ABSTRACT We report the first case of successful bilateral cataract surgery performed under modified topical anesthesia in an adolescent with Down syndrome and a difficult airway. Airway management under general anesthesia (GA) for this patient population presents significant challenges, including increased risk of adverse intraoperative and postoperative events. This report details our innovative anesthetic approach, termed trained topical anesthesia (TTA), which facilitated uneventful successive cataract surgery in both eyes. The success of this approach highlights the importance of comprehensive psychological […]