 0.02). HCVA of 0.22 logMAR or better was achieved in 88.6% of eyes. NEI-VFQ-25 scores demonstrated marked improvements, particularly in general vision, near and distance activities, social functioning, and vision-related mental health (all p < 0.05). Additionally, there was an increase in eye pain scores (higher scores indicate less pain according to this scale), with higher scores associated with better outcomes;  only three patients (six eyes) discontinued hybrid contact lens use due to intolerance, and no serious eye complications were observed.

Next-generation hybrid contact lenses provide significant improvements in visual acuity and vision-related quality of life in patients with advanced keratoconus and irregular astigmatism. SynergEyes UltraHealth® lenses are an effective and well-tolerated alternative, particularly for patients intolerant of RGP lenses.