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The reference: (b)(4) has been allocated to this case by rayner.The event description provided states that the lens tore in the patient's eye, necessitating explantation and exchange.The iol was explanted and exchanged during the original surgery session; however, the back-up lens failed to deliver into the eye (see (b)(4) - fda mdr 3012304651-2024-00270).A third lens was implanted successfully within the original surgery session without harm or injury to the patient."iol replacement or extraction" is listed in the "adverse events" section of the rayone ifu.The device has not been returned to rayner.The rayone preloaded iol injection system use risk analysis identifies the following as possible causes of "trapped/torn lens haptic/optic during insertion"; inadequate amount of viscoelastic, inadequate quality of viscoelastic, haptic trapped by plunger override due to fast motion, user opens closed flaps and closes again before use, plunger advanced too quickly, insertion of viscoelastic through nozzle leading to inadequate amount of viscoelastic, user removed injector from tray prior to inserting viscoelastic - causing lens to be improperly placed in cartridge, user removes injector from tray prior to closing cartridge - resulting in cartridge not being clipped closed properly and optic edge trapped/damaged on closure of cartridge.Our review of production records for the rayone emv rao200e batch: 044238547 showed that all manufacturing and quality checks were conducted with successful results.There is insufficient evidence and information available in this case to establish the cause of the damage to the lens occurred during implantation.
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