K Number
K231466
Device Name
RxSight Insertion Device
Manufacturer
Date Cleared
2023-06-12

(24 days)

Product Code
Regulation Number
886.4300
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The RxSight® Insertion Device is indicated for the folding and insertion of a 3-piece silicone, intraocular lens into the human eye through a surgical incision. The RxSight Insertion Device is intended for the insertion of the RxSight Light Adjustable Lens®, RxSight Light Adjustable Lens+, the Bausch & Lomb LI61A0 IOL and IOL models validated for use with this device in IOL approved labeling.
Device Description
The RxSight Insertion Device is a two-part IOL injector device comprised of a re-usable handheld titanium injector, and a single use, non-preloaded disposable polypropylene cartridge intended to be used to fold and insert the intraocular lenses into the eye through a small incision.
More Information

Not Found

No
The summary describes a mechanical device for inserting an intraocular lens and does not mention any AI or ML components or functionalities.

No.
The device is used for the "folding and insertion of a 3-piece silicone, intraocular lens into the human eye through a surgical incision." It facilitates a surgical procedure rather than directly treating a disease or condition.

No

The device is described as an "IOL injector device" used for "folding and insertion of a 3-piece silicone, intraocular lens into the human eye through a surgical incision." Its purpose is to deliver a treatment (the lens insertion), not to diagnose a condition.

No

The device description explicitly states it is comprised of a "re-usable handheld titanium injector" and a "single use, non-preloaded disposable polypropylene cartridge," indicating it is a physical medical device with hardware components.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use is for the folding and insertion of an intraocular lens into the human eye through a surgical incision. This is a surgical procedure performed directly on the patient's body.
  • Device Description: The device is described as an IOL injector device used to fold and insert lenses. This is a surgical tool.
  • Anatomical Site: The anatomical site is the human eye, but the action is a surgical insertion, not an in vitro test.

IVD devices are used to examine specimens derived from the human body (like blood, urine, tissue) in vitro (outside the body) to provide information for diagnosis, monitoring, or screening. This device does not perform any such function. It is a surgical instrument.

N/A

Intended Use / Indications for Use

The RxSight® Insertion Device is indicated for the folding and insertion of a 3-piece silicone, intraocular lens into the human eye through a surgical incision. The RxSight Insertion Device is intended for the insertion of the RxSight Light Adjustable Lens®, RxSight Light Adjustable Lens+, the Bausch & Lomb LI61A0 IOL and IOL models validated for use with this device in IOL approved labeling.

Product codes

MSS

Device Description

The RxSight Insertion Device is a two-part IOL injector device comprised of a re-usable handheld titanium injector, and a single use, non-preloaded disposable polypropylene cartridge intended to be used to fold and insert the intraocular lenses into the eye through a small incision.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

human eye

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies

The descriptive characteristics are well-defined and adequate to ensure substantial equivalence of the RxSight Insertion Device with the predicate device.

Key Metrics

Not Found

Predicate Device(s)

K192926

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 886.4300 Intraocular lens guide.

(a)
Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to direct the insertion of an intraocular lens and be removed after insertion is completed.(b)
Classification. Class I (general controls). Except when used as folders or injectors for soft or foldable intraocular lenses, the device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 886.9.

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food & Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

June 12, 2023

RxSight, Inc. Maureen O'Connell Senior Vice President, Clinical/Regulatory Affairs 100 Columbia Aliso Viejo, California 92656

Re: K231466

Trade/Device Name: RxSight® Insertion Device Regulation Number: 21 CFR 886.4300 Regulation Name: Intraocular Lens Guide Regulatory Class: Class I, reserved Product Code: MSS Dated: May 19, 2023 Received: May 19, 2023

Dear Ms. Maureen O'Connell:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part

1

801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

BennettDigitally signed
N. Walkerby Bennett N. Walker -S
-SDate: 2023.06.12
12:44:19 -04'00'

Bennett Walker, Ph.D. Assistant Director DHT1A: Division of Ophthalmic Devices OHT1: Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K231466

Device Name RxSight® Insertion Device

Indications for Use (Describe)

The RxSight® Insertion Device is indicated for the folding and insertion of a 3-piece silicone, intraocular lens into the human eye through a surgical incision. The RxSight Insertion Device is intended for the insertion of the RxSight Light Adjustable Lens®, RxSight Light Adjustable Lens+, the Bausch & Lomb LI61A0 IOL and IOL models validated for use with this device in IOL approved labeling.

Type of Use (Select one or both, as applicable)
Prescription Use (Part 21 CFR 801 Subpart D)Over-The-Counter Use (21 CFR 801 Subpart C)

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510(K) SUMMARY

This 510(k) Summary is being submitted in accordance with the requirements of 21 CFR 807.92(a).

| APPLICANT: | RxSight, Inc.
100 Columbia
Aliso Viejo, CA 92656 |
|---------------------------|----------------------------------------------------------------------------------------------------------------------------|
| CONTACT PERSON: | Maureen O'Connell
Senior Vice President Clinical and Regulatory Affairs
moconnell@rxsight.com
Tel: (978) 207-1245 |
| DATE SUMMARY
PREPARED: | June 8, 2023 |
| TRADE NAME: | RxSight® Insertion Device |
| COMMON NAME: | IOL Injector |
| CLASSIFICATION NAME: | Folders and Injectors, Intraocular Lens (IOL) |
| DEVICE CLASSIFICATION: | Class I; 21 CFR 886.4300 |
| PRODUCT CODE: | MSS |
| PREDICATE DEVICE: | RxSight® Insertion Device, K192926 |

1.1 DEVICE DESCRIPTION

The RxSight Insertion Device is a two-part IOL injector device comprised of a re-usable handheld titanium injector, and a single use, non-preloaded disposable polypropylene cartridge intended to be used to fold and insert the intraocular lenses into the eye through a small incision.

1.2 INDICATIONS FOR USE

The RxSight® Insertion Device is indicated for the folding and insertion of a 3-piece silicone, intraocular lens into the human eye through a surgical incision. The RxSight Insertion Device is intended for the insertion of the RxSight Light Adjustable Lens®, RxSight Light Adjustable Lens+, the Bausch & Lomb LI61A0 IOL and IOL models validated for use with this device in IOL approved labeling.

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1.3 TECHNOLOGICAL CHARACTERISTICS COMPARISON

The technical features of the RxSight Insertion Device, both predicate and proposed, are the same as no modifications to these features are proposed in this Special 510(k) Premarket Notification. A comparison of the technological characteristics of the proposed and predicate devices is provided in the table below.

| | RxSight Insertion Device
Proposed Device | RxSight Insertion Device
Predicate Device
(K192926) |
|---------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Product Code | MSS | MSS |
| Indications for Use | The RxSight® Insertion Device is indicated
for the folding and insertion of a 3-piece
silicone, intraocular lens into the human eye
through a surgical incision. The RxSight
Insertion Device is intended for the
insertion of the RxSight Light Adjustable
Lens®, RxSight Light Adjustable Lens+,
the Bausch & Lomb LI61A0 IOL and IOL
models validated for use with this device in
IOL approved labeling. | The RxSight Insertion Device is indicated
for the folding and insertion of a 3-piece
silicone, intraocular lens into the human
eye through a surgical incision. The
RxSight Insertion Device is intended for
the insertion of the RxSight Light
Adjustable Lens, the Bausch & Lomb
LI61A0 IOL and IOL models validated for
use with this device in IOL approved
labeling. |
| Operating Principle | An IOL is placed in a loading cartridge.
Cartridge snapped into the handpiece.
Screw plunger advances the IOL through
the cartridge which folds the IOL and
advances it into the eye. | An IOL is placed in a loading cartridge.
Cartridge snapped into the handpiece.
Screw plunger advances the IOL through
the cartridge which folds the IOL and
advances it into the eye. |
| Pre-loaded IOL | No | No |
| Material (Injector) | Titanium | Titanium |
| Material (cartridge) | Polypropylene | Polypropylene |
| Cartridge Coating | LubriMATRIX™ | LubriMATRIX™ |
| How Supplied
(Reusable/Single Use) | Handpiece - Reusable
Cartridge - Single Use, supplied sterile | Handpiece - Reusable
Cartridge - Single Use, supplied sterile |
| Method of
Sterilization | Handpiece - Autoclave
Cartridge - Ethylene Oxide to SAL 10-6 | Handpiece - Autoclave
Cartridge - Ethylene Oxide to SAL 10-6 |

SUMMARY OF PERFORMANCE TEST RESULTS 1.4

The descriptive characteristics are well-defined and adequate to ensure substantial equivalence of the RxSight Insertion Device with the predicate device.

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Conclusion

The RxSight Insertion Device has the same intended use as the legally marketed predicate devices identified in this 510(k) premarket notification and other IOL injectors regulated under 21 CFR 886.4300. This device continues to meet all product design requirements and applicable standards and embodies technological characteristics similar to the predicate device.