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To compare whether patients with irregular corneas are more comfortable wearing Synergeyes, a hybrid contact lens, compared with rigid gas permeable contact lenses.A retrospective chart review of patients seen from the specialty contact lens practice at the University of Pittsburgh, who were refit with hybrid lenses from November 2005 to December 2006. Inclusion criteria included presence of irregular astigmatism in at least one eye from any cause, prior use of rigid gas-permeable lenses within the past year in at least one eye, lens tolerance issues, and all day use of contacts to attain functional vision. Best corrected spectacle and hybrid lens corrected Snellen acuities, the number of lenses needed to complete the fitting, lens related complications, and whether patients preferred the Synergeyes or rigid lens after at least 3 months of follow-up were used as the variables to compare the safety and efficacy between the two lens modalities.Seventy-nine eyes of 54 patients met criteria for inclusion. The average improvement over spectacle acuity was four Snellen lines with the Synergeyes lens. The average number of lenses required to successful fitting was 1.71. On review of patient opinions in follow-up, 79.5% of patients reported comfort was improved compared with rigid lenses, 13.5% said comfort was not better or the same, and 7% believed they were less comfortable.In this population, the Synergeyes lens resulted in increased lens tolerability for many patients wearing therapeutic contacts. Patients who are otherwise unable to tolerate rigid gas permeable contacts should attempt use of a hybrid lens before resorting to penetrating keratoplasty.