New generation hybrid lenses offer promising safety, efficacy for advanced keratoconus

New generation hybrid lenses offer promising safety, efficacy for advanced keratoconus

Cornea/External Disease, Refractive Mgmt/Intervention

Investigators evaluated the visual and corneal outcomes of new generation hybrid contact lenses (HCL) in patients with advanced keratoconus.

Study design

This retrospective study undertaken at a single academic center included 45 eyes with advanced keratoconus who elected to not undergo corneal transplantation surgery between 2016 and 2018. Researchers fitted new generation HCLs and evaluated visual outcomes and corneal endothelial cell density (ECD) at 6 months.


Approximately 71% of the cohort was successfully fitted with HCLs. Those who could not be fit either had comfort issues with the lens or inadequate visual acuity.

Among those who were successfully fitted, none developed ocular surface or contact lens-related complications. There was no significant reduction in ECD or alterations in cell morphology at the 6-month visit. The mean improvement in visual acuity was 0.4 logMar and all patients achieved a BCVA of at least 20/40 in the fitted eye.


This study was limited by its retrospective nature and small sample size. Some patients opted out due to poor visual acuity in the HCL. There was also no control group to compare visual outcomes, although traditionally scleral lenses can be used in a similar population but may not have as much comfort as the HCL.

Clinical significance

New generation HCLs do not appear to jeopardize corneal health and may be a reasonable option for patients with advanced keratoconus who elect to avoid transplant surgery. If a patient has comfort or fit issues with traditional rigid lenses and/or scleral lenses, HCL fitting may be attempted to delay or avoid surgery while improving functional vision.