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Additional information provided in b.5., d.9., h.3., h.6.And h.11.The lens was returned in the lens case.A small amount of viscoelastic was visible on the lens.The lens had been cut into two pieces across the center, typical of removal.The lens was cleaned with klrp for further evaluation.One optic portion had a stutter type scratch on the posterior surface near the edge.This portion also had damage beside the cut area.This appeared to be removal damage.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.A qualified handpiece was indicated.The account indicated the use of a non-qualified cartridge.Viscoelastic information was not provided.It is unknown if a qualified viscoelastic was used.The reported scratch was observed.The optic had a narrow stutter scratch on the posterior surface near the edge.The root cause for the observed damage is most likely related to a failure to follow the instructions for use (ifu).A non-qualified cartridge was used.The lens is outside the qualified diopter range for the company cartridge of 6.0 to 25.0.The company 27.5 diopter lens is only qualified for use with the company cartridge.The correct cartridge is listed on the lens carton label and on the lens case label.The ifu instructs: company foldable iols are qualified for use with an company qualified delivery system (handpiece and cartridge) and ophthalmic viscosurgical device (ovd) combination.The ifu instructs that an 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 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 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).H.10 reflects all related report numbers associated with this product event that have been submitted at this time.
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