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Comparative Evaluation of 26-Gauge Needle Versus Kimura Spatula for Corneal Scraping in Infective Keratitis: A
Prafulla Kumar Maharana1, Aafreen Bari, Sohini Mandal
1Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, (P.K.M., A.B., S.S.P., N.H., R.S., T.A., N.S., J.S.T.), New Delhi, Delhi, India; and (S.M.), LVPEI, Bhubaneswar, India.
Purpose:
Microbial keratitis accounts for significant proportion of corneal blindness. To know the underlying etiological micro-organism, performing corneal scraping is important for initiating the correct antibiotic therapy. A study was conducted to compare the efficacy and safety of 26-gauge needle and Kimura spatula for the same.
Methods:
A prospective, comparative randomized pilot study was conducted to compare Kimura spatula (group 1) to 26-gauge needle (group 2). In total, 115 patients were recruited in the 2 groups-67 in group 1 and 48 in group 2.
Results:
Both the groups were comparable in adequacy of sample, microbiological staining and culture, and safety ( P >0.05). However, in subgroup analysis, the number of fully adequate samples was higher and nonadequate samples was lower in the 26-gauge needle group ( P =0.004).
Conclusion:
Both Kimura spatula and 26-gauge needle are safe and effective tools for corneal scraping. However, in adequacy, cost-effectiveness, easy availability, disposable nature, and nondependency on sterilization unit, 26-gauge needle is superior to Kimura spatula.
Insights
A 26-gauge needle is a superior tool for corneal scraping compared to a Kimura spatula, offering better sample adequacy and cost-effectiveness for diagnosing microbial keratitis.
Area of Science:
- Ophthalmology
- Microbiology
- Medical Devices
Background:
- Microbial keratitis is a major cause of corneal blindness worldwide.
- Accurate etiological diagnosis through corneal scraping is crucial for effective antibiotic treatment.
Purpose of the Study:
- To compare the efficacy and safety of a 26-gauge needle versus a Kimura spatula for corneal scraping.
- To evaluate sample adequacy, microbiological yield, and safety profiles of both instruments.
Main Methods:
- A prospective, comparative randomized pilot study involved 115 patients.
- Patients were randomized into two groups: Kimura spatula (n=67) and 26-gauge needle (n=48).
- Key outcomes included sample adequacy, staining, culture results, and safety.
Main Results:
- Both instruments demonstrated comparable safety and microbiological yield (P >0.05).
- The 26-gauge needle group showed a significantly higher number of fully adequate samples (P=0.004).
- The 26-gauge needle group had fewer non-adequate samples.
Conclusions:
- Both Kimura spatula and 26-gauge needle are safe and effective for corneal scraping.
- The 26-gauge needle offers advantages in sample adequacy, cost-effectiveness, availability, and disposability.
- The 26-gauge needle is a preferred tool for corneal scraping due to its superior performance and practical benefits.
