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A non-health care professional reported that during an intraocular lens (iol) implant procedure, there was micro crack on lens.Additional information was received and stated, the lens was removed from the patient eye and a similar lens of same model was implanted and completed the procedure on the same day.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 adhered to the underside of the lid of the lens case.The base of the lens case was not returned.Solution was dried on the lens.The posterior of the optic has a long, deep scrape mark near the optic edge.The scrape mark was most likely interpreted as the reported complaint.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 account indicated the use of qualified associated products.A deep scrape mark was observed on the posterior optic surface.This damage was most likely interpreted as the reported complaint.The root cause cannot be determined for the reported complaint.The questionnaire indicated there was no issue in loading the lens.Based on the returned sample evaluation, the location of the damage along the posterior of the optic may suggest an incorrect lens position during lens advancement and/or a handpiece plunger underride.The instructions for use (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 ophthalmic visco surgical device (ovd) filled cartridge.The lens should be inserted until the optic is a little more than halfway 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.It is unknown if adequate viscoelastic was used in the cartridge.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.Use the company cartridge at operating room temperatures between 18 degrees centigrade (64 degrees fahrenheit) and 23 degrees centigrade (73 64 degrees fahrenheit).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 alcon.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 intra ocular lens (iol) will now be in the dwell position.Inspect to ensure the plunger is behind the optic.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 recommendations may result in iol damage.Ifu note: during lens loading and insertion, do not allow the company 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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