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The reference (b)(4) has been allocated to this case by rayner.The event description provided states that immediately following implantation, a cut was identified in the centre of the optic.The lens was explanted and exchanged during the original surgery session without harm or injury to the patient."iol replacement or extraction" is listed in the "adverse events" section of the rayone ifu.The device was not returned.The rayone preloaded iol injection system risk matrix identifies the following as possible causes of "trapped/ torn lens haptic/ optic during insertion"; inadequate amount of viscoelastic; inadequate quality of viscoelastic; haptic trapped by plunger override due to fast motion; user opens closed flaps and closes again before use; plunger advanced too quickly, insertion of viscoelastic through nozzle leading to inadequate amount of viscoelastic; user removed injector from tray prior to inserting viscoelastic, causing lens to be improperly placed in cartridge; user removed injector from tray prior to closing cartridge, resulting in cartridge not being clipped properly; optic edge trapped/ damaged on closure of cartridge, sharp edge instruments and dehydration of the lens prior to implantation.Our review of production records for the rayone aspheric rao600c batch 085278472 showed that all manufacturing and quality checks were conducted with successful results.Qa batch control testing (includes injection testing whereby injection performance, lens orientation and injector/lens condition post-injection is evaluated prior to the batch being released for distribution) confirms the tested device performed as intended/per design.No issues with lens injection/ejection were detected (e.G., no resistance).The lens was injected successfully without any damage to the lens or injector post injection.Without the ability to examine the device and without clear event details being provided it is not possible to establish the cause of the event.
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