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 positiondue to the levator complex dysfunction. In this condition, the aesthetic and functional abnormalityis obvious and is accompanied by severe visual field defect. Ptosis surgery is one of the mostcommon oculoplastic procedures with different surgical procedures. The decision for anappropriate surgical procedure and the material used to minimize the incidence of complicationdepends on proper evaluation of the patient.Aims of study: To evaluate Mehta's Modification of the Crawford technique for frontalis slingsurgery with silicon rod in sever ptosis.Patients and Methods: We considered 10 patients (12 lids) who were treated between February2017 and June 2018. There were seven males and three females; two patients were bilateral andthree patients had negative Bell's phenomenon, which was surgically treated with Mehta'smodification 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 clearvisual field, with smooth and regular eyelid margin and no notching. Nine out of 10 patientsachieved good results according to the above-mentioned criteria, and in addition to that, bothpatient and parents' satisfaction were taken into consideration. Only one patient had developedrecurrence (1- month postop.)Conclusions: Mehta's modification of the Crawford technique for frontalis sling surgery withsilicon rod in sever ptosis used for the treatment of severe ptosis with poor levator excursion is aneasy and simple procedure that promises good postoperative results.