Hybrid optics
A GP center masks corneal irregularity and astigmatism while the soft skirt centers the lens and improves comfort.
Specialty contact lenses · Hybrid and custom soft
Hybrid and Custom Soft Lenses Between a standard soft lens and a scleral.
Hybrid lenses pair a rigid gas permeable center with a soft skirt, giving GP optics with soft-lens comfort. Custom soft lenses are lathe-made to parameters stock lenses do not reach, including thick-center designs for irregular corneas. Both keep specialty patients in lenses that feel familiar.
2022CooperVision added SynergEyes hybrids to Specialty EyeCare
RGP + softHybrid construction
Lathe-cutCustom soft lenses made to order
92310Typical corneal lens fitting code
Where they fit
Two problem-solvers for hard-to-fit eyes
Use them when a stock soft lens cannot correct the vision and the patient will not tolerate a corneal GP.
SynergEyes portfolio
Duette, UltraHealth and SynergEyes iD lenses, now part of CooperVision Specialty EyeCare.
Custom soft for keratoconus
Thicker-center designs such as Alden Optical's NovaKone and UltraVision's KeraSoft IC help neutralize irregular astigmatism.
Out-of-range prescriptions
Made-to-order soft lenses cover high spheres and cylinders that stock lenses do not.
When GPs fail
Custom soft lenses are an option when a patient cannot achieve comfort in GP keratoconus lenses.
Choosing between the options
Fit choice follows corneal shape, vision goals and what the patient can handle.
- Comfort of soft, optics of GP
- Made to the patient's eye
- Stays inside routine lens habits
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Hybrid
Best when a patient needs GP-quality vision but rejects corneal GP comfort.
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Custom soft
Useful for mild to moderate irregularity, out-of-range powers and patients who want a soft-lens feel.
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Piggyback
A GP worn over a soft lens remains an option when neither alone works.
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Scleral
When the cornea is too irregular or the surface needs a fluid reservoir, step up to a scleral.
In the practice
Fitting sequence
Expect more than one lens order. Price the fit as a specialty service.
Map the cornea
Topography identifies the irregularity and guides the lab's starting lens.
Trial and over-refract
Evaluate fit, movement and vision with a diagnostic lens, then send the data to the lab.
Refine and train
Adjust parameters, teach handling and set a replacement schedule with the lab.
At a glance
Hybrid and custom soft lens overview
| Hybrid construction | Rigid gas permeable center bonded to a soft hydrophilic skirt |
|---|---|
| Hybrid brands | SynergEyes Duette, UltraHealth and iD (CooperVision Specialty EyeCare) |
| Custom soft keratoconus examples | Alden NovaKone; UltraVision KeraSoft IC |
| Stock extended-range examples | Biofinity XR and XR Toric (CooperVision) |
| Typical patients | Keratoconus, post-surgical corneas, high astigmatism, GP intolerance |
| Fitting code | 92310 for corneal lenses; 92072 for an initial keratoconus fit |
| Care | Follow the manufacturer's system; hybrids usually use specific care products |
| Supply | Ordered from the manufacturer or specialty lab, not stocked |
Questions doctors ask
Are hybrids still available after the CooperVision acquisition?
Yes. CooperVision added SynergEyes, including Duette, UltraHealth and iD lenses, to its Specialty EyeCare unit in 2022.
When is a custom soft lens better than a GP?
When a patient cannot get comfortable in a GP keratoconus lens, or other options have failed or are not wanted.
Do standard toric soft lenses work for keratoconus?
Usually only in the earliest stages. Thicker custom designs are made to mask irregular astigmatism.
How do I bill these fits?
Corneal lens fits use 92310; initial keratoconus fits can use 92072. Material codes depend on lens type. See the coding guide.
Do these lenses earn the participation credit?
No. Contact lenses are excluded. Eligible OTC care products ordered on VisionRescue.com through RescueLink earn the 15% credit.
References
Keep hard-to-fit patients in lenses.
Hybrid and custom soft designs fill the gap between stock lenses and sclerals.
Product names are trademarks of their respective manufacturers. Follow each manufacturer's fitting guide and labeling. Contact lenses are excluded from the 15% participation credit. Individual results vary.