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The lens was not returned.A photo was provided.The photo showed an implanted single-piece lens.There is a small crack at the gusset area of one haptic.This damage was similar in appearance to damage caused by a plunger override.The used company cartridge was returned to the opened pouch.No viscoelastic was observed in the cartridge.No damage was observed.The cartridge had evidence of placement into a handpiece.The used company cartridge was cleaned for further evaluation.The lens was removed during cleaning.Topcoat dye stain testing was conducted with acceptable results.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 appears to be related to a failure to follow the ifu (instruction for use).The lens remains implanted.Review of the provided photo showed a small crack at the gusset area of one haptic.This damage was similar in appearance to damage caused by a plunger override.No viscoelastic was observed in the returned company cartridge.No cartridge damage was observed.Topcoat dye stain testing was conducted with acceptable results.The ifu instructs to completely fill the cartridge with ovd (ophthalmic viscoelastic device) 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.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.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.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 contact the barrel, turn the knob clockwise approximately half turn to engage the threads and then stop.The iol (intraocular lens) 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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A nurse reported that during an intraocular lens (iol) implantation procedure, it was observed that the lens was damage by the injector, and the crack was noticed after the lens was implanted.The crack was located where the injector touched the lens.The lens was subsequently removed during initial procedure and the surgery was completed on the same day.Additional information was requested, but no further information was available.
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