Case Report February 11, 2026 February 11, 2026

Successful management of bilateral cataracts in an adolescent subject with Down syndrome with difficult airways via surgery under modified topical anesthesia

DOI: 10.37039/1982.8551.20260008

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 evaluation, patient preparation, and effective doctor–patient communication. This case report therefore proposes TTA as a viable and safe alternative to GA for cataract surgery in carefully selected patients with Down syndrome.