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The lens was returned positioned incorrectly in the lens case inside the lens carton.Solution was dried on the lens.One haptic/optic junction edge was broken.The missing lens material from the broken area was not returned.This haptic was also broken in the distal area (not returned).The optic was cut into two pieces, typical of an insertion and removal.The lens was cleaned with klrp for further evaluation.One optic portion had a linear scrape mark on the posterior surface near the optic center.The optic edge was torn.The anterior optic surface had a small scratch near the opposite edge.The second optic portion had a linear scrape mark on the posterior surface near the optic center which aligned with the damage of the first optic portion.The posterior surface had several small cracked damaged areas.The opposite side of this lens portion had cracked damage in the shape of an instrument used to grasp the lens, seen on the anterior and directly opposite on the posterior surface.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.Qualified associated products were used.The reported scratch damage was observed.All lenses are 100% inspected for cosmetic attributes and the damage exhibited by the returned complaint sample would not have met company release criteria.Based on our observation, and the review of manufacturing records, it can be reasonably concluded that the damage is not manufacturing related.Due to the presence of surgical solution and the condition of the returned sample, the damage is most likely related to customer handling.The scratch was noted to be observed after the lens was implanted.The posterior of the optic has a linear scrape mark in the optic center, consistent with damage caused from a plunger underride.The returned lens was cut into two portions, typical in appearance to an insertion and removal.Additional lens damage was also observed.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 ifu instructs to completely fill the cartridge with ovd immediately prior to loading and delivery of the lens.Do not attempt to load the lens without adequate ovd in the device.Not adequately filling the device with viscoelastic will result in inadequate coverage of lens and the lens fold path with ovd, which may result in 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 response indicated the lens was in the cartridge for less than 3 minutes.This is within the recommendations of the ifu.The ifu instructs: follow the section regarding directions for use for information on the maximum allowed time for the iol to stay in the folded condition.Failure to adhere to manufacturer¿s recommendations may result in iol damage.Ifu note: during lens loading and insertion, do not allow the clareon iol to remain in a folded condition within the selected iol delivery system for more than 3 minutes prior to completing insertion into the capsular bag.The manufacturer internal reference number is: (b)(4).
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