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A non-healthcare professional reported during intraocular lens (iol) implant procedure, upon implantation, surgeon noticed that the lens was cracked and had to explant lens and insert a replacement during same procedure.Additional information has been requested and received stating in the surgeon¿s opinion, product caused or contributed to the product malfunction.There was no patient harm.
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Additional information was provided in d.9., h.3., h.6.And h.11.The lens was returned in two pieces inside the lens case.One portion was returned in the well area.One portion was returned on top of a post of the lens case.This caused further damage to the lens.Viscoelastic was observed on the lens.The optic had been cut into two pieces across the center.The lens was cleaned with klrp for further evaluation.The portion damage by the lens case post had other cracked areas.This damage was similar in appearance to damage that can occur if there is a plunger override.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.Associated products were not provided.It is unknown if qualified products were used.The root cause for cracked optic cannot be determined.The lens was returned in two pieces inside the lens case.One portion was returned on top of a post of the lens case.This caused further damage to the lens.The portion damage by the lens case post had other cracked areas.This damage was similar in appearance to damage that can occur if there is a plunger override.It is unknown if qualified associated products were used.The instructions for use (ifu) instructs: company foldable intraocular lenses (iols) are qualified for use with a company qualified delivery system (handpiece and cartridge) and ophthalmic viscosurgical device (ovd) combination.The ifu instructs that a company qualified delivery system and viscoelastic combination should be used.The use of an unqualified combination may cause damage to the lens and potential complications during the implantation process.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.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 half 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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