Background: This study was undertaken to examine the possible effect of microcannula-guided entry sites on the rate of intraoperative retinal break formation. Methods: In this historical cohort study, all patients having undergone vitrectomy with epiretinal or internal limiting membrane peeling performed by one surgeon between January 2005 and March 2009 were included. All procedures with microcannula-guided entry sites (23- and 25-gauge vitrectomy) were compared to procedures without the use of microcannulas (20-gauge vitrectomy). Results: A total of 221 eyes with a follow-up of at least 30 days were analyzed. The total incidence of intraoperative retinal break formation was 25.2% (n = 28/111) for the 20-gauge group and 12.7% (n = 14/110) for the 23-/25-gauge group, resulting in an odds ratio of 2.313 (95% confidence interval 1.142–4.685) of an increased rate in the 20-gauge group. Conclusion: This study demonstrates that intraoperative retinal breaks during vitrectomy are reduced in the microcannula-guided techniques compared to 20-gauge vitrectomy. This effect may be attributed to the protection of the vitreous base during surgery. Further prospective studies are warranted.

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