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Additional information provided in d.9., h.3., h.6.And h.11.The lens was returned in the lens case.Viscoelastic was dried on the lens.The lens had been cut into two pieces across the center.A narrow scratch was observed on the anterior surface.A chipped area was also observed along the cut near one edge.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.Qualified associated products were indicated.The root cause for the reported lens damage appears to be related to a failure to follow instructions for use (ifu).The lens damage was on the anterior surface.If the lens is loaded properly the anterior surface does not contact the cartridge lumen.Damage to the anterior surface may be caused by a plunger override of by loading forceps.Inadequate viscoelastic was observed in the returned cartridge.The cartridge tip had a large aneurysm on the left side.This would indicate the lens/plunger were not in acceptable positions for advancement.The lens and cartridge damage would indicate a plunger override occurred.Top coat dye stain testing was conducted with acceptable results.The ifu instructs to completely fill the cartridge with ophthalmic visco surgical device (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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