The use of SoftPerm hybrid lenses was investigated as part of a 10 year retrospective audit of keratoconus in the Contact Lens Service at Nottingham University Hospital which serves a population of approximately one million. During this period, nine patients (14 eyes) were fitted with SoftPerm a lenses for keratoconus. Two further patients (two eyes) were included with a diagnosis of irregular astigmatism and one patient (one eye) was fitted post-corneal graft. Seven patients were regarded as successful hybrid lens wearers and five were regarded as unsuccessful wearers. Of the unsuccessful cases, one patient managed satisfactorily using a rigid gas permeable corneal on the unaffected eye, two patients subsequently had successful corneal grafts, one patient continued with restricted rigid gas permeable lens wear and one patient defaulted.