Evaluation of Mehta's modification of the Crawford technique for Frontalis Sling Surgery with Silicon rod in Severe Ptosis

Abstract

Background: Ptosis is the drooping of the upper lid margin below its normal anatomic position due to the levator complex dysfunction. In this condition, the aesthetic and functional abnormality is obvious and is accompanied by severe visual field defect. Ptosis surgery is one of the most common oculoplastic procedures with different surgical procedures. The decision for an appropriate surgical procedure and the material used to minimize the incidence of complication depends on proper evaluation of the patient. Aims of study: To evaluate Mehta's Modification of the Crawford technique for frontalis sling surgery with silicon rod in sever ptosis. Patients and Methods: We considered 10 patients (12 lids) who were treated between February 2017 and June 2018. There were seven males and three females; two patients were bilateral and three patients had negative Bell's phenomenon, which was surgically treated with Mehta's modification of the Crawford technique for frontalis sling surgery with silicon rod. The patients’ age ranged from 4 to 30 years; they all had severe eyelid ptosis (>4mm) with poor levator function (≤4 mm). Results: Our patients' postoperative results were good, functional, and aesthetic, showing a clear visual field, with smooth and regular eyelid margin and no notching. Nine out of 10 patients achieved good results according to the above-mentioned criteria, and in addition to that, both patient and parents' satisfaction were taken into consideration. Only one patient had developed recurrence (1- month postop.) Conclusions: Mehta's modification of the Crawford technique for frontalis sling surgery with silicon rod in sever ptosis used for the treatment of severe ptosis with poor levator excursion is an easy and simple procedure that promises good postoperative results. Keywords: Eyelid ptosis, Silicon rod, Mehta's Modification of Crawford technique.