Contact Lens Care & Compliance
Cleaning and Disinfecting Hybrid Contact Lenses
By Susan J. Gromacki, OD, MS, FAAO
Hybrid contact lenses, by definition, contain a GP center and a soft (hydrophilic) skirt. These lenses have a proven advantage in that the rigid portion provides excellent optics, while the soft portion enhances comfort as well as lens retention.
What's Changed in Hybrids
Since my last column on this topic three-and-a-half years ago, much has changed in the availability and care of this category of contact lens. First, Softperm (Ciba Vision [Ciba]) was discontinued. Secondly, ClearKone (SynergEyes, Inc.), a lens designed specifically for keratoconus, was made available. And perhaps most notably, just this January, SynergEyes completed the rollout of the Duette Hybrid Lens for Astigmatism, the company's new hybrid lens that features a silicone hydrogel skirt.
Duette's rigid center has a diameter of 8.4mm and a posterior optic zone of 7.0mm. Its MaxVu (petrafocon A) material has a Dk of 130 and contains a Class II UV blocker, which the company says prevents >80 percent of UVA and >95 percent of UVB from reaching the cornea. Its prolate aspheric design helps provide an alignment fit, while its 0.75mm junction lift area and soft skirt help ensure that the rigid portion never touches the cornea. The soft skirt (hem-larafilcon A) has a water content of 32 percent, Dk of 84, and a surface treatment to enhance wettability. Parameters include 14.5mm diameter, base curves from 7.1mm to 7.9mm in 0.2mm steps, powers from +4.00D to–12.00D, and three skirt curve radii.
Hybrid Lens Care
Clear Care (Ciba) is the care system that SynergEyes recommends for disinfection of its hybrid contact lenses. SynergEyes also recommends the following multipurpose solutions (MPSs): Aquify (Ciba), Opti-Free Express (Alcon), Opti-Free Replenish (Alcon), Complete (Abbott Medical Optics [AMO]), and Renu Fresh (formerly ReNu MultiPlus, Bausch + Lomb [B+L]). SynergEyes states that it is in the process of testing the newest multipurpose solutions (Biotrue [B+L] and RevitaLens Ocutec [AMO]) with Duette with the goal of adding them to the list of approved care systems.
Daily digital rubbing and rinsing steps are required for all SynergEyes lenses. This may be performed with any of the above-mentioned care systems or with a daily cleaner approved for use with soft contact lenses. GP-specific cleaners and disinfecting/rewetting solutions are contraindicated with both the original and the Duette SynergEyes contact lenses.
The same care regimen and products are recommended for use with the original SynergEyes family of lenses, including SynergEyes A (ametropia), SynergEyes KC (keratoconus), SynergEyes PS (post-surgical) SynergEyes Multifocal, and ClearKone. The one caveat is that, for irregular corneas, non-preserved solutions should be used for both rinsing (e.g. Unisol saline, Alcon) and disinfection (e.g. Clear Care or Oxysept Ultracare, AMO). The company recommends replacing all of its hybrid contact lenses every six months. CLS
For references, please visit www.clspectrum.com/references.asp and click on document #187.
Dr. Gromacki is a Diplomate in the Cornea, Contact Lenses, and Refractive Technologies section of the American Academy of Optometry. She is chief research optometrist at Keller Community Hospital in West Point, N.Y.