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Tuesday, August 30, 2011

Contact Lens Update: Synergeyes Duette

Soft contact lenses offer wonderful comfort and vision for the large majority of patients needing vision correction, but some patients (due to corneal shape or refractive error) just can't achieve satisfactory vision with a standard soft contact lenses.  Rigid gas permeable (or hard) contact lenses are still available largely because of this fact.  Lately I have had the privilege of working with a new lens design that combines the optical quality of a rigid contact lens with the comfort of a silicone hydrogel (or highly oxygen permeable) soft lens: the Synergeyes Duette.
Picture courtesy www.synergeyes.com

Synergeyes hybrid lenses are not new to the market, but the newer Duette design includes a silicone hydrogel soft skirt that improves comfort and oxygen permeability.  For patients who aren't happy with the comfort or quality of vision with their current lenses, the Duette is a nice alternative.  

Newer to the market is the Synergeyes Duette Multifocal lens that incorporates near and intermediate vision into a lens for presbyopes (or people typically over the age of 40 who are experiencing a natural reduction in their eyes' focusing ability).  The Duette Multifocal lens is different from soft multifocal contact lenses in that the reading power of the lens is intrinsic to the aspheric design.  That means that ONE lens will continue to work for your patient's reading needs even as their required reading power increases over time.  There are 2 different reading zone sizes for the center of the lens.  Small near zone is typically the most successful, but if patients are having difficulty with distance or intermediate vision in the lens, a large near zone is suggested.

What are the drawbacks?  Like any multifocal contact lens, there is no way to return vision to the function that it had at age 20.  There can be some shadowing around letters (but this typically resolves over a week of wear as your brain learns to utilize the lens).  Some patients may never be satisfied with the quality of distance or near vision they are receiving from the contact lens, simply due to the fact that through the contact lens they are receiving information from multiple powers at the same time.  I always like to tell my patients that their expectations may have to be tempered if they expect perfect clarity at all distances.  It is a contact lens; not a time machine to recover younger eyes.  A successful fit is functional vision for the majority of the patient's daily demands (which does not necessarily mean 20/20 at all distances!).
An ideal Synergeyes fit (courtesy Contact Lens Spectrum): Fluorescein staining should show even central clearance under the RGP (rigid) central portion of the lens

As I continue to fit this contact lens (and others) I plan to post from time to time about my personal experiences with these lenses with tips for doctors on how to get the most successful fit!

4 comments:

  1. I will be going for new contacts at the first of the year. Would love to hear your client's feedback so far on these!
    Thanks

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  2. Hello and thanks for the comment! I have only had one patient thus far to be fit into the Synergeyes Duette Multifocal lenses, and I have to tell you, if you are needing a multifocal contact lens the vision with these still takes some getting used to. Fit correctly, your comfort in these lenses will be excellent within the first few days of wear. The multifocal design isn't going to give perfect, crisp 20/20 or 20/15 vision at every distance in most people, but the quality of vision is good in comparison to other products available. If you have a lot of dryness with contact lenses and dailies aren't a good option (if you have higher amounts of astigmatism for example), I think this lens is a great choice! Please post your thoughts if you try it out!

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  3. Hi. I'm glad to find your blog. I've been in a Duette lens (right eye only) for a week now. I am very happy with the vision (some ghosting below objects, but SO much better than with glasses). However I am having trouble with comfort. The lens feels great at first but after a half hour, it just feels like it is too tight almost- and feels dry, and sometimes VERY difficult to remove. I go back for a follow-up next week.Any thoughts? Thanks again for this helpful insight.

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    Replies
    1. Hello! There are a couple of things that could be causing your discomfort. Your doctor will be able to pinpoint which is the culprit, but here are the problems to look for:
      1) Contact Lens Solution: I really suggest using only Biotrue or Aquify with these lenses. Everything else changes the wetting angle too much, making the lens more prone to dryness and haze.
      2) Skirt Curve: Usually the doctor starts with a medium skirt curve. Based on your complaints, changing to a flatter skirt might help with both comfort and removing the lens.
      3) Base Curve: This can only be changed in some circumstances. Your doctor would have measured your corneal curvature to get the correct base curve in your original fit.

      I will tell you that I have had one patient that this lens just didn't fit well. We changed several things and comfort was just never good, so we ended up returning to soft lenses. Hopefully with a little adjustment your lens will be doing better!

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