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A physician reported that during an intraocular lens (iol) implant procedure, while loading the lens, haptic broke.The doctor also complained that this lens was softer than usual company lens.The procedure was completed on the same day.There was no patient harm and no patient contact.
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Additional information has been provided in d.9., h.3., h.6., h.11.The iol in cartridge was returned for analysis.Observation indicate plunger override occurred.The lens was returned in a company cartridge, cavity 1.Viscoelastic was observed in the cartridge.The broken leading haptic was returned at the loading area.The lens was advanced to the nozzle entry area.The trailing haptic was extended back.The broken leading haptic and trailing haptic position indicate a plunger override occurred.The company cartridge was cleaned for further evaluation.The lens was removed during cleaning.Top coat dye stain testing was conducted with acceptable results.We are unable to determine the root cause for the reported complaint lens haptic broken during lens loading.The cartridge with iol were returned for analysis.The lens was misfolded in the cartridge.The trailing haptic was extended back.The broken leading haptic and trailing haptic position indicate a plunger override occurred.The ifu instructs: using holding forceps, grasp the lens by the optic edge and gently place the lens anterior side up into the back of the ovd-filled cartridge.The lens should be inserted until the optic is a little more than half-way inside the cartridge.Use the holding forceps to gently push down on the lens, verifying that the lens is on the bottom surface of the cartridge.Using holding forceps, take the trailing haptic, and gently fold the haptic onto the anterior side of the optic.Slowly grip or push the optic edge to position the lens as far into the cartridge as the forceps will permit, while ensuring the lens remains on the bottom surface of the cartridge and the trailing haptic remains on the optic.Failure to follow these steps may cause the lens to advance incorrectly causing delivery issues and/or damage.Important: the plunger should make initial contact with the cartridge at the ramp.In the event the plunger does not contact the cartridge at the ramp, do not use the handpiece and contact company.The handpiece ifu instructs: verify that the plunger tip is properly engaging the lens optic and that the lens moves forward at the same rate as the plunger while slowly advancing the plunger forward to avoid damaging the lens.When the threads on the knob make contact with the barrel, turn the knob clockwise approximately ½ turn to engage the threads and then stop.The iol will now be in the dwell position.Inspect to ensure the plunger is behind the optic.The doctor also reported this lens is softer than usual company lens.The ifu recommends: use the company cartridge at operating room temperatures between 18° celsius (64° fahrenheit) and 23° celsius (73° fahrenheit).If the operating room temperature is too high (> 23° celsius / 73° fahrenheit) lens folding consistency is negatively affected, the lens is more adherent, and this may inhibit lens advancement.Based on the results from the product history record, the products met release criteria.The manufacturer internal reference number is: (b)(4).
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