Intumescent cataract, an advanced form of hypermature cataract, poses significant risks to patients, including pupillary-block ocular hypertension. Despite its severity, data on this condition in West Africa, particularly in Niger, have been scarce. A team of researchers conducted a prospective study to bridge this knowledge gap, focusing on the epidemiological and clinical aspects of intumescent cataract in Maradi.
The study, which took place from August 5, 2024, to February 6, 2025, at the Makkah Ophthalmological Complex and the Regional Hospital Centre of Maradi, involved 50 patients with confirmed intumescent cataract. These cases represented 1.56% of 3,198 cataract surgeries performed during the study period. The patients' mean age was 62.04 years, with the 56-65 age group being the most represented at 38%.
The study found that females made up 54% of the patients, with a male-to-female ratio of 0.85. A significant 80% of the patients came from rural areas, and the Hausa ethnic group was predominant, accounting for 74% of the cases. Hypertension and diabetes were the most common comorbidities, affecting 16% and 10% of the patients, respectively.
Visual impairment and ocular pain were universal symptoms among the patients. Notably, 58% of the affected eyes had no light perception preoperatively, indicating severe visual impairment. Elevated intraocular pressure and corneal edema were present in 100% and 92% of the patients, respectively. The predominant morphological forms of cataract were total white cataract (38%) and Morgagnian cataract (30%).
The study also found a statistically significant association between the age group and the side of the eye affected (p = 0.02). This finding suggests that age may play a role in the laterality of intumescent cataract. The study's results underscore the need for early detection and treatment of cataract in Maradi and other parts of Niger.
The patients in the study predominantly had a severe functional stage of the disease, indicating a substantial delay in diagnosis. This delay highlights the importance of implementing effective screening programs for cataract in the region. By doing so, patients can receive timely treatment, reducing the risk of complications and improving outcomes.
The study's findings have implications for healthcare policy and practice in Niger and other West African countries. Efforts to increase access to eye care services, particularly in rural areas, are crucial to addressing the burden of intumescent cataract and other eye conditions. Further research is needed to explore the reasons for the low uptake of cataract surgery among patients in the region.
Key points
- The study found that intumescent cataract in Maradi predominantly affects elderly, female, rural patients at a severe functional stage.
- The predominant morphological forms of cataract were total white cataract (38%) and Morgagnian cataract (30%).
- A statistically significant association was found between the age group and the side of the eye affected (p = 0.02).
