Congenital Ptosis Correction with an Expanded Polytetrafluoroethylene (GORE-TEX) sling: Comparative Study Between Crawford and Fox Techniques

Abstract

Background: Frontalis suspension is the procedure of choice for surgical management of congenital ptosis associated with poor elevator function. Objective: The aim of the work was to compare the results of two different frontalis suspension surgery techniques, i.e., the Crawford and Fox techniques, using GORE-TEX for the correction of congenital ptosis with poor levator function. Patients and Methods: fifty eyelids of 30 patients with severe ptosis and poor levator function (≤ 4 mm) were randomly divided into two groups: Group A included 26 eyelids of 16 patients corrected with the Crawford technique, and Group B included 24 eyelids of 14 patients corrected with the Fox technique. The results were evaluated and statistically compared. Results: at the end of the follow-up period (18 months postoperatively), most of the patients in both groups (80.8% of group A, 79.2% of group B) achieved good to excellent cosmetic results. The intergroup difference was not statistically significant (P < 0.05). Regarding contour, Group A was 96.2 %, and Group B was 95.8 %. Regarding symmetry, Group A was 88.5%, and Group B was 79.2%. Conclusion: considering the use of the same sling material (GORE-TEX suture), the Crawford and Fox techniques are both safe and effective with comparable results in the correction of severe ptosis with poor levator function.