FDA Adverse Event Injury Summary report: N

ICL (IMPLANTABLE COLLAMER LENS)

MDR report key: 3812697 · Received May 15, 2014

Report

Report Number
2023826-2014-00366
Event Type
Injury
Date Received
May 15, 2014
Report Date
April 14, 2014
Manufacturer
STAAR SURGICAL COMPANY
Product Code
MTA
PMA / PMN Number
P030016
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UP
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4) - NO INFORMATION. DEVICE EVALUATED BY MANUFACTURER? NO. LENS IMPLANTED. (B)(4).

Additional Manufacturer Narrative · 1

METHOD: MEDICAL REVIEW. RESULTS: MEDICAL REVIEW - PIGMENT DISPERSION MAY BE ORIGINATED FROM PRE-EXISTING CONCAVE IRIS ANATOMY, INFLAMMATION, TRAUMA, OR MECHANICAL CONTACT OF IOLS AND IRIS. LATE ELEVATED IOP MAY OCCUR AS RESULT OF CHRONIC NARROW ANGLES, PIGMENT DISPERSION, INFLAMMATION, ETC. CONCLUSIONS: BASED ON THE COMPLAINT HISTORY AND MEDICAL REVIEW, A SPECIFIC ROOT CAUSE OF THE EVENT COULD NOT BE DETERMINED. (B)(4).

Description of Event or Problem · 1

THE REPORTER INDICATED THE SURGEON IMPLANTED AN ICL IMPLANTABLE COLLAMER LENS IN THE PATIENT'S LEFT EYE (OS) IN 2012. THE PATIENT CAME IN FOR A POST-OP VISIT WITH PIGMENT DISPERSION SYNDROME AND SECONDARY GLAUCOMA. THE ICL IS OK, THE VAULT IS 300 - 350, NOT TOO HIGH. THE PATIENT WAS PUT ON ANTI-GLAUCOMA DROPS. TODAY HE IS COMPENSATED (IOP 15-17). THE LENS REMAINS IMPLANTED. ADDITIONAL INFORMATION HAS BEEN REQUESTED BUT NONE HAS BEEN FORTHCOMING. IF ADDITIONAL INFORMATION IS RECEIVED, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
290503 ICL (IMPLANTABLE COLLAMER LENS) INTRAOCULAR LENS MTA STAAR SURGICAL COMPANY UNK NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention INJECTOR MODEL AND LOT NUMBER UNK| CARTRIDGE MODEL AND LOT NUMBER UNK