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A health care professional reported that during intraocular lens implantation surgery, while injecting the lens, plunger caught the haptic and broken as surgeon was rotating the lens, the other haptic fell off.There was no real harm, but the surgery was completed by extending the operating time as the broken lens was removed and replaced with another unspecified lens.
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Additional information was provided in d.9.,d.10.,h.3., h.6 and in h.11.Only half of the lens was returned loose in an opened non-company peel pouch.Solution was dried on the lens portion returned.One haptic was broken from the haptic/optic junction area (returned adhered by solution to the optic portion returned).The optic was broken/torn into pieces.A large portion which includes the other haptic was not returned for evaluation.A used qualified company iii (d) cartridge was returned.Viscoelastic was observed in the cartridge.The cartridge shows evidence it was placed into a handpiece.No tip damage observed.The photo provided appears to be of the returned sample.A device history record review and a non-conformance review of the reported lot number was conducted.The deviation review did not reveal any potential contributing factors to the reported complaint and all corresponding production release specifications defined in the device master record were met.The file indicated the use of a qualified cartridge and viscoelastic with a non-qualified handpiece.The reported broken haptic was observed.Information was provided that the "plunger caught the haptic and broke it".A non-qualified handpiece was indicated.The root cause for the reported event may be related to a failure to follow the ifu.The ifu instructs: company foldable iols are qualified for use with a company qualified delivery system (handpiece and cartridge) and ophthalmic viscosurgical device (ovd) combination.The use of an unqualified combination may cause damage to the lens and potential complications during the implantation process.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.The handpiece ifu instructs: 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.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 manufacturer internal reference number is: (b)(4).
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