Hybrid Contact Lenses

Why combine the two

Rigid lenses give the best optics but can be felt on the cornea, take time to adapt to, and can decenter on an irregular cornea or in active patients. Soft lenses are comfortable but cannot correct irregular astigmatism. A hybrid bonds the two: the rigid zone covers the cornea's optical center and does the correcting, while the soft skirt lands on the surrounding surface, holds the lens in place and cushions the edge. The eye feels a soft lens; the vision is that of a rigid one.

Designs

Hybrids are made in designs for regular corneas with astigmatism, for keratoconus with a vaulting rigid zone that clears the cone, for post-surgical corneas with a reverse-geometry center, and in multifocal versions for presbyopia. The rigid zone diameter, the vault and the skirt curvature are selected from corneal imaging and a diagnostic fitting.

Who suits a hybrid

• Patients with mild to moderate keratoconus who found corneal rigid lenses uncomfortable or unstable
• Patients with high or irregular astigmatism who want rigid-lens sharpness
• Athletes and active patients, for whom a soft skirt keeps the lens in place
• Patients after LASIK, PRK or RK whose standard lenses decenter
• Presbyopic patients with astigmatism, in a multifocal hybrid

Advanced keratoconus, transplants and severe dry eye are usually better served by scleral lenses, which vault the cornea entirely.

Care and replacement

Hybrids are inserted filled with saline and removed with a gentle pinch of the skirt. They use a dedicated cleaning system and are replaced about every six months as the soft skirt ages. Follow-up confirms the rigid zone clears the cornea and the skirt is not tight.