Restoring functional vision in moderate-advanced keratoconus: quality-of-life outcomes with hybrid contact lenses
International Ophthalmology, vol.46, no.1, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 46 Issue: 1
- Publication Date: 2026
- Doi Number: 10.1007/s10792-026-04028-4
- Journal Name: International Ophthalmology
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Keywords: Functional vision, Hybrid contact lenses, Keratoconus, NEI-VFQ
- Ondokuz Mayıs University Affiliated: Yes
Abstract
Purpose: 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. 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). Results: 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. Conclusion: 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.