Synergeyes Duette Update

8:41 PM

I have had some interest in my experiences with the Synergeyes Duette lenses, so now that I have had more patients wearing the lenses and returning for follow-up I thought it was a good time to share.  If you are interested in my original post, please click here.

For those who may not recall from my previous post, Synergeyes Duette is the hybrid lens that combines a rigid gas permeable (or hard lens) center with a soft contact lens skirt that surrounds the lens.  The soft lens skirt provides added comfort and also helps deliver oxygen to the eye via the new silicone hydrogel material (in comparison to the original Synergeyes lens that had poorer oxygen transfer). It is a great choice for patients experiencing poor quality vision through soft contact lenses, especially in patients with astigmatism or those needing multifocal correction.

Synergeyes contact lens: notice the darker colored  hard lens (RGP) in the center to provide sharp, clear optics


If you are a patient interested in trying the Synergeyes lenses, here are some things to know:

1) The lenses are quite large and can be hard to get used to at first.  A lot of my patients request to try them, but when they see the size difference compared to their soft lenses they aren't as keen.  For best comfort you will fill the contact lens bowl up with solution before inserting it, to provide added moisturization.  To insert the lens patients often need to lean forward over a mirror placed flat on a table, and then insert the lens straight up towards the center of the eye. Due to this insertion method, it is not a great lens choice for a first time wearer due to the learning curve involved with inserting a lens of this size.  Most patients have no trouble after a short course of practice.

2) There may be some dryness and lid awareness, especially early on in the fitting experience.  Lid awareness should resolve with proper fit and adaptation time, but I have had patients with dry eye complaints prior to trying this lens notice their dryness seems worse.  This dryness issue is not affecting all of my patients, but I am still working on how to resolve the complaints. Right now my efforts are centered over adjusting the fit to ensure that adequate tear flow is present under the lens.  As far as solutions, I have been told by reps that the Revitalens solution is highly recommended with Synergeyes wear to improve comfort, though many other multi-purpose solutions can be effectively used.  Personally I have had great success with Aquify and Clearcare solutions with this lens.  Of course, I just love Clearcare in general, but that is another post, hah.

UPDATE:  The above information is now very outdated, and I recommend seeing this post for better information.  Suffice it to say that Revitalens is NOT what the current data supports even though the initial lens launch recommended this product.  BioTrue is the solution of choice for Synergeyes Duette, with regular cleaning with an additional build up remover like MiraFlow.
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3) The multifocal lens (Synergeyes Duette Multifocal) isn't going to be perfect.  I have patients seeing 20/20 with this lens that aren't happy with the quality of their vision. Some of this is inherent in the lens design and I do try to tell patients exactly what their expectations should be. The design of this lens is called "simultaneous vision," and what that means to the wearer is that you are seeing both distance vision and near vision information "simultaneously."  That's a lot for the brain to process.  It can take 1-2 weeks of wearing time to know if this lens design will work for you.   If you are a doctor fitting this lens, to increase distance vision you need to switch to a larger add zone, or consider going to a steep base curve skirt.  To improve near vision, the add zone size needs to be small.  

4) There is a major price tag on these lenses.  Patients should expect to pay a higher contact lens fitting fee because your fit is going to include several visits to perfect your lens parameters.  The lenses themselves are also expensive, typically around $200-$300 for a set of lenses.  Keep in mind that each lens will last only 6 months, so you will need 4 lenses in total for a year's supply (that puts these around the $400-$600 range for your year!).  This is different from traditional RGP (hard) contact lens wearers that may sometimes be able to use their lenses for 1-2 years.

If anyone has stories to share about these lenses, I would love to hear them!

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56 comments

  1. I'm 47 now unfortunately and hate wearing glasses now. At first i only needed them for reading but now the arms legnth is fuzzy and I have an astigmatism along with "OLDER" eyes! I tried to get fitted for soft contacts but didn't like the results so I went to another optomitrist to see about GP lenses. She suggested the new Duette lenses instead since I have seasonal allergies. I am going in tomorrow to see an optomitrist she reccomended that is familiar with the new Duette multifocal lenses. What can I expect at my fitting for these lenses and do you think the Duettes would be a better choice than the GP lenses

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    1. The Duette lenses are a nice option because they offer the vision of a GP lens without the drastic decrease in initial comfort that you will experience comparing a hard lens to a soft lens. Because these lenses are worn 6 months at a time, they can still cause some issues with seasonal allergies and dryness, so you may find that you need a really good prescription allergy eye drop this time of year to control things enough to wear the lenses. When you have astigmatism and presbyopia (the change that happens to all of us after age 40 where reading vision becomes difficult) wearing contact lenses gets significantly more complicated because we are trying to get a lens for you to see both distance and near vision. You may find that the reading vision with the Synergeyes Duette Multifocal lens is still difficult in some situations. Lighting is always a huge help; and this lens functions best in bright light for maximum reading vision. Expect the fitting process with this lens to be a process. Your doctor may need to bring you back 2 or 3 times to get an appropriate fit and visual function with the lens because these are custom lenses. Please feel free to post about your personal experience!

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    2. I've been wearing Duette's now for about 5 months. I am 46 and have worn glasses since I was 6. I couldn't get crisp vision at any depth and I was frustrated. I also have an astigmatism. My eye doc suggested Duettes and I was skeptical. I still can't believe the results I immediately got. The tech put the contacts in and walked away. I grabbed a magazine and could read crystal clear. I thought for sure my distance would be compromised, but sure enough, I was at 20/20. i wear progressive glasses and the Duettes gave me vision that was as good if not better than my progressives without having to shift into the 'right spot'. i swear by them and my husband, who has been told he couldn't wear soft lenses, is in the process of fitting them now.

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  2. I have actually tried these lenses. Unfortunately I cannot use them. I would love to the sight is so much crisper. However can get them in but can't get them out. I have tried numerous times - the last time it appeared to have dried to eye and the ophthalmologist almost couldn't get them out. Severely painful at that point.

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    1. I'm sorry that these lenses didn't work for you -- I have had patients that had similar difficulties. Unfortunately while there are a wide range of parameters, these lenses still don't fit well to every eye shape. It sounds like this lens just won't work for your eye at all. If anyone out there has infrequent difficulty removing this lens, try wearing a latex glove when removing. The glove will easily adhere to the lens surface, and it should come off with relative ease!

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  3. This is my second day of trying the second pair of lenses. I was so happy that everything looks clear and crisp in a distance, with a minor discomfort on the right eye and a little trouble reading up close. Then I read some reviews online and some are complaining about wearing them at night time. Just for my curiosity, I stepped outside the house and to my surprise, there is so much glare with fan-like glare/stars as if I'm watching an electric light show in Disneyland. I'll probably stay with the soft contacts.

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    1. Glare is a really common complaint with all multifocal contact lenses,with soft, hard, and the Synergeyes lenses The reason is that in order for you to see both at distance and near, there are rings of power within the contact lens to give you a range of vision. Think of your multifocal lens like a bullseye target. As light hits each ring, glare is created. For many people the glare will improve as they adjust to the lens design, but if 1-2 weeks goes by without resolution, your brain will likely be unable to ignore the ring-induced glare and you may always have this issue no matter how long you wear the lens.

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  4. Thanks for your reply. I am now testing the third pair. They are very comfortable now and the reading is much better. The left eye looks good so far, clear and no more glare at night. On the right eye, it seems like they reduced the power but still experiencing glares/flares at night, depending on the type of lighting. The doctor told me he gave me a flatter version, not sure what he meant to improve the glare. I will try it out for one week and hope that it will go away.

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  5. What is the medical reasoning that the lenses are no longer good after six months.

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  6. Why can these lenses only be worn for six months. What happens after six months?

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  7. I have worn RGP for about 17 years due to Keratocons and when I began wearing duete lenses I have experience a total of 9 infections and damage in my right eye. I never in 17+ years of RGP experience am infection.

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    1. The soft contact lens skirt on the Synergeyes lens deteriorates to a point that it is not comfortable or healthy to the cornea to wear after 6 months. Traditional RGP or hard lenses do not deteriorate as quickly as soft contact lenses do, which is why RGP wearers often keep their lenses for 1 or 2 years without needing to replace them. If you are getting infections with Synergeyes it could be due to the age of the lens (older than 6 months?), the solution you are using, or simply the way the soft contact lens skirt fits or interacts with the chemistry and curvature your eye. Definitely you should see your doctor-- it's never safe to have infections, especially that many!

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  8. I have been wearing duette lenses for two years now but when I got my new prescription, the lenses have a different feel when I touch them. They also feel different on my eyes and I am having ghost vision like I did the first several months that I got used to my others. Did the company change the material of the lenses or are there different types of duettes? My old bottles say Duette HD and the new bottles just say Duette on the front.

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    1. I haven't heard anything about material changes from Synergeyes. I did notice that they dropped the "HD" from their branding but I was told it's just a new marketing strategy. Were your old lenses older than 6 months when you changed to the new pair? There is a chance that you are just "breaking in" a new lens again -- as the lens ages the material warps and stiffens which changes how it fits on your eye and the vision you will get.

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  9. I've been wearing Duette Multifocals for a few years. Now I see there is a Duette Progressive lens. What is the difference?

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    1. The lenses aren't really different, they just rebranded the fitting matrix for doctors so that it was more like fitting a soft multifocal contact lens (picking the add power instead of a large or small add zone). On the vision side of things they are the same; just more intuitive for the doctor to select your right distance and reading powers now. Many doctors still prefer Duette Multifocal if they learned to fit on that version because they already understand the fitting guide and how to manipulate the add zones.

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  10. I hope all or you are well.....I have a quick question with regards to the duette multifocals or progressives...I am currently in Biofinity multifocal and Air Optix prior to these. My doctor has trouble with the range...If my distance is clear my near vision is not strong enough and if my near is perfect, my distance is blurred. Will the duette multifocals or progressives improve this problem?

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    1. Unfortunately the Synergeyes lens might not help-- it also uses a ring design providing simultaneous distance and near vision. That means for every improvement to distance vision, reading will be a little worse and vice versa. Where this lens shines is if you have uncorrected astigmatism limiting vision in soft lenses. Outside of that it has all the issues of a soft multifocal-- halos, shadows, and the simultaneous vision issues of the eye seeing multiple images at one time.

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  11. Steve, I had the same problems you were having in soft multifocals, using Air Optix and Biotrue's newest soft lens too. The Duette multifocals were a huge improvement! I'm a pharmacist so I need to see who's walking down the hall, the computer, and the tiny little inscriptions on tablets. Multifocals never could get my near vision as crisp as I needed it with only a High or Low add. And I'd tried every brand on the market. Duettes are made individually for my specific prescription. I suggest you give them a try. I didn't experience any of the halos, shadows, or multiple images Dr. L has mentioned. My brain couldn't seem to adapt to modified monovision where you wear a lens in your dominant eye for far vision and a lens in you nondominant eye for near vision. There was no problem with that with Duettes. It did take about a week for my brain to figure things out 100%, but I'm my eye doctor's most discriminating and noncompliant patient. I think if I'd followed my doctor's advise and not tried wearing them 16 hours a day initially the break in period wouldn't have been a week. My only problem was with dryness when using antihistamines during allergy season. Otherwise, the large lens was no problem and getting them in and out was not an issue. I'm Duette's biggest advocate!I researched a solution to my vision problem & introduced them to my eye doctor. Now he also wears them.

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  12. Hello, I've been wearing progressive lens glasses, started losing acuity in one eye, went to see a cornea specialist, who thinks the problem is the result of my Lasik surgery 15 years ago. He suggested switching to soft contacts, tried that but no real improvement. Was thinking about RGP when I saw this page. Now wondering if the Duette Progressive or the UltraHealth FC are worth trying. Neither the specialist nor my regular eye doctor mentioned these. Dr. L, what has been your experience with the UltraHealth?

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    1. Synergeyes lenses can be a great option, but depending on your corneal condition the lens may or may not fit properly. The UltraHealth is made for patients with irregularly steep corneas-- keratoconus or corneal ectasia. With a post-LASIK issue you may need a reverse geometry lens like Synergeyes PS instead. It all depends on your cornea which lens would work if any so your doctor will be able to answer if something in the Synergeyes family is worth considering.

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  13. Hello Dr. L. Just last week I found out about these contacts, although every year when getting my eye exam, I asked my eye dr. if there are any available. Really? I went to a different eye dr. this year and she told me about them. Any way, I am excited about the possibility. I was told $300 for fitting and $600-$1200 for contacts. One article I read said comparable to soft contact lenses, maybe $30 more. How can I find out the "average" yearly cost for Synergeyes Multifocal contacts? Thanks so much for having this site. I appreciate being able to read others' experiences with duette lenses.

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    1. Definitely Synergeyes lenses are more expensive than regular soft lenses. Every doctor's evaluation fee is different but the lenses themselves would likely be in the $600-$700 ballpark for Synergeyes multifocals for a year.

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  14. That would be for 2 pair? Thank you for taking the time to reply. Very much appreciated.

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    1. Yes! 1 lens should last for 6 months so you'll need 4 total for both eyes for a full year.

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  15. How long for 3D shadowing to resolve if it is going to resolve? I have had them for only four days but the shadowing is terrible. I want to quit but if there is a chance it will resolve itself, I'll power through it. The text is larger but shadowed-3D.

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    1. Give it at least 1 week but it could take up to 2. After 2 weeks if the shadowing is still too distracting, it's probably not going to get any better with this lens.

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  16. Hello and thanks for this great page! My left eye has poor vision from a PRK that went bad. I tried a s legal lens but I can't seem to wear it for more than 15 minutes before it becomes quite painful. However, the vision is amazing with it. I remember briefly trying a sample duette in the office and thinking it was uncomfortable. Do you think Imshould give it another try, maybe for a longer period of time? Also, is it possible that my sclera lens just wasn't fit properly? Maybe the fluid reservoir just leaks out because of that. Any feedback would be greatly appreciated!

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    1. If you are post PRK your cornea may be too flat for a lens like Synergeyes Duette. The Synergeyes PS (post-surgical) lens is what most of my post-op fits require. As far as scleral lenses, lots of things could cause discomfort. Fit of course, but also the wrong filling solutions, or just the anatomy of your eye being unable to support a scleral lens. It is hard to give you any specific answers without evaluating your eyes personally, but your optometrist will be able to help get to the bottom of the issue! Since you likely have a flat central cornea from surgery, you'd probably need reverse geometry lenses, but again this is just an assumption based on the info you've shared. Your doctor assesses your cornea and will make the proper fit determinations.

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  17. Thank you for your reply! Yeah, I'm not sure about the place I went for this. After many tries a person there got the scleral lens in my eye and it stayed in without irritation for about 30 minutes. But I've been trying on and off for a year at home and am still not able to keep it in for more than 15 minutes without lots of pain. It starts out a little irritated, then gets super painful in like 10-15 minutes. When I take it out it's super dry and almost sticky. I can't be that bad at putting it in, can I? I mean, I can get it in easily on the first try now. They seem to think I maybe don't have the right touch or something. We've experimented with about half a dozen different fluids too. I'm thinking of just going to another place and starting the process over again, but I'm feeling unsure about it. All of know is my eyesight is getting worse and it's getting difficult to get by without some kind of correction. I do have a flat cornea and it's too thin for another surgical correction. I feel kinda stuck.

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    1. It could be that scleral lenses just won't work for you and that you'd get better results in another lens. Most companies that make specialty contact lenses have a 90 day return policy, so if you can't use your lenses you may be able to return them for a refund and start new with something else.

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  18. I received the Duet lens about 3 days ago. I have worn soft contact lens since I was about 14. I am now 41. Most recently I wore the Biofinity toric lens but had trouble with them rotating. My doctor and I decided to give these a try. So far I have only been able to wear them 2-3 hours a day because they feel scratchy in my eye. Not like debri necessarily. Will this resolve or is this a fit issue? I hate the thought but if these don't work I will have to gontonglasses full time. 😢

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    1. It can take a while to get used to the comfort of Synergeyes lenses. I always tell people you have to choose: if you want comfort, you need to live with the rotation issues of soft lenses. If you want clear vision, you need to sacrifice on the comfort (Synergeyes or RGP lenses just will never feel like nothing in your eye. You will always be able to feel them). Some people love Synergeyes lenses and get great comfort; some people just decide to go back to soft lenses and get the best vision they can achieve with those. There is unfortunately no perfect solution, it's just what you are willing to compromise on.

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  19. I stopped using ClearCare after my Duette lenses were somehow damaged by the solution. The lenses were fairly new, I had only been wearing them about a month. One day I took them out of the case and noticed a white haze on them in the shape of the holes from the ClearCare disinfecting case. They burned my eyes so I took them to my doctor, he ordered a new pair, and recommended Peroxiclear instead. Peroxiclear has been recalled. Any other peroxide solutions recommended?

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    1. Unfortunately that's it. You may want to switch to Biotrue solution nightly and then once a week doing a deep clean with MiraFlow or the generic version Walgreen's Extra Strength Soft Contact Lens Cleaner.

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    2. I have been using the Purilens disinfecting unit nightly with my Duette lenses. I find that this vastly improves the comfort. I also clean them occasionally with Biotrue, but always rinse them with a saline solution before putting them into the Purilens unit.

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  20. Hi Guys
    What’s the usual delivery time on a duette hybrid lens?
    I’ve lost mine and I leave South Africa on holiday for the UK on 8/12/17 so not a lot of time!!
    Thx
    Steve

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    1. Typically new lenses ship in 1.5 - 2 weeks from the company!

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  21. I'm curious what your thoughts are on the synergeye duette multifocals vs. toric multifocals. Thanks, Bob

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    1. Soft multifocal toric lenses have a very low success rate. That’s why only one company makes them, and the lens technology is over 15 years old.

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    2. Dr. L -
      Thanks for your comment re: the toric multis. My Dr just put me in my initial pair of progressive synergeyes - amazing correction for presbyopia, but awful for my distance. He is re-ordering with adjustments, so for now I'm keeping an open mind. I was wearing B&L ultra mulit focal with a low add, but my astigmatism increased enough so that my distance was sub-optimal. He put me in these torics while we waited for the synergeyes and the distance is phenomenal, but now reading/computer use is straining my eyes. So that's why I asked about the toric multis. I just want my 20-yr old eyes back!! :)

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  22. I'm curious what your thoughts are about the Synergeyes Duette multifocal vs. soft toric mutilfocal...thanks, Bob

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  23. I read that a new Tangible Hydra-PEG coating was added to the Duette Lenses in early 2017. In your experience, has this improved the comfort and moisture retention of the lenses? I have dry eyes and a very high prescription (-11 with astigmatism). The only options I have are GP, which I have never used, or custom soft torics, which were horribly thick and uncomfortable. I want to try the Duette lenses but am afraid they will be worse in terms of comfort than the custom soft lenses.

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    1. Yes! I've had great patient satisfaction with Tangible Hydra-PEG with improved lens comfort especially in the later months of wear. It's been working great for my gas permeable lens wearing patients too.

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  24. I've been wearing Duette Progressive lenses for 5 days now. Distance is ok and reading in ok, but monitor distance is horrible. I can also only wear them for about 2-3 hours before they feel very dry and irritating to my eyes. Will this get better over time or are there modifications that can be made? I see my eye doctor again in about 2 weeks.

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    1. You may need to move your appointment up sooner! Discomfort in such a short wearing period may not get better without a change to the lens.

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  25. I get white cloudy deposits on my Duette lenses in about 2-4 months of wear. I use ClearCare Plus to clean/disenfect them daily. I just put a new pair in today after only 10 weeks on this last pair. I went looking for answers and found this in an article to eye doctors:
    White Deposit In some patients, after wearing lenses for four to six months, a white ring may develop in the soft skirt area of the lens (Figure 9). This is more prevalent in patients who have meibomian gland dysfunction or blepharitis. This substance has been tested and identified as a calcium salt. It is completely innocuous. If this is present at the six-month point, it is time to replace the lens anyway. If it is present after only a few months, we reassure these patients that there is no significant effect and use it as a springboard to discuss lid hygiene.

    It says not an issue but does it affect clarity or comfort and if so can I be using a daily or weekly cleaner to help? My eye doctor is great and tells all patients to do "purposeful blinking" at stop signs, and other points during a day. She also recommends drops to moisturize my eyes but I don't want to get "used" to those.

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    1. From your description it sounds like you are a classic dry eye sufferer, so most at risk of having this issue if you are using ClearCare to clean your Synergeyes lenses. There is no way to remove the calcium build up once it appears. Treating your underlying dry eye issues is likely the best prevention, but depending on your personal chemistry, your doctor may recommend changing cleaners or trying a different type of contact lens if the issue is resulting in blurry vision for you.

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  26. Can you use an Enzymatic Cleaner (Ultrazyme) on the Synergeyes Duettes to remove some material that builds un on the soft part ???

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    1. It's best to ask your doctor, or you could contact Synergeyes directly to see if this cleaner would be compatible. They might need to know if your lens has Tangible HydraPeg coating, which is why asking your doctor would likely be best. You can contact Synergeyes Customer support here: https://synergeyes.com/consumer/contact-us/customer-care/

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  27. I started out as soft contact lens wearer in 1974, some years later switched to GP and now have been wearing Duettes for probably three years. The last pair I got was in November/December 2017. In late April 2018 I got my new six month pair and immediately started having comfort problems in term of itching. The itching was so bad that even after I would take my contacts out, I would continue having itching and pain. I went back to my doctor and he diagnosed my problem as dry eye and suggested different moisturizing drops. However, in July, after I couldn't stand the itching any longer, I switched back to my "old" lenses (the ones from November 2017 - no I hadn't thrown them away). The itching immediately stopped. I went back to my doctor the first part of August 2018 and he ordered a new pair, which came in on 08/14. That pair also causes itching, although the left contact is a little more tolerable. However, today I put back in my old lenses because I needed to work and didn't want to take the chance of having to take out my lenses and not be able to see (my prescription is -13 and -13.5 - I know, very nearsighted). Could this new HydraPeg coating be causing an allergic reaction in my eyes?

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    1. I haven't heard or read about people experiencing itching with HydraPeg, but some of my patients have definitely had difficulty with removing the lenses with this new coating. It would definitely be worth asking your doctor if your new lenses were made with HydraPeg. If they do have HydraPeg, you can ask them to return your lenses and have them remade without HydraPeg if they are still within the 90 day warranty.

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  28. I have been wearing mono vision soft contacts for several years. I have not been happy with my ability to read - usually keep a magnifying glass on hand! I was interested in the hybrid contacts that work with both Presbyopia and Astigmatism. My doctor quoted me 1200 a year for 4 lens( 2 per eye). Not including fitting costs. Thar sounds about double for what I have been reading- are there different prices depending on the prescription?
    I tried the soft multifocal but they were worse than the monovision contacts.

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    1. Depending on the type of lenses and your doctor's office cost of goods, prices will vary. You can definitely get price quotes from other local providers for Synergeyes Multifocal/progressive lenses and the cost of an evaluation if you want to price compare.

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  29. Hi I've been interest in getting the Synergeyes Multifocal/progressive with astigmatism. I have extrem astigmatism and was told that I could not get progressive with my level of astigmatism. What is the maxim that the SYNERGEYES DUETTE cal go to. I'm currently using
    Biofinity XR Toric with the following proscription

    POWER BC DIA CYL AXIS
    OD (Right) -0.50 8.7 14.5 -2.75 90
    OS (Left) -0.50 8.7 14.5 -3.25 90

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    1. Synergeyes lenses correct for astigmatism internally, so you're prescription has to match your corneal astigmatism for it to work. If you have the exact same corneal astigmatism (measured by your doctor with a corneal topographer) as you do prescription astigmatism, you could be a good candidate!

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